Journal of spinal disorders & techniques
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J Spinal Disord Tech · Aug 2011
Comparative StudyIs there a difference between simultaneous or staged decompressions for combined cervical and lumbar stenosis?
We evaluated 43 patients diagnosed with tandem spinal stenosis (TSS) from 1999 to 2005 in an academic hospital. ⋯ These results indicate that TSS can be effectively managed by either surgical intervention, simultaneous, or staged decompressions. However, patient age, blood loss, and operative time do significantly impact outcomes. Therefore, operative management should be tailored to the patient's age and the option which will limit blood loss and operative time, whether that is by simultaneous or staged procedures.
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J Spinal Disord Tech · Aug 2011
Comparative expression of matrix-associated genes and inflammatory cytokines-associated genes according to disc degeneration: analysis of living human nucleus pulposus.
The 2 groups of living human nucleus pulposus were prospectively compared according to disc degeneration. ⋯ Mildly degenerated discs showed greater matrix, chondrogenic, and osteoblastic gene expressions than severely degenerated discs, indicating that the ability to produce matrix-associated proteins is greater for cells in mildly degenerated than in severely degenerated discs. However, inflammatory cytokine genes associated with disc degeneration were expressed at higher levels in the severely degenerated group. This study shows that a reduction in matrix synthesis and an increase of inflammatory cytokine levels occurs during disc degeneration at the same time.
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J Spinal Disord Tech · Aug 2011
Randomized Controlled Trial Comparative StudySagittal alignment comparison of Bryan disc arthroplasty with ProDisc-C arthroplasty: a prospective, randomized controlled clinical trial.
A prospective, randomized study of the radiographic outcomes in patients undergoing single-level cervical arthroplasty with Bryan disc and ProDisc-C prosthesis. ⋯ Bryan disc arthroplasty with modified techniques can maintain the lordosis of FSU, whereas ProDisc-C arthroplasty can restore the lordosis of FSU. For the patients with preoperative FSU kyphosis, ProDisc-C arthroplasty may be a better choice to restore the lordosis.
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J Spinal Disord Tech · Aug 2011
Which is the preferred revision technique for loosened iliac screw? A novel technique of boring cement injection from the outer cortical shell.
An in vitro biomechanical cadaver study. ⋯ Wadding corticocancellous bone and increasing screw length failed to provide sufficient anchoring strength for a loosened iliac screw; however, both traditional and boring PMMA-augmented techniques could effectively increase the fixation strength. On the basis of the viewpoint of minimal invasion, the boring PMMA augmentation may serve as a suitable salvage technique for iliac screw loosening.
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J Spinal Disord Tech · Aug 2011
Multilevel lumbar spinal stenosis decompression: midterm outcome using a modified hinge osteotomy technique.
A prospective cohort study was carried out looking at the functional outcome and post procedure translational segmental instability after multi-level lumbar decompression using a hinge osteotomy technique. ⋯ Decompression of multi-level lumbar spine stenosis using the unilateral approach with the hinge osteotomy technique is a safe approach for multi-level stenosis, with good outcome and no evidence of significant segmental translational spinal instability.