Journal of spinal disorders & techniques
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J Spinal Disord Tech · Apr 2006
Comparative Study Controlled Clinical TrialComparison of minimally invasive and conventional open posterolateral lumbar fusion using magnetic resonance imaging and retraction pressure studies.
To determine whether minimally invasive lumbar spinal fusion results in less paraspinal muscle damage than conventional open posterior fusion. ⋯ The peak IMP generated by the minimally invasive retractor was significantly less than with the open retractor. Postoperatively, less muscle edema was demonstrated after the minimally invasive lumbar spinal fusion, with lower mean T2 and apparent diffusion coefficient measurements supporting the hypothesis that less damage occurs using a minimally invasive approach.
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J Spinal Disord Tech · Apr 2006
Clinical TrialMeasurement of the cervical spinal cord volume on MRI.
There are some reports about the relationships between the clinical manifestations and the spine morphology or spinal cord morphology in patients with myelopathy. It has also been reported that there are interindividual variations in the cross-sectional area of the spinal cord. In most of these reports, the cross-sectional area, compression ratio, and anteroposterior diameter were used as morphologic parameters of the spinal cord, but no reports have been published on the use of spinal cord volume. ⋯ We consider that the cervical spinal cord volume ratio can be used to evaluate cervical spinal cord atrophy in patients with cervical myelopathy and can be important information in looking for clinically critical points. The cervical spinal cord volume was larger in males than in the females, decreased with age, and increased with height and body weight. The cervical spinal cord volume ratio was not affected by gender, age, height, or body weight.
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J Spinal Disord Tech · Apr 2006
Comparative StudyPerioperative complications in transforaminal lumbar interbody fusion versus anterior-posterior reconstruction for lumbar disc degeneration and instability.
Multiple different approaches are used to treat lumbar degenerative disc disease and spinal instability. Both anterior-posterior (AP) reconstructive surgery and transforaminal lumbar interbody fusion (TLIF) provide a circumferential fusion and are considered reasonable surgical options. The purpose of this study was to quantitatively assess clinical parameters such as surgical blood loss, duration of the procedure, length of hospitalization, and complications for TLIF and AP reconstructive surgery for lumbar fusion. ⋯ AP lumbar interbody fusion surgery is associated with a more than two times higher complication rate, significantly increased blood loss, and longer operative and hospitalization times than both percutaneous and open TLIF for lumbar disc degeneration and instability.
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J Spinal Disord Tech · Apr 2006
Comparative StudyEfficacy of translaminar facet screw fixation in circumferential interbody fusions as compared to pedicle screw fixation.
Posterior lumbar fixation with translaminar facet screws is a minimally invasive technique with good success rates. Long-term follow-ups show reduced reoperation rates, a decrease in pain scores, and few complications compared with pedicle screw fixation devices. The purpose of this study was to compare the reoperation rate of translaminar facet screw fixation with that of pedicle screw fixation in 360 degrees anterior and posterior fusions for incapacitating low back pain due to lumbar disc degeneration unresponsive to at least 6 months of aggressive nonoperative treatment. ⋯ The success of translaminar facet screws in circumferential fusions is justified.
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J Spinal Disord Tech · Feb 2006
Case ReportsContinuous EMG recordings and intraoperative electrical stimulation for identification and protection of cervical nerve roots during foraminal tumor surgery.
Spinal cord function is now routinely monitored with somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) during surgery for intraspinal cervical dumbbell and foraminal tumors. However, upper extremity nerve roots are also at risk during these procedures. Anatomic relations are frequently difficult to interpret because the nerve roots may be displaced by the tumor. We used electrical stimulation with compound muscle action potential (CMAP) recordings at multiple sites to identify the location and course of the involved nerve root and to provide real-time information regarding the functional status of the roots to predict postoperative outcome. ⋯ Electrical stimulation in the operating field and recording of CMAPs facilitated nerve root identification and predicted postoperative function during dissection and separation from ligamentous or neoplastic tissue in 10 patients. Electrical stimulation might also be useful to predict postoperative preservation of function when nerve root sacrifice is necessary and no motor response is detected intraoperatively.