Journal of neurosurgery. Spine
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Certain cervical spinal conditions require decompression and reconstruction of the entire subaxial cervical spine. There are limited data concerning the clinical details and outcomes of patients treated in this manner. The object of this study was to describe the specific technique employed to perform a total subaxial reconstruction and review the postoperative outcomes following surgery. ⋯ Segmental anterior decompression and reconstruction of the entire subaxial cervical spine, combined with an instrumented posterolateral fusion, can be performed with acceptable morbidity and is of significant benefit in selected patients.
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Granulocyte colony-stimulating factor (G-CSF) is a hematopoietic cytokine that induces undifferentiated stem cells from the bone marrow (BM) into the peripheral blood. Stem cell factor (SCF) is also a hematopoietic cytokine that stimulates the differentiation and proliferation of neural stem cells and has neuroprotective effects. In cerebrally infarcted mice, the combination of G-CSF and SCF promotes the differentiation of BM-derived cells into neural cells, stimulates the proliferation of intrinsic neural stem cells, and improves motor function. The object of this study was to investigate the effects of these cytokines on BM stem cells, intrinsic cells, and motor function recovery in spinal cord-injured mice. ⋯ In this study, the combined administration of SCF and G-CSF in traumatic spinal cord injury not only improved motor function, but also induced the accumulation of intrinsic microglia and the active proliferation of intrinsic oligodendrocyte precursor cells.
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In situ transsacral fusion in the treatment of low-grade isthmic spondylolisthesis has rarely been reported. The authors treated 13 cases of L-5 Grade 2 isthmic spondylolisthesis associated with collapsed disc space and osteoporosis by using transsacral fusion and fixation, and compared its clinical and radiological outcomes with the results of transforaminal lumbar interbody fusion (TLIF) and instrumental reduction in 21 patients. ⋯ For patients with a collapsed disc space and poor bone quality, posterior in situ transsacral cage fusion may be used as an alternative to the TLIF procedure. The short-term clinical and radiological outcomes in the transsacral cage group were comparable with those in the TLIF group, although with a relatively higher neurological complication rate.
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Randomized Controlled Trial
Long-term clinical and radiographic outcomes of cervical disc replacement with the Prestige disc: results from a prospective randomized controlled clinical trial.
The purpose of this study was to determine long-term clinical outcomes in patients undergoing anterior cervical surgery in which a cervical disc prosthesis was used to treat single-level degenerative cervical disc disease. ⋯ The Prestige disc maintains improved clinical outcomes and segmental motion after implantation at 5-year follow-up.
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The reported incidence of complications in spine surgery varies widely. Variable study methodologies may open differing avenues for potential bias, and unclear definitions of perioperative complication make analysis of the literature challenging. Although numerous studies have examined the morbidity associated with specific procedures or diagnoses, no prospective analysis has evaluated the impact of preoperative diagnosis on overall early morbidity in spine surgery. To accurately assess perioperative morbidity in patients undergoing spine surgery, a prospective analysis of all patients who underwent spine surgery by the neurosurgical service at a large tertiary care center over a 6-month period was conducted. The correlation between preoperative diagnosis and the incidence of postoperative complications was assessed. ⋯ The incidence of complications found in this prospective analysis is higher than that reported in previous studies. This association may be due to a greater accuracy of record-keeping, absence of recall bias via prospective data collection, high complexity of pathology and surgical approaches, or application of a more liberal definition of what constitutes a complication. Further large-scale prospective studies using clear definitions of complication are necessary to ascertain the true incidence of early postoperative complications in spine surgery.