Journal of spinal disorders & techniques
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J Spinal Disord Tech · Apr 2014
Cervical laminectomy width and spinal cord drift are risk factors for postoperative C5 palsy.
Cervical laminectomy and fusion (CLF) is a treatment option for multilevel cervical spondylotic myelopathy. Postoperative C5 nerve palsy is a possible complication of CLF. It has been suggested that C5 nerve palsy may be due to posterior drift of the spinal cord related to a wide laminectomy trough. ⋯ A wider laminectomy at C5 was associated with an increased risk of postoperative C5 palsy. Increased preoperative spinal canal diameter is also associated with increased risk of C5 palsy. In addition, patients who experienced C5 nerve palsy had a significantly greater posterior spinal cord drift. Strategies to reduce postoperative laminectomy trough width and spinal cord drift may reduce the risk of postoperative C5 palsy.
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J Spinal Disord Tech · Apr 2014
Comparative StudyPedicle screws can be 4 times stronger than lateral mass screws for insertion in the midcervical spine: a biomechanical study on strength of fixation.
A biomechanical study. ⋯ Not forgetting the potential risks of inserting pedicle screws in cervical vertebrae, pedicle screws are a better biomechanical choice than lateral mass screws for cervical fixation at the levels C3 through to C6.
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J Spinal Disord Tech · Apr 2014
The retrospective analysis of the effect of balloon kyphoplasty to the adjacent-segment fracture in 171 patients.
Analysis of the adjacent-segment fractures in 171 balloon kyphoplasty (BK)-performed patients. ⋯ If the patients experience severe or mild back pain with higher preoperative KA, especially in the first 2 months, then they deserve detailed radiologic examination. To avoid subsequent fracture in the same or adjacent level, vertebral body should be filled adequately and sagittal balance should be obtained with KA correction. BK alone did not influence the incidence of subsequent VCF.
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J Spinal Disord Tech · Apr 2014
Does lumbar disk degeneration increase segmental mobility in vivo? Segmental motion analysis of the whole lumbar spine using kinetic MRI.
This is a retrospective analysis of lumbar segmental motion using Kinetic magnetic resonance imaging(KMRI). ⋯ In functional positions assessed utilizing weight bearing KMRI, segmental motion at levels with degenerated disks was decreased. The contribution of upper lumbar segments to the total lumbar motion was not smaller than that of the lower segments. The L5–S1 level showed the smallest ROM in lumbar motion.
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Retrospective analysis. ⋯ The condylar entry point should be medial to the condylar fossa, midcondylar, and ≥2 mm caudal to the skull base. An optimal trajectory for the OC screw should have a medial angulation of ≥20 degrees relative to the sagittal midline, trying to stay parallel to the skull base. Minor adjustments in angulation can be made, but any adjustment approaching 10 degrees cranial or caudal leads to an increased risk of hypoglossal canal cranially or atlantooccipital joint compromise caudally.