The spine journal : official journal of the North American Spine Society
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Interbody spacers for anterior spine fusion are made of different materials, which can affect the postfusion magnetic resonance imaging (MRI) scans. Susceptibility artifacts specially for metallic implants can decrease the image quality. ⋯ Susceptibility artifacts were clearly affected by the implant material, shape, and implant volume. Independent of the implant material, with regard to a more advantageous IV/TAV and CSA/MAA relation, for larger implants the artifact rate was more limited to the implant's direct surroundings. On the basis of a high magnetizability for titanium implants with an equal IV, the range of implant-related susceptibility artifacts was influenced by the material as well as implant shape in favor of cylindric implants. According to the very low MRI artifact rate of carbon implants, the implant shape did not have any significant effect on the artifact behavior.
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Severe and disabling dysphagia is a relatively uncommon complication of anterior cervical spine surgery. However, the incidence of dysphagia ranges widely (2% to 60%). Furthermore, risk factors that contribute to the development of dysphagia have not been well identified. ⋯ Overall the incidence of dysphagia 2 years after anterior cervical spine surgery was 13.6%. Risk factors for long-term dysphagia after anterior cervical spine surgery include gender, revision surgeries, and multilevel surgeries. The use of instrumentation, higher levels, or corpectomy versus discectomy did not significantly increase the prevalence of dysphagia.
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Meta Analysis Comparative Study
The safety of instrumented outpatient anterior cervical discectomy and fusion.
Reported hospitalization times after an anterior cervical discectomy and fusion (ACDF) procedure range between 20 hours to 4 days. Reasons for this wide variation are manifold, but the safety of an instrumented ACDF in the setting of a hostile medical-legal climate is most likely the primary concern influencing such a discrepancy. ⋯ Performing ACDF with instrumentation on an outpatient basis is feasible, and it is not associated with higher overall or hardware-related complication rates as compared with complication rates reported in the literature, suggesting that this procedure is safe to perform on an outpatient basis.
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Comparative Study
Psychometric properties of the Cervical Spine Outcomes Questionnaire and its relationship to standard assessment tools used in spine research.
The Cervical Spine Outcomes Questionnaire (CSOQ), a disease-specific outcomes instrument, has not been systematically compared with the Short Form-36 (SF-36) or the Neck Disability Index (NDI). ⋯ The CSOQ domain scores provide a disease-specific assessment of functional limitations resulting from cervical spine disorders. The domain scores for functional disability and psychological distress provide similar information to that provided by the NDI and SF-36. The CSOQ domain scores for pain severity provide information that is more specific to cervical disc disease than does the physical health score of the SF-36.
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Comparative Study
Biomechanical comparison of adjacent segmental motion after ventral cervical fixation with varying angles of lordosis.
Complications, such as graft subsidence and adjacent segment degeneration, are not uncommon after ventral cervical fusion. It has been theorized, but not proven, that sagittal alignment may affect this process. It is therefore hypothesized that increasing lordosis during anterior cervical fusion decreases adjacent segment motion (ASM) and thus decreases the rate of adjacent disc degeneration. A study was designed to test the first portion of this hypothesis; ie, that increasing lordosis during anterior cervical fusion decreases ASM. ⋯ Under the conditions of this study, there is a significant increase in ASM with the achievement of a modest increase in lordosis (small spacer) that is not observed with a greater increase in lordosis (large spacer).