Orthopaedic surgery
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Orthopaedic surgery · Nov 2016
Comparative StudyAnterior and Posterior Instrumentation with Different Debridement and Grafting Procedures for Multi-Level Contiguous Thoracic Spinal Tuberculosis.
To evaluate the clinical outcomes of anterior and posterior instrumentation with different debridement and graft fusion methods for multi-level contiguous thoracic spinal tuberculosis. ⋯ Posterior instrumentation was more effective than anterior instrumentation in the correction of kyphosis and the maintenance of the correction. However, postoperative sinus formation was more frequent in patients who underwent a single-stage posterior procedure.
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Orthopaedic surgery · Nov 2016
Review Comparative StudyComparison of Anterior Cervical Discectomy and Fusion versus Posterior Cervical Foraminotomy in the Treatment of Cervical Radiculopathy: A Systematic Review.
Controversy remains over whether anterior cervical discectomy and fusion (ACDF) or posterior cervical foraminotomy (PCF) is superior for the treatment of cervical radiculopathy. We therefore performed a systematic review including three prospective randomized controlled trails (RCT) and seven retrospective comparative studies (RCoS) by searching PubMed and EMBASE. These studies were assessed on risk of bias according to the Cochrane Handbook for Systematic Reviews of Interventions, and the quality of evidence and level of recommendation were evaluated according to the GRADE approach. ⋯ In conclusion, the PCF was just as safe and effective as the ACDF in the treatment of cervical radiculopathy. Meanwhile, PCF might have lower medical cost than ACDF and decrease the incidence of adjacent segment disease. Based on the available evidence, PCF appears to be another good surgical approach in the treatment of cervical radiculopathy.
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Orthopaedic surgery · Nov 2016
Clinical TrialCorrelations of Japanese Orthopaedic Association Scoring Systems with Gait Parameters in Patients with Degenerative Spinal Diseases.
Japanese Orthopaedic Association (JOA) scoring systems were developed to evaluate the neurological function of patients with cervical or lumbar degeneration. As patient-based and multi-dimensional clinical evaluation tools, these systems should be capable of reflecting the walking disability of patients. The association between JOA scores and gait parameters, however, are not well characterized. The purpose of this study was to determine the correlations between JOA scores and gait parameters of patients with cervical spondylotic myelopathy (CSM) and lumbar intervertebral disc herniation (LDH). ⋯ There is a significant correlation between gait parameters and functional disability as measured by the JOA lumbar scoring system, which indicates that the JOA lumbar scoring system can reflect gait impairment. The JOA cervical scoring system, however, may need to be improved for efficiently evaluating the walking ability of CSM patients in the assessment of motor function of the lower extremity.