European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
-
Multicenter Study Comparative Study
Comparison between single- and multi-level patients: clinical and radiological outcomes 2 years after cervical disc replacement.
In cervical multi-level degenerative pathology, considering the morbidity of the extensive fusion techniques, some authors advocate for the multilevel disc replacement. This study compared the safety and efficacy of disc replacement with an unconstrained prosthesis in multi- versus single-level patients. A total of 231 patients with cervical degenerative disc disease (DDD) who were treated with cervical disc replacement and completed their 24 months follow-up were analyzed prospectively: 175 were treated at one level, 56 at 2 levels or more. ⋯ Multi-level DDD is a challenging indication in the cervical spine. This study showed no major significant clinical difference between the two groups. We need further studies to know more about the impact of multi-level arthroplasty, especially on the adjacent segments, but these results demonstrate initial safety and effectiveness in this patient sample.
-
Comparative Study
Correlation of clinical outcome and spinopelvic sagittal alignment after surgical treatment of low-grade isthmic spondylolisthesis.
The aim of this prospective study was to assess the sagittal alignment of the spine and pelvis before and after surgical treatment of isthmic spondylolisthesis with flat sacrum. At the same time, the functional outcome was analyzed and correlation examined. ⋯ Surgical management of low- and mid-grade isthmic spondylolisthesis showed good clinical outcome with restoration of correct values for the pelvic position-dependent parameters, i.e., pelvis tilt, sacral slope, C7 plumb line position and SSA.
-
Comparative Study
Comparison of Nurick grading system and modified Japanese Orthopaedic Association scoring system in evaluation of patients with cervical spondylotic myelopathy.
The purpose of this study was to determine the correlation between Nurick grade and modified Japanese Orthopaedic Association (mJOA) scores in the preoperative and postoperative follow-up evaluation of patients with cervical spondylotic myelopathy (CSM). This retrospective study included 93 patients with CSM who underwent central corpectomy (CC) between 1998 and 2008. Preoperative and postoperative Nurick grade and total mJOA (tmJOA) and lower limb mJOA (llmJOA) score of each patient was documented and the correlation between the Nurick grades and the mJOA scores was studied. ⋯ Although Nurick grade and llmJOA had good correlation preoperatively, at follow-up evaluation after surgery, there was disagreement in 11.8% (11/93) patients. One of the major reasons for the discrepancy between the Nurick scale and the llmJOA at follow-up evaluation was the ability of patients to regain employment without an improvement in the llmJOA score. As disease-specific scales, both Nurick scale and mJOA score should be utilized in the evaluation of patients with CSM.