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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Construct subsidence is a relatively common complication following anterior cervical fusion. Its occurrence has been revealed to be closely related to endplate-implant contact interface. But current literature focusing on the anatomy of cervical endplate is very scarce. The purpose of this morphometric study was to analyse the sagittal geometry, especially the concavity and slope, of vertebral endplates from C3 to C7 by employing data from CT scans. ⋯ Superior endplate is more flat than its inferior counterpart in middle and lower cervical spine, and the concavity apex is always located in the posterior half of the endplate. Endplate slope is correlated with cervical curvature, greater slope implying more significant lordosis. These sagittal endplate geometrical parameters should be taken into consideration when investigating implant subsidence following anterior cervical fusion.
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Reduced driving reaction time (DRT) has already been studied in context with lumbar disc surgeries. Data on whether cervical spine pathologies impair driving abilities are still lacking. In addition, no return-to-driving recommendations after anterior cervical fusion procedures have been published. Therefore, we assessed DRT before and after anterior cervical discectomy and fusion. ⋯ The present results show a positive effect of anterior cervical discectomy and fusion on driving safety. Based on our data we state that it appears to be safe to resume driving after discharge from hospital. However, patients scheduled to undergo anterior cervical discectomy and fusion should be informed about increased DRT as compared to healthy individuals.
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To determine whether motion preservation following oblique cervical corpectomy (OCC) for cervical spondylotic myelopathy (CSM) persists with serial follow-up. ⋯ Although the OCC preserves segmental and whole spine ROM, serial measurements show a progressive decrease in ROM albeit without clinical worsening. The reduction in this ROM is probably related to degenerative ossification of spinal ligaments.
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Flexion and extension radiographs are often used in the setting of trauma to clear a cervical spine injury. The utility of such tests, however, remains to be determined. We hypothesized that in patients who underwent a negative computed tomography (CT) cervical spine scan, flexion and extension radiographs did not yield useful additional information. ⋯ Adequate flexion extension films are difficult to obtain and are minimally helpful for clearance of the cervical spine in awake and alert trauma patients.
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Previous studies have reported that the alignments of the occipital-cervical and subaxial spine were closely interrelated in asymptomatic individuals; however, none have focused on a population with atlantoaxial dislocation. ⋯ Anterior dislocations of the atlas are associated with diminished lordosis or even kyphosis of the occipital-cervical junction, and result in compensatory hyperlordosis of the subaxial cervical spine, collectively presenting as a "swan neck" deformity. Atlantoaxial dislocation may influence the global cervical alignment.