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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This anatomic, radiographic study investigated locational differences in the C2 pedicle and isthmus [pediculoisthmic component (PIC)] and characterized its narrowest section for clinical application in posterior C2 screw fixation. ⋯ The PIC is located between superior and inferior C2 facets. The superior flat area is the isthmus and the inferomedial area connecting the inferior facet and vertebral body is the pedicle. The pedicle is partially tubular and projects posteromedially to the transverse foramen. The narrowest PIC section is the narrowest point of the C2 pedicle. Considering its thin lateral cortical bone, medial and superior pedicle screw placement and preoperative CT reconstruction are recommended.
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To test the usefulness of a novel performance test, the tally counter test (counter test), which uses a hand tally counter to objectively assess the severity of cervical myelopathy. ⋯ The tally counter test is objective and quantitative assessment method for patients with cervical myelopathy. The test is simple, reliable, and capable of detecting small functional changes.
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Symptomatic thoracic disc herniations (TDHs) are uncommon and can be surgically treated. Although transthoracic decompression is considered the gold standard, it is associated with significant comorbidities. In particular, approach via a posterior laminectomy has been associated with poor results. Several strategies have been developed for the resection of TDHs without manipulating the spinal cord. We describe a minimally invasive technique by using 3-D navigation and tubular retractors with the aid of a robotic holder via an oblique paraspinal approach. ⋯ The oblique paraspinal approach may offer an alternative surgical option for treating TDHs.
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Congenital cervical stenosis (CCS) occurs when the bony anatomy of the cervical canal is smaller than expected in the general population predisposing an individual to symptomatic neural compression. No studies have defined CCS based on the normal population. The diagnosis is currently made based on clinical impression from radiographic studies. The aim of this study is to establish parameters that are associated with CCS, based on anatomic measurements on a large sample of skeletal specimens. ⋯ Based on our study of a large population of adult skeletal specimens, we have defined CCS at each level. Values of SCD < 13 mm and IPD < 23 mm are strongly associated with the presence of CCS at all levels.