Journal of spinal disorders & techniques
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J Spinal Disord Tech · Jul 2006
Comparative StudySingle-stage treatment of pyogenic spinal infection with titanium mesh cages.
Single institution retrospective review. ⋯ Titanium mesh cages present a viable option for single-stage anterior surgical debridement and reconstruction of vertebral osteomyelitis, without evidence of chronic infection or rejection. When used in conjunction with pedicle screw instrumentation, there is minimal cage settling without loss of sagittal alignment.
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J Spinal Disord Tech · Jul 2006
Comparative StudyThe effect of lumbar total disc replacement on the spinopelvic alignment and range of motion of the lumbar spine.
A lumbar total disc replacement (TDR) is a type of motion-preserving surgery, which aims to restore and maintain the normal range of motion (ROM) and the sagittal balance of the spine. However, little is known regarding how the spinopelvic alignment and ROM of the lumbar spine are influenced by the lumbar TDR with ProDisc. This study retrospectively analyzed the sagittal alignment and ROM of the lumbar spine in 26 consecutive patients who had undergone the TDR with ProDisc with a minimum follow-up of 24 months. ⋯ In the patients who underwent single-level TDR, the mean segmental lordosis at the L5-S1 and L4-5 operative levels increased significantly from 15.8 degrees to 23.2 degrees and from 14.1 degrees to 24.9 degrees, respectively. The mean ROM at L5-S1 and L4-5 increased significantly from 7.1 degrees to 11.2 degrees and from 11.4 degrees to 14.6 degrees, respectively. The sagittal balance and ROM of the lumbar spine improved significantly after the lumbar TDR.
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J Spinal Disord Tech · Jul 2006
Comparative StudyBiomechanical aspects of the cervical cord: effects of postural changes in healthy volunteers using positional magnetic resonance imaging.
The area in cross-sectional view of the cervical cord (ACSCC) at each disc levels was measured in supine and erect positions using positional magnetic resonance imaging (pMRI). ⋯ We found posture-dependent differences of ACSCC in the recumbent and erect series. These results may be valuable for identifying a dynamic factor in patients with cervical spondylotic myelopathy.
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J Spinal Disord Tech · Jul 2006
Comparative StudyA comparison of retraction pressure during anterior cervical plate surgery and cervical disc replacement: a cadaveric study.
Dysphagia is a well-recognized complication after anterior cervical discectomy and fusion, observed in as high as 50% of cases by videofluoroscopic evaluation postoperatively. Esophageal injury due to surgical retraction is a complication due to which swallowing difficulties may ensue. There are limited published data evaluating the effect of soft tissue retraction on intraesophageal pressures during anterior cervical instrumentation procedures. ⋯ On the basis of the data presented here, anterior cervical plating results in significantly greater intraesophageal pressures when performed at C5-6 compared to C3-4. This holds regardless of whether the plate spans the distance from C3 to C6 (3-level plate) or the single C5-6 level. In addition, the insertion of the cervical disc replacement seems to require less esophageal retraction and hence reduced intraesophageal pressures when compared to anterior cervical plating.
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J Spinal Disord Tech · Jun 2006
Controlled Clinical TrialProspective evaluation of a 3-blade speculum cannula for minimally invasive lumbar microdiscectomy.
Minimally invasive spine technology is still in an evolutionary stage. This prospective study reports the technical feasibility, benefits, and limitations of using a 3-blade speculum cannula for minimally invasive lumbar microdiscectomies. We studied 52 consecutive patients, 24 males and 28 females, with a mean age of 36.1 years (range 20 to 68 years) and body mass index of 29.6 who underwent a microdiscectomy using this access device that opened to create a cylindrical working channel. ⋯ Two symptomatic hematomas required reoperation using the retractor at 3 days and 4 weeks postoperatively. This new speculum minimal access device was effective for lumbar microdiscectomy in limiting the size of the incision without the need for sequential dilation, providing excellent visualization with the aid of a microscope, allowing same-day discharge after surgery, and demonstrating improved outcomes even in obese patients. This device may provide insights for the improvement of design considerations for other minimally invasive access devices.