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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Spinal Cord Society (SCS) and Spine Trauma Study Group (STSG) established a panel tasked with reviewing management and prognosis of acute traumatic cervical central cord syndrome (ATCCS) and recommend a consensus statement for its management. ⋯ There is reasonable evidence that patients with ATCCS secondary to vertebral fracture, dislocation, traumatic disc herniation or instability have better outcomes with early surgery (< 24 h). In patients of ATCCS secondary to extension injury in stenotic cervical canal without fracture/fracture dislocation/traumatic disc herniation/instability, there is requirement of high-quality prospective randomized controlled trials to resolve controversy regarding early surgery versus conservative management and delayed surgery if recovery plateaus or if there is a neurological deterioration. Until such time decision on surgery and its timing should be left to the judgment of physician, deliberating on pros and cons relevant to the particular patient and involving the well-informed patient and relatives in decision making. These slides can be retrieved under Electronic Supplementary Material.
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To investigate the adjacent segment kinematics, including the instantaneous axis of rotation (IAR) and range of motion (ROM), after anterior cervical discectomy and fusion (ACDF), and to compare between ACDF with zero-profile anchored spacer (ACDF-Z) and ACDF with plate (ACDF-P). ⋯ Both ACDF-Z and ACDF-P significantly impacted cervical kinematics, although both procedures obtained satisfactory clinical results in the treatment of cervical spondylosis. After both ACDF-Z and ACDF-P, C2-C7 ROM decreased significantly, while adjacent segment ROMs were preserved. ACDF-Z and ACDF-P impact the location of adjacent segment IAR-SI in similar way, while impact the location of adjacent segment IAR-AP in diverse ways. These slides can be retrieved under Electronic Supplementary Material.
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Comparative Study
Comparison of a novel anterior-only approach and the conventional posterior-anterior approach for cervical facet dislocation: a retrospective study.
The surgical treatment of lower cervical facet dislocation is controversial. The objective of this study was to compare the surgical trauma and clinical results of a novel anterior-only approach and with those of the conventional posterior-anterior approach to obtain an optimal method to treat lower cervical facet dislocation. ⋯ Compared with the conventional posterior-anterior approach, the novel anterior-only approach with two reduction techniques, including Caspar pins kyphotic paramedian distraction and anterior facetectomy, achieved a 100% reduction success rate and induced less surgical trauma, indicating that this method can be recommended as an alternative for lower cervical facet dislocation. These slides can be retrieved under Electronic Supplementary Material.
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To investigate the influence of the immediate post-operative change in disc space angle relative to preoperation on heterotopic ossification (HO) occurrence following cervical disc arthroplasty (CDA) and on clinical and radiographic outcomes. ⋯ Patients with a more than 5° increase in immediate post-operative DSA showed adverse effects on HO formation. Overcorrected DSA was associated with poor prosthesis stability, inadequate endplate coverage, and limited SROM, although it did not affect the clinical outcomes. These slides can be retrieved under Electronic Supplementary Material.
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Previous studies have shown poor health-related outcomes among patients with spinal sagittal malalignment of the thoracolumbar or spinopelvic region, and less interest has been paid to the relationship between cervical sagittal balance and functional outcome of the patients. This study aims to compare the cervical sagittal parameters between patients with non-specific neck pain and asymptomatic controls. ⋯ Our findings showed that the slope of the upper endplate of T1 vertebrae body (T1 slope) is significantly lower among patients with non-specific neck pain compared to controls. A compensatory mechanism to bring the center of head gravity back to the spinal axis might be the possible explanation for this difference. These slides can be retrieved under Electronic Supplementary Material.