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
-
Vertebral artery occlusion (VAO) is an increasingly recognized complication of cervical spine trauma. However, the management strategy of VAO remains heavily debated. Therefore, the aim of this retrospective study was to investigate the safety of early fusion surgery for traumatic VAO. ⋯ Despite the lack of a concurrent control group with preoperative antiplatelet therapy or endovascular embolization for VAO, our results showed low symptomatic stroke rate (4.5%), high recanalization rate (40.9%), and low mortality rate (0%). Therefore, we believe that the indication for early stabilization surgery as management strategy of asymptomatic VAO might be one of the safe and effective treatment options for prevention of symptomatic cerebral infarction.
-
Purpose Atlantodens osteoarthritis and atlantoaxial osteoarthritis cause neck pain and suboccipital headaches. Currently, knowledge on the risk factors for atlantoaxial osteoarthritis is lacking. This study aimed to investigate the factors related to the increased risk of atlantoaxial osteoarthritis. ⋯ The following factors were independently and significantly associated with atlantoaxial osteoarthritis in the multivariable logistic regression analysis: age in the sixth decade or older (odds ratio [OR], 20.5; 95% confidence interval [CI], 6.2‒67.2, p < 0.001), having calcific synovitis (OR, 4.9; 95% CI, 2.4‒9.9, p < 0.001), women sex (OR, 3.3; 95% CI, 1.9‒5.7, p = 0.002), and not having atlantodens osteoarthritis (OR, 2.1; 95% CI, 1.2‒3.8, p = 0.014). Conclusion In the multivariable logistic regression analysis, age in the sixth decade or older, calcification of the transverse ligament, being women, and not having atlantodens osteoarthritis were found to be significantly associated with atlantoaxial osteoarthritis. Delayed diagnosis and treatment can be avoided by focusing on these risk factors.
-
The diagnosis and classification of ossification of the posterior longitudinal ligament (OPLL) can be difficult with radiography alone; therefore, computed tomography (CT) is also usually performed. There are many reports on the usefulness of digital tomosynthesis (DTS) for image analysis in orthopedics. This study aimed to compare the accuracy of DTS with radiography and CT for the diagnosis and classification of cervical OPLL (C-OPLL). ⋯ This study revealed that DTS may be an alternative to CT for the diagnosis and classification of C-OPLL by specialists. Caution should be exercised in diagnosing and classifying C-OPLL using radiography and DTS by residents, and the use of CT is recommended.
-
To compare the Atlas (C1) lateral mass screw placement between screw trajectories of 0° and 15° medial angulation while using the intersection between lateral mass and inferomedial edge of the posterior arch. ⋯ A starting point of 3-mm lateral to the intersection between lateral mass and inferomedial edge of the Atlas posterior arch can be safely and effectively used to insert C1 lateral mass using both 0° and 15° medial angulation.
-
To investigate improvement rates, adverse events and predictors of clinical outcome after laminectomy alone (LAM) or laminectomy with instrumented fusion (LAM + F) for degenerative cervical myelopathy (DCM). ⋯ These findings suggest that surgical intervention at an earlier myelopathy stage might be beneficial and that less invasive procedures are preferable in this patient population.