Journal of spinal disorders & techniques
-
J Spinal Disord Tech · Jul 2007
Randomized Controlled Trial Multicenter StudyAnterior cervical microdiscectomy with or without fusion.
Anterior cervical microdiscectomy (ACD) is commonly applied in the surgical treatment of cervical disc herniation. However, following discectomy procedure to perform a fusion process is still controversial. Therefore, a controlled, multicentric, prospective, randomized study was designed. ⋯ ACD technique offers satisfactory outcome regardless of whether fusion process is applied or not. Fusion with semirigid plate offers an advantage at operated level in immediate postoperative period in regard of disc height and neural foramen height. However, semirigid anterior plates by definition do not stop subsidence and the advantage that is offered by this technique is not persistent. On the other hand, to apply fusion process with semirigid plate system offers significantly less narrowing in disc height compared with simple ACD technique.
-
J Spinal Disord Tech · Jul 2007
Failure of the Wallis interspinous implant to lower the incidence of recurrent lumbar disc herniations in patients undergoing primary disc excision.
Ipsilateral recurrent disc herniation after lumbar discectomy is a significant problem in the management of lumbar disc disease and may necessitate repeat surgical intervention. A population-based study in Finland found that about 14% of all primary lumbar discectomies required additional surgical interventions. Interspinous devices, which have been shown to unload the posterior anulus, may reduce the occurrence of recurrent herniations. We report our short-term experience with the use of the Wallis device in the management of patients with lumbar disc herniation undergoing primary disc excision. ⋯ The current Wallis implant is probably incapable of reducing the incidence of recurrent herniations, but it still may be useful in patients with discogenic back pain due to early degenerative disc disease.
-
J Spinal Disord Tech · Jul 2007
Screw pull-out force is dependent on screw orientation in an anterior cervical plate construct.
Two common justifications for orienting cervical screws in an angled direction is to increase pull-out strength and to allow use of longer screws. This concept is widely taught and has guided implant design. Fixed versus variable angle systems may offer strength advantages. ⋯ When all 4 screws are 90 degrees to the plate the construct has the greatest ability to resist pullout. Fixed angle designs show no advantage over variable angle. These findings are contrary to current teaching.
-
J Spinal Disord Tech · Jul 2007
Clinical TrialPsychophysical measurements during lumbar discography: a heart rate response study.
Prospective clinical data analysis. ⋯ Lumbar discography induces positive HR response only in positive discograms. Although there is no immediate practical application of these results, 2 implications may deserve future research: (a) correlation of HR response with surgical and intradiscal electrotherapy treatment outcomes; (b) evaluation of HR measurement in cases of false-positive results (concordant pain on discography but no HR response).
-
J Spinal Disord Tech · Jul 2007
Treatment of myelopathy due to cervicothoracic OPLL via open door laminoplasty.
Postoperative long-term follow-up study of open door laminoplasty for the ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine. ⋯ Open door laminoplasty is a useful procedure for OPLL of the thoracic spine. This method enables wide-range posterior decompression, especially for the continuous type OPLL extending from the cervical spine to the thoracic spine, even if the apex of the thoracic kyphosis is included.