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
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Randomized Controlled Trial Multicenter Study
The Norwegian Cervical Arthroplasty Trial (NORCAT): 2-year clinical outcome after single-level cervical arthroplasty versus fusion-a prospective, single-blinded, randomized, controlled multicenter study.
Standard surgical treatment for symptomatic cervical disc disease has been discectomy and fusion, but the use of arthroplasty, designed to preserve motion, has increased, and most studies report clinical outcome in its favor. Few of these trials, however, blinded the patients. We, therefore, conducted the Norwegian Cervical Arthroplasty Trial, and present 2-year clinical outcome after arthroplasty or fusion. ⋯ The present study showed excellent clinical results and no significant difference between treatments at any scheduled follow-up. However, the rate of index level reoperations was higher and the duration of surgery longer with arthroplasty.
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Review Case Reports
Management of destructive Candida albicans spondylodiscitis of the cervical spine: a systematic analysis of literature illustrated by an unusual case.
Candida induced spondylodiscitis of the cervical spine in immunocompetent patients is an extremely rare infectious complication. Since clinical symptoms might be nonspecific, therapeutic latency can lead to permanent spinal cord damage, sepsis and fatal complications. Surgical debridement is strongly recommended but there is no standard antimycotic regime for postsurgical treatment. This paper summarizes available data and demonstrates another successfully treated case. ⋯ Candida albicans spondylodiscitis of the cervical spine presents a potentially life-threatening disease. To our knowledge, this is the fifth case in literature that describes the treatment of C. albicans spondylodiscitis in an immunocompetent patient. Surgical debridement has to be considered, following antimycotic regime recommendations vary in pharmaceutical agents and treatment duration.
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To identify whether expansive open-door laminoplasty (Lam) is more appropriate than laminectomy and instrumented fusion (LIF) for cases with ossification of the posterior longitudinal ligament (OPLL) and straight cervical lordosis. ⋯ When compared with the LIF, the Lam is recommended for cases with OPLL and straight cervical lordosis when taking comparable neurological recovery, less axial pain and better neck function improvement into consideration.
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To describe vertebral artery (VA) course at the C0-C1-C2 complex in patients with congenital bony craniovertebral junction (CVJ) anomalies. ⋯ In occipitalization of the atlas, the VA course is usually abnormal-typically passing through a canal within the C0-C1 fused complex or below the C1 arch. A redundant VA loop is more likely to be seen in os odontoideum and irreducible atlantoaxial dislocation. Careful study of the vertebral artery course with 3D CT angiography is mandatory while contemplating CVJ realignment surgery in congenital anomalies of the CVJ.
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To test the association between arcuate foramen (AF) in the first cervical vertebra with acute headache attributed to whiplash. ⋯ The presence of bilateral AF is associated to an increased frequency of acute headache after suffering a whiplash, information of interest for the attention to these patients.