Journal of spinal disorders & techniques
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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.
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J Spinal Disord Tech · Jul 2007
Clinical TrialDirect repair of multiple levels lumbar spondylolysis by pedicle screw laminar hook and bone grafting: clinical, CT, and MRI-assessed study.
A prospective analysis of 6 cases with multiple-level spondylolysis treated by direct repair with pedicle screw laminar hook is presented. The objective of the study was to evaluate the clinical outcome, plain radiographs, computed tomography (CT) scan, and magnetic resonance imaging to demonstrate the result of direct repair in the treatment of multiple-level spondylolysis. ⋯ Direct repair of multiple-level spondylolysis by pedicle screw laminar hook and autogenous bone graft would be the alternative of treating patients with persistent back pain after 6 months of conservative treatment The favorable clinical outcome was correlated with bony healing rate in this series.
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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).
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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.
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J Spinal Disord Tech · Jul 2007
Acute mortality and complications of cervical spine injuries in the elderly at a single tertiary care center.
Retrospective database review of all traumatic cervical spine injuries at a single tertiary care center. ⋯ In this large comprehensive series of elderly patients with cervical spine injuries, statistically comparable survival rates were achieved in both operatively treated and nonoperatively treated patient populations. This finding challenges the conclusion that the nonoperative treatment of the elderly necessarily results in increased acute mortality.