The Orthopedic clinics of North America
-
Minimally invasive approaches and operative techniques are becoming increasingly popular for the treatment of cervical spine disorders. Minimally invasive spine surgery attempts to decrease iatrogenic muscle injury, decrease pain, and speed postoperative recovery with the use of smaller incisions and specialized instruments. ⋯ Complications are also discussed. Additionally, illustrated cases are presented detailing the use of minimally invasive surgical techniques.
-
Orthop. Clin. North Am. · Jan 2012
ReviewManagement of adjacent segment disease after cervical spinal fusion.
Adjacent segment disease (ASD) was described after long-term follow-up of patients treated with cervical fusion. The term describes new-onset radiculopathy or myelopathy referable to a motion segment adjacent to previous arthrodesis and often attributed to alterations in the biomechanical environment after fusion. ⋯ Although prevention of ASD was one major impetus behind the development of motion-sparing surgery, the literature does not yet clearly distinguish a difference in the rate of ASD between fusion and disk replacement. Surgical techniques during index surgery may reduce the rate of ASD.
-
Orthop. Clin. North Am. · Jan 2012
Review Comparative StudyAnterior approach for complex cervical spondylotic myelopathy.
Cervical spondylotic myelopathy (CSM) is a slowly progressive disease resulting from age-related degenerative changes in the spine that can lead to spinal cord dysfunction and significant functional disability. The degenerative changes and abnormal motion lead to vertebral body subluxation, osteophyte formation, ligamentum flavum hypertrophy, and spinal canal narrowing. ⋯ Disease extent and location dictate the choice of surgical approach. Anterior spinal decompression and instrumented fusion is successful in preventing CSM progression and has been shown to result in functional improvement in most patients.