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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Literature has described a risk for subsequent vertical subluxation (VS) and subaxial subluxation (SAS) following atlantoaxial subluxation in rheumatoid patients; however, the interaction of each subluxation and the radiographic findings for atlantoaxial fixation has not been described. The purpose of this study was to evaluate the effects of two different posterior atlantoaxial screw fixation on the development of subluxation in patients with rheumatoid atlantoaxial subluxation. ⋯ Atlantoaxial posterior screw fixation may be an appropriate prophylactic intervention for VS and SAS if the atlantoaxial joint develops bony fusion following physiological alignment. Compared to TA, SR provided optimal atlantoaxial angle and prevented lower adjacent segment degeneration, thereby reducing SAS.
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The objective of this study was to investigate thoracic myelopathy caused by ossification of the yellow ligament (OYL) in patients with posterior instrumented lumbar fusion. ⋯ We report seven patients who suffered from thoracic myelopathy after instrumented lumbar fusion. Surgeons must be aware of the possibility of thoracic myelopathy caused by OYL at the thoracolumbar junction, especially in patients with a complaint of gait disturbance after long instrumented lumbar fusion.
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Three- or four-level anterior cervical discectomy and fusion with autograft and plate fixation have demonstrated relatively good fusion rates and outcomes, but donor site morbidity and the limitations of autograft harvest remain problematic. The purpose of this study is to assess the radiographic and clinical outcomes of three- or four-level anterior cervical discectomy and fusion with a PEEK cage and plate construct. ⋯ Three- or four-level anterior cervical discectomy and fusion with a PEEK cage, and plate construct provide good clinical and radiographic outcomes including high fusion rates, low complication rates, low donor site morbidity, and good maintenance of the lordotic angle and disc height in the treatment of multilevel cervical spondylosis.
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How the lumbar neural foramina are affected by segmental deformities in patients in whom degenerative lumbar scoliosis (DLS) is unknown. Here, we used multidetector-row computed tomography (MDCT) to measure the morphology of the foramina in three dimensions, which allowed us to elucidate the relationships between foraminal morphology and segmental deformities in DLS. ⋯ The new analysis method proposed here is useful for understanding the pathomechanisms of foraminal stenosis in DLS patients.
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To investigate the effect of an anti-TNF-α agent (etanercept) on recovery processes in a partial spinal cord injury (SCI) model using clinical and electrophysiological tests. ⋯ These results show that blocking TNF-α mediated inflammation pathway by an anti-TNF-α agent enhances clinical and electrophysiological recovery processes in partial SCI model.