Journal of spinal disorders & techniques
-
J Spinal Disord Tech · Aug 2007
Clinical TrialSagittal alignment of the subaxial cervical spine after C1-C2 transarticular screw fixation in rheumatoid arthritis.
Several articles reported the association between the development of subaxial kyphosis and the hyperlordotic fixation of C1-C2. However, their patients were heterogeneous in both primary disease and operative procedure. Transarticular screw fixation has become a popular procedure for C1-C2 arthrodesis instead of wiring techniques in which C1-C2 is difficult to fix in the intended alignment. ⋯ Neurologic deterioration recurred in 4 patients, because of the postoperative development of subaxial subluxation. Common radiographic changes included an increase in C1-C2 lordosis, constant inclination of C1, an anterior shift of C2, and a decrease in C2-C7 lordosis. Many factors, not only C1-C2 angle, are associated with subaxial sagittal alignment change after C1-C2 transarticular screw fixation.
-
J Spinal Disord Tech · Aug 2007
Unilateral cervical facet fractures with subluxation: injury patterns and treatment.
This is a retrospective study of patients with unilateral cervical facet fractures from a Level I academic trauma center. ⋯ We conclude the following: (a) anterior discectomy and fusion with a static (constrained) plating system is appropriate treatment for this type of injury, (b) in the absence of significant neurologic deficit with residual canal or foraminal stenosis, preoperative closed reduction is not necessary, (c) a small percentage of these patients will have vertebral artery injury, thus warranting screening with 16-slice computed tomographic angiography.
-
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
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.
-
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).