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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Alterations of three-dimensional cervical curvature in conventional anterior cervical approach position are not well understood. The purpose of this study was to evaluate alignment changes of the cervical spine in the position. In addition, simulated corpectomy was evaluated with regard to sufficiency of decompression and perforation of the vertebral artery canal. ⋯ In the ER-position, the degrees of right rotation of subaxial vertebrae were small but significant. Therefore, preoperative understanding of this alteration of cervical alignment is essential for performing safe and sufficient anterior corpectomy of the cervical spine.
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Comparative Study
Biomechanical comparison of vertebral augmentation with silicone and PMMA cement and two filling grades.
Vertebral augmentation with PMMA is a widely applied treatment of vertebral osteoporotic compression fractures. Subsequent fractures are a common complication, possibly due to the relatively high stiffness of PMMA in comparison with bone. Silicone as an augmentation material has biomechanical properties closer to those of bone and might, therefore, be an alternative. The study aimed to investigate the biomechanical differences, especially stiffness, of vertebral bodies with two augmentation materials and two filling grades. ⋯ This study for the first time directly compared the stiffness of silicone-augmented and PMMA-augmented vertebral bodies. Silicone may be a viable option in the treatment of osteoporotic fractures and it has the biomechanical potential to reduce the risk of secondary fractures.
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To relate the progress of vertebral segmental stability after interbody fusion surgery with radiological assessment of spinal fusion. ⋯ In vivo vertebral segment stability, defined as a significant reduction in ROM, is achieved in an early stage of spinal fusion, well before a radiological bony fusion between the vertebrae can be observed. Therefore, plain radiography underestimates vertebral segment stability.
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Anterior lumbar interbody fusion (ALIF) is an established treatment for structural instability associated with symptomatic disk degeneration (SDD). Stand-alone ALIF offers many advantages, however, it may increase the risk of non-union. Recombinant human bone morphogenetic protein-2 (BMP-2) may enhance fusion rate but is associated with postoperative complication. The optimal dose of BMP-2 remains unclear. This study assessed the fusion and subsidence rates of stand-alone ALIF using the SynFix-LR interbody cage with 6 ml/level of BMP-2. ⋯ The overall fusion rate of stand-alone ALIF using the SynFix-LR system with BMP-2 was 90.6 %, comparable with other published series. No BMP-2 related complication occurred at a dose of 6 mg/level. Degenerative spondylolisthesis and obesity seemed to increase the rate of implant subsidence, and thus we believe that adding posterior fusion for these cases should be considered.