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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Post-operative visual loss (POVL) following spinal surgery is a rare but devastating complication. Although a number of intra-operative and post-operative factors have been implicated, the exact etiology may still remain unclear. ⋯ This is the only documented case of POVL to have resolved completely within 48 h.
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The authors report an extremely rare cause of cervicomedullary cord compression by anomalous ectatic vertebral arteries. ⋯ Anomalous course of the vertebral artery can result in symptoms of high cervical cord compression. Vasculopexy can result in lasting cure from symptoms.
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With regard to the literature, several factors are considered to have an impact on postoperative mobility after lumbar total disc replacement (TDR). As TDR results in a distraction of the ligamentous structures, theoretically the postoperatively disc height and ligamentous integrity have also an influence on biomechanics of a treated segment. The purpose of the study was to evaluate the influence of posterior longitudinal ligament (PLL) resection and segmental distraction on range of motion (ROM). ⋯ But it still remains unclear if this increase which is in median not more than 1° may alter the clinical results. Moreover, the destabilizing effect of PLL resection can be reversed using a higher implant. The prosthesis height seems more crucial than PLL preservation to maintain the primary stability after TDR.
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Posterior migration of spinal cord is a common complication of posterior cervical decompression, whereas anterior migration of spinal cord after anterior cervical decompression has not been reported previously. This report presents a case of anterior migration of spinal cord after cervical corpectomy. A 65-year-old male underwent a cervical corpectomy of the C4 and C5 for cervical spondylotic myelopathy. ⋯ However, at 12 months postoperatively, the patient complained that improved gait aggravated again, and the MRI showed an anterior migration of the spinal cord at the level of the C4 and C5, and a compression of spinal cord at the level of caudal endplate of C3. Secondary surgery, laminaplasty of C3 and C4 was conducted. The postoperative MRI showed that the spinal canal increased at the C3 and C4 levels, and the spinal cord went through smoothly without sharp turning.
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We present a unique variant of C1 fracture, which, at the best of our knowledge, has never been previously reported. This lesion consists in a lateral mass atlas fracture with a longitudinal separation of the transverse ligament that remains functionally preserved. ⋯ Even if many classifications of atlas fractures have been proposed, none of them ever described this uncommon variant. We debate about biomechanical aspects and therapeutic implication of the reported case.