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  1. Anterior cervical plating

    Directory of Open Access Journals (Sweden)

    Gonugunta V

    2005-01-01

    Full Text Available Although anterior cervical instrumentation was initially used in cervical trauma, because of obvious benefits, indications for its use have been expanded over time to degenerative cases as well as tumor and infection of the cervical spine. Along with a threefold increase in incidence of cervical fusion surgery, implant designs have evolved over the last three decades. Observation of graft subsidence and phenomenon of stress shielding led to the development of the new generation dynamic anterior cervical plating systems. Anterior cervical plating does not conclusively improve clinical outcome of the patients, but certainly enhances the efficacy of autograft and allograft fusion and lessens the rate of pseudoarthrosis and kyphosis after multilevel discectomy and fusions. A review of biomechanics, surgical technique, indications, complications and results of various anterior cervical plating systems is presented here to enable clinicians to select the appropriate construct design.

  2. Artrodese cervical anterior em três e quatro níveis com dispositivo intersomático não associado à placa cervical Artrodesis cervical anterior en tres y cuatro niveles con dispositivo intersomático no asociado a placa cervical Anterior cervical arthrodesis for three and four levels using stand-alone interbody cages without cervical plates

    Directory of Open Access Journals (Sweden)

    Marcel Luiz Benato

    2009-06-01

    en tercer y cuarto niveles; dolor axial y/o irradiada; con mínimo seis meses de postoperatorio. El criterio de exclusión fue la presencia de inestabilidad cervical traumática. Fueron evaluadas las tasas de consolidación, la presencia de síntomas, la tasa de complicaciones y la posición de los dispositivos intersomáticos (subsidente después de seis meses. RESULTADOS: todos los pacientes obtuvieron consolidación en tres meses, sin embargo, dos pacientes presentaron el fenómeno de subsidente, o sea, migración con consolidación en cifosis, sin alterar los resultados clínicos y la consolidación de la artrodesis a los seis meses de postoperatorio. Los pacientes presentaron mejoría del dolor preoperatorio y solo tres (15% presentaron dolor residual. No hubo complicaciones mayores. El tiempo de hospitalización fue de dos días. No fue utilizada inmovilización rígida en el postoperatorio. CONCLUSIÓN: fue obtenida consolidación con esta técnica en todos los casos. La técnica se mostró segura y promovió buenos resultados radiológicos y clínicos.evaluate the rates of fusion of the anterior cervical discectomy and arthrodesis for three and four levels using interbody cages (stand-alone without cervical plates six months after post-operative. METHODS: from November 2005 to July 2008, 20 patients were treated as proposed. The inclusion criteria were: cervical degenerative disease of three and four levels; axial and/or irradiated pain at least six months of follow-up. The exclusion criteria were: cervical traumatic instability. The fusion rate, clinical symptoms, rate of complications and the implant position were evaluated six months after post-operative. RESULTS: results were favorable in 100% of the patients, with residual pain in two cases. Fusion was found in 100% of the patients, except for two cases with minimum subsidence and fusion in a slight kyphotic position. There were not significant complications. The discharge of the hospital was performed

  3. Artrodese cervical anterior em três e quatro níveis com dispositivo intersomático não associado à placa cervical Artrodesis cervical anterior en tres y cuatro niveles con dispositivo intersomático no asociado a placa cervical Anterior cervical arthrodesis for three and four levels using stand-alone interbody cages without cervical plates

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    Marcel Luiz Benato; Ed Marcelo Zaninell; Xavier Soler i Graells; Marcos Andre Sonagli

    2009-01-01

    OBJETIVO: avaliar a taxa de consolidação em pacientes submetidos à artrodese cervical anterior de três e quatro níveis utilizando dispositivo intersomático não associado à placa cervical no sexto mês de pós-operatório. MÉTODOS: no período de Novembro de 2005 a Julho de 2008, 20 pacientes foram submetidos ao tratamento cirúrgico proposto. Os critérios de inclusão foram: diagnóstico clínico e por imagem de doença discal degenerativa cervical em três ou quatro níveis; dor axial e/ou irradiada co...

  4. Artrodesis del raquis cervical por vía anterior con placa atornillada: criterios para la selección del implante

    OpenAIRE

    Barberá, José; Barberá, D.

    2005-01-01

    El propósito de esta revisión es analizar el mecanismo de acción de las placas utilizadas en la artrodesis instrumentada del raquis cervical por vía anterior, con el fin de llegar a un criterio que sirva para seleccionar aquella que sea más adecuada para cada tipo de patología. Se identifican cinco tipos de placas cuyo factor diferencial es la relación mecánica entre el tornillo y el orificio de la placa. Con este criterio se consideran cinco tipos de placa: 1º la de interfaz tornillo-placa l...

  5. Anterior Cervical Spinal Surgery for Multilevel Cervical Myelopathy.

    OpenAIRE

    Jung-Ju Huang; Lih-Huei Chen; Chi-Chien Niu; Tsai-Sheng Fu; Po-Liang Lai; Wen-Jer Chen

    2004-01-01

    Background: In multilevel spinal cord compression caused by cervical spondylosis, surgeonsface the choice of performing a posterior route as a laminectomy orlaminoplasty, or an anterior route as multiple adjacent interbody decompressionsor corpectomies. The anterior cervical operation is not considered bysome clinicians because of concerns about complications and the complexityof multilevel anterior cervical surgery.Methods: In this retrospective study, 14 patients with multilevel cervical sp...

  6. Resultados clínicos e radiológicos en serie de artrodesis cervical anterior con caja de fusión intersomática y placa Resultados clínicos e radiológicos em série de artrodese cervical anterior com dispositivo de fusão intersomática e placa Clinical and radiologica outcomes in series of anterior cervical fusion with intersomatic cage and plate

    OpenAIRE

    Lyonel Beaulieu Lalanne; Gonzalo Arriagada Ocampo

    2012-01-01

    OBJETIVOS: Analizar los resultados clínicos e radiológicos de una serie de pacientes sometidos a artrodesis cervical anterior con caja de fusión intersomática (CAGE) y placa. MÉTODOS: Análisis retrospectivo de serie de pacientes sometidos a artrodesis cervical anterior con caja de fusión intersomática y placa entre los años 2004 y 2009. Revisión de fichas clínicas y radiografías, registro de edad, sexo, diagnósticos, nivel operado, complicaciones, evolución clínica y radiológica. Técnica quir...

  7. Anterior cervical hypertrichosis: a sporadic case.

    Science.gov (United States)

    Bostan, Sezen; Yaşar, Şirin; Serdar, Zehra Aşiran; Gizlenti, Sevda

    2016-03-01

    Anterior cervical hypertrichosis is a very rare form of primary localized hypertrichosis. It consists of a tuft of terminal hair on the anterior neck just above the laryngeal prominence. The etiology is still unknown. In this article, we reported a 15-year-old female patient who presented to our clinic with a complaint of hypertrichosis on the anterior aspect of the neck for the last five years. Her past medical history revealed no pathology except for vesicoureteral reflux. On the basis of clinical presentation, our patient was diagnosed with anterior cervical hypertrichosis and she was considered to be a sporadic case due to lack of other similar cases in familial history. To date, 33 patients with anterior cervical hypertrichosis have been reported. Anterior cervical hypertrichosis can be associated with other abnormalities, but it frequently presents as an isolated defect (70%). The association of vesicoureteral reflux and anterior cervical hypertrichosis which was observed in our patient might be coincidental. So far, no case of anterior cervical hypertrichosis associated with vesicoureteral reflux has been reported in the literature. PMID:27103865

  8. ANTERIOR OSTEOPHYTE IDENTIFICATION IN CERVICAL VERTEBRAE

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    A. T. Chougale

    2011-06-01

    Full Text Available Radiologist always examines X-ray to determine abnormal changes in cervical, lumbar & thoracic vertebrae. Osteophyte (bony growth may appear at the corners of vertebrae so that vertebral shape becomes abnormal. This paper presents the idea from Image processing techniques such as customised Hough transform which will be used for segmentation which should be independent of rotation, scale, noise & shape. This segmented image will be then used for computing size invariant, convex hull based features to differentiate normal cervical vertebrae from cervical vertebrae containing anterior osteophyte. This approach effectively finds anterior osteophytes in cervical vertebrae.

  9. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

    Full Text Available Anterior Cervical Discectomy and Fusion with Plating Broward Health Medical Center Fort Lauderdale, FL November 17, 2011 I'm Dr. Matthew Moore, head of the Spine Care Center here at North Broward Medical Center. And ...

  10. Resultados clínicos e radiológicos en serie de artrodesis cervical anterior con caja de fusión intersomática y placa Resultados clínicos e radiológicos em série de artrodese cervical anterior com dispositivo de fusão intersomática e placa Clinical and radiologica outcomes in series of anterior cervical fusion with intersomatic cage and plate

    Directory of Open Access Journals (Sweden)

    Lyonel Beaulieu Lalanne

    2012-06-01

    Full Text Available OBJETIVOS: Analizar los resultados clínicos e radiológicos de una serie de pacientes sometidos a artrodesis cervical anterior con caja de fusión intersomática (CAGE y placa. MÉTODOS: Análisis retrospectivo de serie de pacientes sometidos a artrodesis cervical anterior con caja de fusión intersomática y placa entre los años 2004 y 2009. Revisión de fichas clínicas y radiografías, registro de edad, sexo, diagnósticos, nivel operado, complicaciones, evolución clínica y radiológica. Técnica quirúrgica de Smith-Robinson. Las cajas de fusión intersomática fueron llenadas con sustitutos de huesos. Deambulación 12 horas después de la cirugía, alta a las 48 horas, collar cervical intermitente por 2 semanas. Evaluación clínica mediante criterios de Odom. Seguimiento 17 a 78 meses. RESULTADOS: Diagnósticos: Hernia del núcleo pulposo (HNP cervical, 44 (71%, mielopatía, 11 (17,7%, fracturas, 7 (11,3%. Nivel 1: 44 (71%, Nivel 2: 15 (24,2%, Nivel 3: (4,8%. El nivel C5-C6 incluyó 92% de los casos. Alivio del dolor radicular: 60 (97%. Recuperación del déficit neurológico: 59 (95,2%. Alivio de la mielopatía: 8/11 pacientes (73%. Alivio del dolor cervical: 56 (90%. Resultados clínicos: 91,9% excelentes y buenos. Complicaciones (12,9%: 4 disfagias transitorias (6,5%, 1 disfagia permanente (1,6%, 2 disfonías transitorias (3,3%, 1 subcidencia con aflojamiento del implante y fractura asintomática de placa (1,6%. No hubo pseudoartrosis. CONCLUSIONES: Esta serie presenta buenos resultados clínicos, com alivio del dolor y recuperación neurológica comparables con los hallazgos en la literatura. El uso de la caja de fusión intersomática evita complicaciones de la zona dadora y, cuando es asociado a placa cervical anterior permite fijación intersomática inmediata, dando soporte estructural adecuado, con buenos resultados y sin complicaciones a largo plazo.OBJETIVOS: Analisar os resultados clínicos e radiológicos de uma série de

  11. Pharyngocutaneous fistula after anterior cervical spine surgery

    OpenAIRE

    Sansur, Charles A.; Early, Stephen; Reibel, James; Arlet, Vincent

    2009-01-01

    Pharyngocutaneous fistulae are rare complications of anterior spine surgery occurring in less than 0.1% of all anterior surgery cases. We report a case of a 19 year old female who sustained a C6 burst fracture with complete quadriplegia. She was treated urgently with a C6 corpectomy with anterior cage and plating followed by posterior cervical stabilization at another institution. Post operatively she developed a pharyngocutaneous fistula that failed to heal despite several attempts of closu...

  12. Avaliação do tratamento da discopatia degenerativa cervical pela artrodese via anterior utilizando placas associadas a cages ou cages em peek isoladamente Evaluación del tratamiento de la enfermedad degenerativa del disco cervical por la artrodesis anterior utilizando placas asociadas con jaulas o jaulas en peec, aisladamente Evaluation of cervical degenerative disc disease treatment by anterior arthrodesis using plates associated with cages or cages in peek alone

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    André Rafael Hübner; Marcelo Ribeiro Mendes; Jean Carlo Frigotto Queruz; Jean Marcel Dambrós; Álvaro Diego Heredia Suárez; Leandro de Freitas Spinelli

    2011-01-01

    OBJETIVOS: Avaliar comparativamente o tratamento da discopatia degenerativa cervical por discectomia e artrodese cervical via anterior utilizando placas associadas a cages ou cages em PEEK isoladamente. MÉTODOS: Foi realizado um estudo retrospectivo comparativo entre dois grupos de pacientes operados pela técnica de discectomia e artrodese cervical via anterior. Foram selecionados aleatoriamente 70 pacientes, 35 operados com o método de fixação com placas associadas a cages - denominado Grupo...

  13. Avaliação do tratamento da discopatia degenerativa cervical pela artrodese via anterior utilizando placas associadas a cages ou cages em peek isoladamente Evaluación del tratamiento de la enfermedad degenerativa del disco cervical por la artrodesis anterior utilizando placas asociadas con jaulas o jaulas en peec, aisladamente Evaluation of cervical degenerative disc disease treatment by anterior arthrodesis using plates associated with cages or cages in peek alone

    Directory of Open Access Journals (Sweden)

    André Rafael Hübner

    2011-01-01

    Full Text Available OBJETIVOS: Avaliar comparativamente o tratamento da discopatia degenerativa cervical por discectomia e artrodese cervical via anterior utilizando placas associadas a cages ou cages em PEEK isoladamente. MÉTODOS: Foi realizado um estudo retrospectivo comparativo entre dois grupos de pacientes operados pela técnica de discectomia e artrodese cervical via anterior. Foram selecionados aleatoriamente 70 pacientes, 35 operados com o método de fixação com placas associadas a cages - denominado Grupo I - e 35 com o cage em PEEK isoladamente - Grupo II. Realizou-se anamnese, exame físico, escores de dor (escala visual e analógica da dor e função (critérios de Odom's, SF-36, Indice de incapacidade do pescoço o pré e pós-operatório e exames de imagem. RESULTADOS: Houve predominância de pacientes do sexo feminino em ambos os grupos, com média de idade de 55 anos no Grupo I e 47 no Grupo II. Ambos os grupos apresentaram distribuição semelhante quanto ao número de níveis operados, assim como nas complicações encontradas e escores de dor, cervicalgia e SF36 no pré e pós-operatório. Houve 97.1% de fusão com 94.3% de bons resultados no Grupo I e 100% de fusão, com 97 % de bons resultados no Grupo II. CONCLUSÕES: O estudo comparativo da utilização de placas com cages e cages em PEEK isoladamente apresentou resultados semelhantes e satisfatórios para os grupos estudados, não se constatando superioridade ou inferioridade de um método com relação ao outro.OBJETIVOS: Evaluar comparativamente el tratamiento de la enfermedad degenerativa del disco cervical por discectomía y artrodesis cervical vía anterior, utilizando placas asociadas con el uso de jaulas o estas en PEEK [Poliéster-Éter-Éter-Cetona], aisladamente. MÉTODOS: fue realizado un estudio retrospectivo comparativo de dos grupos de pacientes tratados con la técnica de discectomía y artrodesis cervical vía anterior. Se seleccionaron al azar 70 pacientes, 35 operados

  14. Anterior Cervical Spinal Surgery for Multilevel Cervical Myelopathy.

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    Jung-Ju Huang

    2004-07-01

    Full Text Available Background: In multilevel spinal cord compression caused by cervical spondylosis, surgeonsface the choice of performing a posterior route as a laminectomy orlaminoplasty, or an anterior route as multiple adjacent interbody decompressionsor corpectomies. The anterior cervical operation is not considered bysome clinicians because of concerns about complications and the complexityof multilevel anterior cervical surgery.Methods: In this retrospective study, 14 patients with multilevel cervical spondylosiswho were operated on via an anterior route were enrolled to evaluate thecomplexity, safety, and clinical results. The collected parameters were operationtime, blood loss, hospital days, and early and late complications forevaluating the operative complexity, radiographic follow-up for evaluatingfusion, graft problems, implants problems, and the recovery rate using theJapanese Orthopaedic Association score (JOA score for evaluating the operativeresults.Results: The mean operation time was 363.4 min, and blood loss was 431.4 ml. Anearly complication was noted in 1 patient with combined deep vein thrombosisand a pulmonary embolism. Late complications were screw breakage in1 patient and screw loosening in 5 patients. The mean duration of follow-upwas 21.9 months. The mean recovery rate of the JOA score was 38.8% postoperativelyand 51.9% at the final follow-up. The fusion rate was 100% inthis series.Conclusions: Anterior cervical decompression and fusion for multilevel stenosis requires alonger operation time than posterior procedures; however, the clinical resultsare satisfactory.

  15. Roentgenographic findings following anterior cervical fusion

    International Nuclear Information System (INIS)

    We reviewed the pre- and postoperative lateral cervical roentgenograms in 90 patients who had anterior fusions and compared their findings with age and sex-matched people without neck problems. The average interval from surgery to review was 5 years. Preoperatively, all patients had a higher incidence of degenerative spondylosis at the levels to be fused than their asymptomatic counterparts. Postoperatively, there was no difference in the incidence of degenerative change between the operated and the control group at the levels above and below the fusion with the exception of anterior osteophyte formation which was more frequent in those with fusions. (orig.)

  16. Anterior retropharyngeal approach to the cervical spine.

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    Behari S

    2001-10-01

    Full Text Available The anterior retropharyngeal approach (ARPA accesses anteriorly situated lesions from the clivus to C3, in patients with a short neck, Klippel Feil anomaly or those in whom the C2-3 and C3-4 disc spaces are situated higher in relation to the hyoid bone and the angle of mandible where it is difficult to approach this region using the conventional anterior approach, due to the superomedial obliquity of the trajectory. The ARPA avoids the potentially contaminated oropharyngeal cavity providing for a simultaneous arthrodesis and instrumentation during the primary surgical procedure. Experience of five patients with high cervical extradural compression, who underwent surgery using this approach between 1994 and 1999, is presented. The surgical procedures included excision of ossified posterior longitudinal ligament (n=2; excision of prolapsed disc and osteophytes (n=2; and excision of a vertebral body neoplasm (n=1. Following the procedure, vertebral arthrodesis was achieved using an iliac graft in all the patients. Only one patient with vertebral body neoplasm required an additional anterior cervical plating procedure for stabilisation the construct. The complications included transient respiratory insufficiency and neurological deterioration in two patients; and, pharyngeal fistula and donor site infection in one patient.

  17. Missing Screw as a Rare Complication of Anterior Cervical Instrumentation

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    Yusuf Kurtuluş Duransoy; Mesut Mete; Baha Zengel; Mehmet Selçukı

    2013-01-01

    Although anterior cervical arthrodesis is an effective procedure for the treatment of cervical disorders, the method has some complications. Here, we describe this rare complication of cervical instrumentation with a literature review. A 23-year-old male patient was operated for a C6-C7 dislocation. At postoperative month 10, he presented with hemoptysis and dysphagia. Cervical roentgenograms showed anterior migrations of one broken screw and a plate-locking screw at the C6 corpus. One screw ...

  18. Complications of the anterior approach to the cervical spine

    OpenAIRE

    Marcelo Lemos Vieira da Cunha; Francisco Alves de Araújo Júnior; Cássio Czottis Grapiglia; Denildo César Amaral Veríssimo; Roberta Rehder; Samir Ale Bark; Luis Alencar Biurrum Borba

    2014-01-01

    OBJECTIVE: To evaluate the complications of anterior approach to the cervical spine in patients who underwent cervical arthrodesis with instrumentation. METHODS: Prospective and descriptive study was conducted from January 2009 to April 2010. All patients who underwent arthrodesis of the cervical spine by anterior approach were included, regardless the diagnosis. Access was made by the anterior approach on the right side. We evaluated the number of operated levels (1, 2 or 3 levels) and,...

  19. Endoscopic anterior decompression in cervical disc disease

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    Yad Ram Yadav

    2014-01-01

    Full Text Available Background: Although microscopic anterior cervical discectomy with or without fusion are common surgical procedures for treatment of cervical herniated discs, loss of disc height, pseudarthrosis, and adjacent disc degeneration are some of the problems associated with it. This study is aimed to evaluate results of endoscopic microforaminotomy in cervical disc diseases. Materials and Methods: A prospective study of 50 patients of mono segmental soft or hard disc causing myeloradiculopathy was undertaken. A visual analogue scale (VAS for neck and arm pain and functional outcomes using the Nurick grading system were assessed. There were 28, 12, 8, and 2 patients at C5-6, C6-7, C4-5, and C3-4 levels disc diseases, respectively. Patients with two or more level disc, instabilities, disc extending more than half vertebral body height, and previous operation at the same segment were excluded. Results: Age ranged from 21 to 67 years. Average postoperative reduction in disc height, operating time, and blood loss was 1.1 mm, 110 minutes, and 30 ml, respectively. Average pre-operative VAS score for arm pain and Nurick grading was 7.6 and 2.7, which improved to 1.9 and 0.82, respectively. All patients improved; 1, 2, 3 grade improvement was seen in 10, 27, and 10 patients, respectively. There was no significant complication or any mortality. Conclusion: Although longer follow up of large number of patients is required, endoscopic microforaminotomy is a safe and an effective alternative to microscopic anterior discectomy with or without fusion.

  20. Dysphagia due to anterior cervical osteophytosis: case report

    OpenAIRE

    Frederico Miguel Santos Silva Marquez Correia; João Paulo de Sousa Goucha Jorge; Ana Sofia Teixeira Neves; Gabriel Filipe Gonçalves Xavier; Marco Miguel Barroso de Oliveira; José Eduardo Paiva Ferreira

    2014-01-01

    The objective of this study is to highlight the possibility of dysphagia induced by anterior cervical osteophytes. When not diagnosed early this condition may be responsible for complications such as severe dysphagia and potential lung aspiration, especially in elderly patients. Analysis of a case report of a 72-year old woman who presented cervical pain and progressive dysphagia. Imaging studies have shown anterior ce...

  1. Anterior cervical discectomy and fusion for noncontiguous cervical spondylotic myelopathy

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    Sun Qizhi

    2016-01-01

    Full Text Available Background: Noncontiguous cervical spondylotic myelopathy (CSM is a special degenerative disease because of the intermediate normal level or levels between supra and infraabnormal levels. Some controversy exists over the optimal procedure for two noncontiguous levels of CSM. The study was to evaluate the outcomes of the anterior cervical discectomy and fusion (ACDF with zero-profile devices for two noncontiguous levels of CSM. Materials and Methods: 17 consecutive patients with two noncontiguous levels of CSM operated between December 2009 and August 2012 were included in the study. There were 12 men and 5 women with a mean age of 60.7 years (range 45-75 years. Involved disc levels were C3/4 and C5/6 in 11 patients and C4/5 and C6/7 in six patients. Preoperative plain radiographs, computed tomography (CT with 3-D reconstruction and magnetic resonance imaging (MRI of the cervical spine were taken in all patients. All radiographs were independently evaluated by 2 spine surgeons and 1 radiologist. The outcomes were assessed by the average operative time, blood loss, Japanese Orthopedic Association (JOA score, improvement rate, neck dysfunction index (NDI, swallowing quality of life (SWAL-QOL score, the cervical lordosis and complications. Results: The mean followup was 48.59 months (range 24-56 months. The average operative time and blood loss was 105.29 min and 136.47 ml, respectively. The preoperative JOA score was 8.35, which significantly increased to 13.7 at the final followup ( P 0.05. Cerebrospinal fluid leak, dysphagia and radiological adjacent segment degeneration occurred in one patient, respectively. Conclusion: The ACDF with zero-profile devices is generally effective and safe in treating two noncontiguous levels of CSM.

  2. Thyroid storm following anterior cervical spine surgery for tuberculosis of cervical spine

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    Sanjiv Huzurbazar

    2014-01-01

    Full Text Available Objective: The primary objective was to report this rare case and discuss the probable mechanism of thyroid storm following anterior cervical spine surgery for Kochs cervical spine.

  3. Dysphagia due to anterior cervical osteophytosis: case report

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    Frederico Miguel Santos Silva Marquez Correia

    2014-12-01

    Full Text Available The objective of this study is to highlight the possibility of dysphagia induced by anterior cervical osteophytes. When not diagnosed early this condition may be responsible for complications such as severe dysphagia and potential lung aspiration, especially in elderly patients. Analysis of a case report of a 72-year old woman who presented cervical pain and progressive dysphagia. Imaging studies have shown anterior cervical osteophytosis and multilevel degenerative changes in the cervical spine. The patient underwent surgical excision of the cervical anterior osteophytes (C4, C5 and C6 and C5/C6 arthrodesis through anterior approach. The postoperative period was uneventful and symptoms resolved within 2 weeks. Early diagnosis and treatment led to complete resolution, avoiding late and serious complications associated with this pathology in the geriatric population, especially severe and progressive dysphagia and risk of pulmonary aspiration, and the consequent morbidity and mortality associated. A multidisciplinary approach is essential for the correct assessment of this condition

  4. Tratamento cirúrgico por via anterior na mielopatia cervical espondilótica com seguimento mínimo de dez anos Tratamiento quirúrgico por vía anterior en la mieolopatía cervical espondilótica con seguimiento mínimo de diez años Anterior decompression and fusion for spondilotic cervical mielopathy with a minimal ten-year follow-up

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    Rui Peixoto Pinto

    2010-06-01

    Full Text Available OBJETIVO: a mielopatia cervical espondilótica (MEC é uma causa frequente de disfunção da medula espinhal na população adulta. O tratamento implica em descompressão cirúrgica precoce. O objetivo foi apresentar um estudo retrospectivo da descompressão anterior e artrodese para MEC com um seguimento mínimo de dez anos. MÉTODOS: pacientes operados entre Janeiro de 1990 e Dezembro de 1994 foram avaliados por sexo, idade, número de níveis operados, avaliação funcional pela escala de Nurick pré-operatória um ano após cirurgia e após a revisão final que ocorreu em 2004, evidência de consolidação e complicações. RESULTADOS: foram avaliados 91 pacientes, 69 do sexo masculino, 22 do sexo feminino, com uma média de idade de 56,6 anos (42-86 e um seguimento médio de 11,9 anos. Ocorreram cinco óbitos: três pacientes no pós-operatório imediato, um no primeiro ano e um durante o restante período. Em média, foram operados 2,7±1,0 níveis por paciente (1-4. O valor médio de Nurick pré-operatório foi de 3,8±0,9. Houve uma melhoria significativa do estado neurológico um ano após a cirurgia (2,2±1,1; pOBJETIVO: la mielopatía cervical espondilótica (MEC es una causa frecuente de disfunción de la médula espinal en la población adulta. El tratamiento implica una descompresión quirúrgica precoz. El objetivo es presentar un estudio retrospectivo de la descompresión anterior y artrodesis para MEC con un seguimiento mínimo de diez años. MÉTODOS: pacientes operados entre Enero de 1990 y Diciembre de 1994 fueron evaluados según el sexo, la edad, el número de niveles operados, la evaluación funcional por la escala de Nurick pre operatoria un año después de la cirugía y después de la revisión final que fue en el 2004, evidencia de consolidación y complicaciones. RESULTADOS: fueron evaluados 91 pacientes, 69 del sexo masculino, 22 del sexo femenino, con un promedio de edades de 56.6 años (42 a 86 y un seguimiento

  5. Is dysphonia permanent or temporary after anterior cervical approach?

    OpenAIRE

    Kahraman, Serdar; Sirin, Sait; Erdogan, Ersin; Atabey, Cem; Daneyemez, Mehmet; Gonul, Engin

    2007-01-01

    The rate, causes and prognosis of dysphonia after anterior cervical approach (ACA) were investigated in our clinical series. During a 10-year interval, 235 consecutive patients with cervical disc disease underwent surgical treatment using anterior approach. Retrospective chart reviews showed recurrent laryngeal nerve (RLN) injury in 3 (1.27%) patients. All three patients were men and only one patient had multilevel surgery. These patients had RLN injury after virgin surgery. Laryngoscopic exa...

  6. Tratamento cirúrgico por via anterior na mielopatia cervical espondilótica com seguimento mínimo de dez anos Tratamiento quirúrgico por vía anterior en la mieolopatía cervical espondilótica con seguimiento mínimo de diez años Anterior decompression and fusion for spondilotic cervical mielopathy with a minimal ten-year follow-up

    OpenAIRE

    Rui Peixoto Pinto; José Oliveira; Rui Matos; Nuno Neves; Manuel Ribeiro da Silva; Pedro Cacho Rodrigues; Rui M Barros; Abel Trigo Cabral

    2010-01-01

    OBJETIVO: a mielopatia cervical espondilótica (MEC) é uma causa frequente de disfunção da medula espinhal na população adulta. O tratamento implica em descompressão cirúrgica precoce. O objetivo foi apresentar um estudo retrospectivo da descompressão anterior e artrodese para MEC com um seguimento mínimo de dez anos. MÉTODOS: pacientes operados entre Janeiro de 1990 e Dezembro de 1994 foram avaliados por sexo, idade, número de níveis operados, avaliação funcional pela escala de Nurick pré-ope...

  7. Transverse cervical skin incision and vertical platysma splitting approach for anterior cervical vertebral column exposure

    Directory of Open Access Journals (Sweden)

    Agrawal Amit

    2014-03-01

    Full Text Available Anterior surgical approaches provide direct access to symptomatic areas of the cervical spine, allow management of the vast spectrum of cervical spine pathologies and there are many articles in the literature that discussed these techniques in detail. Cosmesis is an important issue for patients who undergone surgeryon neck structures as an improperly placed incision attracting significant morbidity and few publications discuss this issue in details. The purpose of the present article is to describe our experience with transverse cervical skin incision and vertical platysma splitting approach for anterior cervical vertebral column exposure.

  8. Missing Screw as a Rare Complication of Anterior Cervical Instrumentation

    Directory of Open Access Journals (Sweden)

    Yusuf Kurtuluş Duransoy

    2013-01-01

    Full Text Available Although anterior cervical arthrodesis is an effective procedure for the treatment of cervical disorders, the method has some complications. Here, we describe this rare complication of cervical instrumentation with a literature review. A 23-year-old male patient was operated for a C6-C7 dislocation. At postoperative month 10, he presented with hemoptysis and dysphagia. Cervical roentgenograms showed anterior migrations of one broken screw and a plate-locking screw at the C6 corpus. One screw was missing. We concluded that the missing screw had perforated the esophagus and had been eliminated spontaneously through the gastrointestinal tract. No screw should migrate. Even loose screws should be noted in follow-up X-ray studies. If such findings are detected, a second operation for revision should be considered as soon as possible to prevent potentially fatal complications.

  9. Bone graft substitutes in anterior cervical discectomy and fusion

    OpenAIRE

    Chau, Anthony M.T.; Mobbs, Ralph J.

    2009-01-01

    Anterior cervical discectomy with fusion is a common surgical procedure for patients suffering pain and/or neurological deficits and unresponsive to conservative management. For decades, autologous bone grafted from the iliac crest has been used as a substrate for cervical arthrodesis. However patient dissatisfaction with donor site morbidity has led to the search for alternative techniques. We present a literature review examining the progress of available grafting options as assessed in hum...

  10. Complications of Anterior and Posterior Cervical Spine Surgery

    OpenAIRE

    Cheung, Jason Pui Yin; Luk, Keith Dip-Kei

    2016-01-01

    Cervical spine surgery performed for the correct indications yields good results. However, surgeons need to be mindful of the many possible pitfalls. Complications may occur starting from the anaesthestic procedure and patient positioning to dura exposure and instrumentation. This review examines specific complications related to anterior and posterior cervical spine surgery, discusses their causes and considers methods to prevent or treat them. In general, avoiding complications is best achi...

  11. Complications of the anterior approach to the cervical spine

    Directory of Open Access Journals (Sweden)

    Marcelo Lemos Vieira da Cunha

    2014-09-01

    Full Text Available OBJECTIVE: To evaluate the complications of anterior approach to the cervical spine in patients who underwent cervical arthrodesis with instrumentation. METHODS: Prospective and descriptive study was conducted from January 2009 to April 2010. All patients who underwent arthrodesis of the cervical spine by anterior approach were included, regardless the diagnosis. Access was made by the anterior approach on the right side. We evaluated the number of operated levels (1, 2 or 3 levels and, the type of procedure performed: discectomy and placement of cage and plate (D+C+P, discectomy with placement of a cage (D+C or corpectomy with placement of cage and plate (C+C+P. All complications related to surgical approach were reported. RESULTS: We studied 34 patients, 70% male. The average age was 50 years and mean follow-up was 8 months. Eighteen percent of patients had complications, distributed as follows: dysphasia (33% and dysphonic (67%. Among patients who developed complications, most underwent to D+C+P (83% and no complications were found in patients where no cervical plate was used. Regarding levels, both complications were identified in patients operated to one or two levels. However, in patients operated on three levels, only dysphonia was identified. CONCLUSION: The most frequent complication was dysphonia. Patients who presented more complications were those undergoing discectomy and fusion with cage and anterior cervical plate. All cases of dysphonia were in this group. The number of accessible levels does not seem to have affected the incidence of complications.

  12. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

    Full Text Available ... Cervical Discectomy and Fusion with Plating Broward Health Medical Center Fort Lauderdale, FL November 17, 2011 I' ... the Spine Care Center here at North Broward Medical Center. And today we're operating on an ...

  13. Anterior retropharyngeal approach to the cervical spine.

    OpenAIRE

    Behari S; Banerji D; Trivedi P; Jain V; Chhabra D

    2001-01-01

    The anterior retropharyngeal approach (ARPA) accesses anteriorly situated lesions from the clivus to C3, in patients with a short neck, Klippel Feil anomaly or those in whom the C2-3 and C3-4 disc spaces are situated higher in relation to the hyoid bone and the angle of mandible where it is difficult to approach this region using the conventional anterior approach, due to the superomedial obliquity of the trajectory. The ARPA avoids the potentially contaminated oropharyngeal cavity providing ...

  14. Anterior cervical decompression and fusion with caspar plate fixation

    International Nuclear Information System (INIS)

    Objective: To evaluate the role of anterior cervical decompression and fixation with Caspar plating in cervical spine injury on neurological outcome. Study Design: A case series. Place and Duration of Study: Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, from July 2008 to March 2011. Methodology: Thirty patients admitted with cervical spine injuries were inducted in the study. All cases were evaluated for their clinical features, level of injury and degree of neurological injury was assessed using Frankel grading. Pre and postoperative record with X-rays and MRI were maintained. Cervical traction was applied to patients with sub-luxation. All patients underwent anterior cervical decompression, fusion and Caspar plate fixation. The follow-up period was 6 months with clinical and radiological assessment. Results: Among 30 patients, 24 (80%) were males and 6 (20%) were females. Age ranged from 15 to 55 years. Causes of injury were road traffic accident (n = 20), fall (n = 8) and assault (n = 2). Commonest mode of injury was road traffic accident (66.6%). Postoperative follow-up showed that pain and neurological deficit were improved in 21 patients. There was no improvement in 7 patients, one patient deteriorated and one expired. All patients developed pain at donor site. Conclusion: Anterior decompression, fusion and fixation with Caspar plate is an effective method with good neurological and radiological outcome. However, it is associated with pain at donor site. (author)

  15. Genetic studies in congenital anterior midline cervical cleft

    DEFF Research Database (Denmark)

    Jakobsen, L P; Pfeiffer, P; Andersen, M;

    2012-01-01

    Congenital anterior midline cervical cleft (CAMCC) is a rare anomaly, with less than 100 cases reported. The cause of CAMCC is unknown, but genetic factors must be considered as part of the etiology. Three cases of CAMCC are presented. This is the first genetic study of isolated CAMCC. Conventional...

  16. Anterior spinal artery syndrome of the cervical hemicord.

    Science.gov (United States)

    Baumgartner, R W; Waespe, W

    1992-01-01

    Three patients developed signs of a unilateral cervical cord lesion 6 to 36 h after the acute onset of severe cervico-brachial pain. The neurological deficit progressed over 6 to 18 h. On the painful side a central Horner's syndrome, a hemiparesis with plegia of the hand, and a slight pallhypaesthesia were found. On the opposite side thermhypaesthesia and hypalgesia were noted with a level at the dermatome C5 or C6. T2-weighted MR images revealed in one patient a small area of increased signal intensity restricted to one half of the cervical cord, and electromyography in another patient showed after 6 months evidence of segmental chronic denervation. Both abnormalities were found at the clinically expected level. The findings are consistent with a small infarction of the cervical cord in the perfusion territory of a central (sulco-commissural) artery, a duplicated anterior spinal artery or an anterior spinal branch of the vertebral artery. PMID:1315578

  17. Late Results of Anterior Cervical Discectomy and Fusion with Interbody Cages

    OpenAIRE

    Dağlı, Murat; Er, Uygur; Şimşek, Serkan; Bavbek, Murad

    2013-01-01

    Study Design Retrospective analysis. Purpose To evaluate the effectiveness of anterior cervical discectomy with fusion for degenerative cervical disc disease. Overview of Literature Anterior spinal surgery originated in the mid-1950s and graft for fusion was also employed. Currently anterior cervical microdiscectomy and fusion with an intervertebral cage is a widely accepted procedure for treatment of cervical disc hernia. Artificial grafts and cages for fusion are preferred because of their ...

  18. Anterior Cervical Corpectomy and Fusion Accelerates Degenerative Disease at Adjacent Vertebral Segments

    OpenAIRE

    Pickett, Gwynedd E.; Duggal, Neil; Theodore, Nicholas; Sonntag, Volker K.H.

    2008-01-01

    Background Anterior cervical corpectomy provides the most direct and thorough surgical approach for anterior decompression when spinal cord compression is found directly behind the vertebral body. However, anterior cervical fusion has been shown to be associated with the development of new degenerative changes at levels immediately adjacent to the fused segments. Th e incidence of adjacent segment disease (ASD) following anterior cervical corpectomy has not been widely reported. We set out to...

  19. Effect of Anterior Cervical Discectomy and Fusion on Patients with Atypical Symptoms Related to Cervical Spondylosis.

    Science.gov (United States)

    Muheremu, Aikeremujiang; Sun, Yuqing; Yan, Kai; Yu, Jie; Zheng, Shan; Tian, Wei

    2016-09-01

    Background A considerable number of patients with cervical spondylosis complain about one or multiple atypical symptoms such as vertigo, palpitations, headache, blurred vision, hypomnesia, and/or nausea. It remains unclear whether surgical intervention for cervical spondylosis can also effectively alleviate those symptoms. The current study was performed to see if anterior cervical diskectomy and fusion (ACDF) offers such an extra benefit for patients with cervical spondylosis. Objective To investigate if patients who received ACDF for the treatment of cervical spondylotic myelopathy and/or radiculopathy can also achieve alleviation of certain atypical symptoms associated with cervical spondylosis after the surgery in the long run. Methods Sixty-seven patients who underwent ACDF for the treatment of cervical spondylotic myelopathy and/or radiculopathy were involved in this study. All these patients also complained about various associated atypical symptoms. They were followed up for 26 to 145 months after the surgery. Severity and frequency scores of the atypical symptoms before the surgery and at last follow-up were compared by paired t tests. Results Most patients reported significantly alleviated symptoms at the last follow-up compared with before the surgery. The severity of vertigo, headache, nausea, and palpitations were significantly alleviated at the last follow-up (with p values of p cervical spondylotic myelopathy and/or radiculopathy, but it is not effective in alleviating symptoms such as tinnitus, blurred vision, and hypomnesia. It can be considered for alleviating atypical symptoms when other treatment options prove ineffective. PMID:27168319

  20. Anterior cervical fusion versus minimally invasive posterior keyhole decompression for cervical radiculopathy

    Directory of Open Access Journals (Sweden)

    Richard M. Young

    2015-12-01

    Conclusion: ACDF has been demonstrated to be an effective surgical procedure in treating degenerative spine disease in patients with radiculopathy and/or myelopathy. However, in a population with isolated radiculopathy and radiological imaging confirming an anterolateral disc or osteophyte complex, the MIPKF can provide similar results without the associated risks that accompany an anterior cervical spine fusion.

  1. Anterior Cervical Discectomy with Arthroplasty versus Arthrodesis for Single-Level Cervical Spondylosis: A Systematic Review and Meta-Analysis

    OpenAIRE

    Aria Fallah; Elie A Akl; Shanil Ebrahim; Ibrahim, George M.; Alireza Mansouri; Foote, Clary J.; Yuqing Zhang; Fehlings, Michael G.

    2012-01-01

    OBJECTIVE: To estimate the effectiveness of anterior cervical discectomy with arthroplasty (ACDA) compared to anterior cervical discectomy with fusion (ACDF) for patient-important outcomes for single-level cervical spondylosis. DATA SOURCES: Electronic databases (MEDLINE, EMBASE, Cochrane Register for Randomized Controlled Trials, BIOSIS and LILACS), archives of spine meetings and bibliographies of relevant articles. STUDY SELECTION: We included RCTs of ACDF versus ACDA in adult patients with...

  2. Comparison of inpatient vs. outpatient anterior cervical discectomy and fusion: a retrospective case series

    OpenAIRE

    Friedman Jonathan A; Briner Rudy P; Liu Jeffrey T

    2009-01-01

    Abstract Background Spinal surgery is increasingly being done in the outpatient setting. We reviewed our experience with inpatient and outpatient single-level anterior cervical discectomy and fusion with plating (ACDF+P). Methods All patients undergoing single-level anterior cervical discectomy and fusion with plating between August 2005 and May 2007 by two surgeons (RPB or JAF) were retrospectively reviewed. All patients underwent anterior cervical microdiscectomy, arthrodesis using structur...

  3. Anterior Cervical Reconstruction Using Free Vascularized Fibular Graft after Cervical Corpectomy.

    Science.gov (United States)

    Addosooki, Ahmad Ibraheem; Alam-Eldin, Mohamed; Abdel-Wanis, Mohamed El-Sayed; Yousef, Mohamed Abdelhamid Ali; Dionigi, Paolo; Kenawey, Mohamed Omar

    2016-05-01

    Study Design Prospective study. Objective The aim of this study was to evaluate the clinical and radiologic results of using free vascularized fibular graft (FVFG) for anterior reconstruction of the cervical spine following with varying levels of corpectomy. Methods Ten patients underwent anterior cervical reconstruction using an FVFG after cervical corpectomy augmented with internal instrumentation. All patients were evaluated neurologically according to the Japanese Orthopaedic Association (JOA) and modified JOA scoring systems and the Nurick grading system. The neurologic recovery rate was determined, and the clinical outcome was assessed based on three factors: neck pain, dependence on pain medication, and ability to return to work. The fusion status and maintenance of lordotic correction by the strut graft were determined by measuring the lordosis angle and fused segment height (FSH). Results All patients achieved successful fusion. The mean follow-up period was 35.2 months (range, 28 to 44 months). Graft union occurred at a mean of 3.5 months. The mean loss of lordotic correction was 0.95 degrees, and the mean change in FSH was <1 mm. The neurologic recovery rate was excellent in four patients, good in five, and fair in one. All patients achieved satisfactory clinical outcome. No neurologic injuries occurred during the operations. Conclusion The use of FVFG is a valuable and effective technique in anterior cervical reconstruction for complex disorders. PMID:27099811

  4. Multilevel cervical spondylotic myelopathy treated by anterior cervical decompression in subsection and autograft fusion

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective:To investigate a novel surgical method for multilevel cervical spondylotic myelopathy (CSM). Methods: Totally 21 patients with multilevel CSM undergoing a novel surgical procedure from April 2001 to January 2004 were analyzed retrospectively. All patients experienced anterior cervical decompression surgery in subsection, autograft fusion and internal fixation. Preoperative, immediate postoperative and follow-up image data, X-rays and semi-quantitative Japanese orthopaedics association (JOA) scores were used to evaluate the restoration of lordosis (Cobb's angle), intervertebral heights, the stability of the cervical spine and the improvement of neurological impairment. Results: Preoperative symptoms were markedly alleviated or disappeared in most of the patients. According to the JOA scores, the ratio of improvement in neurological function was 72.2%, including excellent in 9 cases (42.9%), good in 7 cases (33.3%), fair in 3 cases (14.3%) and poor in 2 cases (9.5%). Immediate postoperative X-rays showed obvious improvements in lordosis and in the intervertebral height of the cervical spine (P<0.01). There is no evidence of instrument failure during the mean follow-up period of 14.2 months (9-24 months, P>0.01). Conclusion:Anterior cervical decompression in subsection, autograft fusion and internal fixation is a rational effective method for the surgical treatment of multilevel CSM.

  5. The advantages of submandibular gland resection in anterior retropharyngeal approach to the upper cervical spine

    OpenAIRE

    Skaf, Ghassan S.; Sabbagh, Amira S.; Hadi, Usamah

    2006-01-01

    Anterior surgery to the upper cervical spine, although rare, several successful approaches were described in the literature. To avoid the risks and limitations of transoral approach, the anterior retropharyngeal approach was developed. In this study, we describe our experience with anterior retropharyngeal approach to the upper cervical spine and discuss the significance of resecting the submandibular gland. From July 2001 to July 2004, we performed six anterior prevascular retropharyngeal ap...

  6. Anterior Cervical Osteophytes Causing Dysphagia and Dyspnea: An Uncommon Entity Revisited

    OpenAIRE

    Giger, Roland; Dulguerov, Pavel; Payer, Michael

    2007-01-01

    Large anterior cervical osteophytes can occur in degeneration of the cervical spine or in diffuse idiopathic skeletal hyperostosis (DISH). We present the case of an 83-year-old patient with progressive dysphagia and acute dyspnea, necessitating emergency tracheotomy. Voluminous anterior cervical osteophytes extending from C3 to C7 and narrowing the pharyngoesophageal segment by external compression and bilateral vocal fold immobility were diagnosed radiologically and by fiberoptic laryngoscop...

  7. Surgical Treatments on Patients with Anterior Cervical Hyperostosis-Derived Dysphagia

    OpenAIRE

    Song, Ah Rom; Yang, Hee Seung; Byun, Eunjin; Kim, Youngbae; Park, Kwan Ho; Kim, Kyung Lyul

    2012-01-01

    Anterior cervical hyperostosis may be a cause of dysphagia. For anterior cervical hyperostosis, medical or surgical treatments can be adhibited in view of the causative mechanisms and intensities of dysphagia. We report 3 cases of cervical hyperostosis-derived progressive dysphagia that underwent operation. Radiologic diagnosis and Video Fluoroscopic Swallowing Study were performed on the three patients for evaluation. One had history of recurrent aspiration pneumonia accompanied by weight lo...

  8. Freeze-dried fibular allograft in anterior spinal surgery: cervical and lumbar applications.

    OpenAIRE

    Wetzel, F.T.; Hoffman, M. A.; Arcieri, R. R.

    1993-01-01

    Fifty-six patients who underwent anterior fusion utilizing fibular allograft are reviewed. Thirty-two patients underwent multiple-level anterior cervical discectomy and fusion utilizing fibular strut allograft, and 24 underwent anterior lumbar discectomy and fusion using fibular strut allograft. Cervical surgery was performed via the strut technique of Whitecloud and LaRocca and lumbar surgery was performed via a transperitoneal or retroperitoneal approach. Postoperatively, patients were assi...

  9. Comparison between anterior cervical discectomy with fusion and anterior cervical corpectomy with fusion for the treatment of cervical spondylotic myelopathy: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Fei Q

    2015-11-01

    Full Text Available Qi Fei,* Jinjun Li,* Nan Su, Bingqiang Wang, Dong Li, Hai Meng, Qi Wang, Jisheng Lin, Zhao Ma, Yong Yang, Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China *These authors contributed equally to this work Background: Whether anterior cervical discectomy with fusion (ACDF or anterior cervical corpectomy with fusion (ACCF is superior in the treatment of cervical spondylotic myelopathy remains controversial. Therefore, we conducted a meta-analysis to quantitatively compare the efficacy and safety of ACDF and ACCF in the treatment of cervical spondylotic myelopathy.Methods: PubMed, Embase, Web of Science, SinoMed (Chinese BioMedical Literature Service System, People’s Republic of China, and CNKI (China National Knowledge Infrastructure, People’s Republic of China were systematically searched to identify all available studies comparing efficacy and safety between patients receiving ACDF and ACCF. The weighted mean difference (WMD was pooled to compare the Japanese Orthopaedic Association scores, visual analog scale scores, hospital stay, operation time, and blood loss. The risk ratio was pooled to compare the incidence of complications and fusion rate. Pooled estimates were calculated by using a fixed-effects model or a random-effects model according to the heterogeneity among studies.Results: Eighteen studies (17 observational studies and one randomized controlled trial were included in this meta-analysis. Our results suggest that hospital stay (WMD =-1.33, 95% confidence interval [CI]: -2.29, -0.27; P=0.014, operation time (WMD =-26.9, 95% CI: -46.13, -7.67; P=0.006, blood loss (WMD =-119.36, 95% CI: -166.94, -71.77; P=0.000, and incidence of complications (risk ratio =0.51, 95% CI: 0.33, 0.80; P=0.003 in the ACDF group were significantly less than that in the ACCF group. However, other clinical outcomes, including post-Japanese Orthopaedic Association score (WMD =-0.27, 95

  10. An anterior cervical retractor utilizing a novel principle.

    Science.gov (United States)

    Seex, Kevin A

    2010-05-01

    The alarmingly high soft-tissue complication rates after anterior cervical surgery suggests that the design of current retractors is inadequate. A review of retractor design and consideration of new designs is worthwhile. The author reviewed the literature and the 7 described devices (Cloward, Caspar, Thompson-Farley, Tresserras, Ozer, Takayasu, and Oh devices). With the exception of Cloward/Caspar and Thomson-Farley systems, the author's search of the literature failed to disclose any independent review or investigations of the other retractors, suggesting that the use of these devices is limited. The Cloward/Caspar-style retractors depend for stability on small teeth at the ends of the blades that impale and stretch the longus colli muscle. For stability this self-retaining design requires equal tissue counterpressure. These devices are thus ill suited for a wound with substantially greater pressure from the medial structures and are prone to migration. The Thomson-Farley type of systems use arms with mechanical joints fixed to a table-mounted frame. The releasable joints allow adjustability and independent relaxation. Their limitations include bulk causing obstruction to the surgeons and radiographs, increased setup time, and ease with which excessive force can be applied. The author describes a new anterior cervical retractor that is based on a novel principle. The principle is that bone fixation can be used to provide the retractor blade an axis of rotation inside the wound. This gives improved retractor blade stability with the mechanical advantage of a lever. The stable rotation produced allows adjustable retraction and tissue relaxation without compromise in stability. To the author's knowledge, there are no previously described retractors with this ability. The system consists of a small 2-piece sliding frame fixed to the spine with the distraction screws. Bone fixation is preferable to sharp teeth and longus colli dissection because it works better and

  11. Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease (Review)

    NARCIS (Netherlands)

    Jacobs, W.; Willems, P.C.P.H.; Limbeek, J. van; Bartels, R.H.M.A.; Pavlov, P.; Anderson, P.G.; Oner, C.

    2011-01-01

    BACKGROUND: The number of surgical techniques for decompression and solid interbody fusion as treatment for cervical spondylosis has increased rapidly, but the rationale for the choice between different techniques remains unclear. OBJECTIVES: To determine which technique of anterior interbody fusion

  12. Anterior cervical allograft arthrodesis and instrumentation: Multilevel interbody grafting or strut graft reconstruction

    OpenAIRE

    Swank, M. L.; Lowery, G. L.; Bhat, A. L.; McDonough, R. F.

    1997-01-01

    This retrospective study evaluated a single surgeon's series of patients treated by multilevel cervical disc excision (two or three levels), allograft tricortical iliac crest arthrodesis, and anterior instrumentation. The objective of this retrospective study was to compare fusion success and clinical outcome between multilevel Smith-Robinson interbody grafting and tricortical iliac strut graft reconstruction, both supplemented with anterior instrumentation in the cervical spine. The incidenc...

  13. Combined Anterior Approach with Transcorporeal Herniotomy for a Huge Migrated Cervical Disc Herniation

    OpenAIRE

    Choi, Kyung-Chul; Ahn, Yong; Lee, Choon Dae; Lee, Sang-Ho

    2011-01-01

    The report describes the herniation of a huge migrated cervical disc, which was treated by a combined anterior approach. A 50-year-old man presented with radiculopathy and myelopathy. Radiological images revealed the herniation of a huge disc which had migrated superiorly from the C6-7 disc to the C5-6 disc. We tried to combine an anterior cervical discectomy and fusion (ACDF) and transcorporeal herniotomy to avoid corpectomy. Postoperatively, successful clinical and radiological results were...

  14. Anterior Cervical Discectomy and Fusion Alters Whole-Spine Sagittal Alignment

    OpenAIRE

    Kim, Jang Hoon; Park, Jeong Yoon; Yi, Seong; Kim, Kyung Hyun; Kuh, Sung Uk; Chin, Dong Kyu; Kim, Keun Su; Cho, Yong Eun

    2015-01-01

    Purpose Anterior cervical discectomy and fusion (ACDF) has become a common spine procedure, however, there have been no previous studies on whole spine alignment changes after cervical fusion. Our purpose in this study was to determine whole spine sagittal alignment and pelvic alignment changes after ACDF. Materials and Methods Forty-eight patients who had undergone ACDF from January 2011 to December 2012 were enrolled in this study. Cervical lordosis, thoracic kyphosis, lumbar lordosis, sagi...

  15. Cervical vertebral column morphology and head posture in preorthodontic patients with anterior open bite

    DEFF Research Database (Denmark)

    Kim, Phong; Sarauw, Martin Toft; Sonnesen, Liselotte

    2014-01-01

    INTRODUCTION: Cervical vertebral column morphology and head posture were examined and related to craniofacial morphology in preorthodontic children and adolescents with anterior open bite. METHODS: One hundred eleven patients (ages, 6-18 years) with an anterior open bite of more than 0 mm were...

  16. Anterior cervical surgery methods for central cord syndrome without radiographic spinal fracture-dislocation

    Institute of Scientific and Technical Information of China (English)

    Chengwei JING; Qin FU; Xiaojun XU

    2009-01-01

    This study was aimed to explore the anterior cervical surgery methods to treat central cord syndrome without radiographic spinal fracture-dislocation (CCSWORFD), retrospectively analyze the cases of CCSWORFD, and evaluate the curative effect of anterior cervical surgery methods for CCSWORFD. Twenty four cases of CCSWORFD (19 males and 5 females), all suffering from cervical hyperextension injury, between 45-68 (average 59) years old, were operated on by anterior cervical surgery methods. Among these, 18 cases had been followed up for 6-24 (average 15) months; 18 cases, who had anterior decompression and plate fixation with titanium mesh bone grafting or iliac bone grafting achieved reliable effects based on the Japanese Orthopedics Association (JOA) evaluation (improved scores of cases with titanium mesh bone grafting, t = 2.800, P0.05). Most of these cases had degeneration of cervical vertebra. The decompression which relieves the oppression to the spinal cord can help lessen edema of the spinal cord, and early fixation for stability of cervical vertebra is better for the recovery of spinal cord injury. Anterior operation with titanium mesh bone grafting or iliac bone grafting are both reliable curative methods for CCSWORFD, and titanium mesh bone grafting can avoid the trauma of the supplying graft. Mesh bone grafting can also shorten hospital stay.

  17. Traumatic anterior cervical pseudomeningocele causing intracranial hypotension successfully treated with blood patch: case report.

    Science.gov (United States)

    Takahashi, Edwin A; Eckel, Laurence J; Diehn, Felix E; Schwartz, Kara M; Hunt, Christopher H; Daniels, David J

    2015-09-01

    Cervical pseudomeningocele is a rare complication of trauma. It develops when an extradural collection of cerebrospinal fluid (CSF) develops after a dural breach. The authors present the unusual case of a 33-year-old man with progressive headache, neck pain, mental status changes, and cardiopulmonary instability after polytrauma sustained from a motorcycle-versus-deer collision, without improvement during a 5-day hospitalization. Magnetic resonance imaging revealed a collection of CSF anterior to the cervical thecal sac compatible with an anterior cervical pseudomeningocele. A nontargeted epidural blood patch was performed with subsequent resolution of the patient's symptoms. Anterior cervical pseudomeningoceles are usually asymptomatic; however, these lesions can cause orthostatic headaches, neck pain, and cardiopulmonary compromise, as it did in the featured patient. Pseudomeningoceles should be included in the differential diagnosis for posttrauma patients with progressive neurological decline or postural headache, and blood patch may be an effective minimally invasive treatment. PMID:26023899

  18. Anterior cervical osteophytes causing dysphagia and dyspnea: an uncommon entity revisited.

    Science.gov (United States)

    Giger, Roland; Dulguerov, Pavel; Payer, Michael

    2006-10-01

    Large anterior cervical osteophytes can occur in degeneration of the cervical spine or in diffuse idiopathic skeletal hyperostosis (DISH). We present the case of an 83-year-old patient with progressive dysphagia and acute dyspnea, necessitating emergency tracheotomy. Voluminous anterior cervical osteophytes extending from C3 to C7 and narrowing the pharyngoesophageal segment by external compression and bilateral vocal fold immobility were diagnosed radiologically and by fiberoptic laryngoscopy. Surgical removal of all osteophytes led to the resolution of symptoms. Dyspnea with or without dysphagia caused by hypertrophic anterior cervical osteophytes is an uncommon entity. The exhaustive diagnostic workup proposed in the literature could be simplified by using fiberoptic laryngoscopy and dynamic videofluoroscopy. The causes, treatment, and outcome are discussed. PMID:17216390

  19. Efficacy of PEEK Cages and Plate Augmentation in Three-Level Anterior Cervical Fusion of Elderly Patients

    OpenAIRE

    Song, Kyung Jin; Kim, Gyu Hyung; Choi, Byeong Yeol

    2011-01-01

    Background To evaluate the clinical efficacy of three-level anterior cervical arthrodesis with polyethyletherketone (PEEK) cages and plate fixation for aged and osteoporotic patients with degenerative cervical spinal disorders. Methods Twenty one patients, who had undergone three-level anterior cervical arthrodesis with a cage and plate construct for degenerative cervical spinal disorder from November 2001 to April 2007 and were followed up for at least two years, were enrolled in this study....

  20. One stage anterior-posterior approach for traumatic at- lantoaxial instability combined with subaxial cervical spinal cord injury

    Directory of Open Access Journals (Sweden)

    WANG Chang-sheng

    2011-06-01

    Full Text Available 【Abstract】 Objectives: To explore the clinical fea- tures of traumatic atlantoaxial instability combined with subaxial cervical spinal cord injury (CSCI, and to analyze the feasibility, indication and therapeutic effects of ante- rior-posterior approach in such cases. Methods: From March 2004 to September 2009, 16 cases with this trauma were admitted and surgically treated in our department. Before surgery, skull traction was performed. Posterior atlantoaxial pedicle screw internal fixa- tion and bone graft fusion were conducted to manage trau- matic atlantoaxial instability . As for subaxial CSCI, anterior cervical corpectomy or discectomy decompression, bone grafting and internal fixation with steel plates were applied. Results: All operations were successful. The average operation time was 3 hours and operative blood loss 400 ml. Satisfactory reduction of both the upper and lower cervical spine and complete decompression were achieved. All pa- tients were followed up for 12 to 36 months. Their clinical symptoms were improved by various levels. The Japanese Orthopaedic Association (JOA scores ranged from 10 to 16 one year postoperatively, 13.95±2.06 on average (improvement rate=70.10%. X-rays, spiral CT and MRI con- firmed normal cervical alignments, complete decompression and fine implants’ position. There was no breakage or loos- ening of screws, nor exodus of titanium mesh or implanted bone blocks. The grafted bone achieved fusion 3-6 months postoperatively and no atlantoaxial instability was observed. Conclusions: Traumatic atlantoaxial instability may combine with subaxial CSCI, misdiagnosis of which should be especially alerted and avoided. For severe cases, one stage anterior-posterior approach to decompress the upper and lower cervical spine, together with reposition, bone grafting and fusion, as well as internal fixation can immedi- ately restore the normal alignments and stability of the cer- vical spine and effectively

  1. Value of intraoperative neurophysiological monitoring to reduce neurological complications in patients undergoing anterior cervical spine procedures for cervical spondylotic myelopathy.

    Science.gov (United States)

    Thirumala, Parthasarathy D; Muralidharan, Aditya; Loke, Yoon K; Habeych, Miguel; Crammond, Donald; Balzer, Jeffrey

    2016-03-01

    The primary aim of this study was to conduct a systematic review of reports of patients with cervical spondylotic myelopathy and to assess the value of intraoperative monitoring (IOM), including somatosensory evoked potentials, transcranial motor evoked potentials and electromyography, in anterior cervical procedures. A search was conducted to collect a small database of relevant papers using key words describing disorders and procedures of interest. The database was then shortlisted using selection criteria and data was extracted to identify complications as a result of anterior cervical procedures for cervical spondylotic myelopathy and outcome analysis on a continuous scale. In the 22 studies that matched the screening criteria, only two involved the use of IOM. The average sample size was 173 patients. In procedures done without IOM a mean change in Japanese Orthopaedic Association score of 3.94 points and Nurick score by 1.20 points (both less severe post-operatively) was observed. Within our sub-group analysis, worsening myelopathy and/or quadriplegia was seen in 2.71% of patients for studies without IOM and 0.91% of patients for studies with IOM. Variations persist in the existing literature in the evaluation of complications associated with anterior cervical spinal procedures. Based on the review of published studies, sufficient evidence does not exist to make recommendations regarding the use of different IOM modalities to reduce neurological complications during anterior cervical procedures. However, future studies with objective measures of neurological deficits using a specific IOM modality may establish it as an effective and reliable indicator of injury during such surgeries. PMID:26677786

  2. The Effect of the PEEK Cage on the Cervical Lordosis in Patients Undergoing Anterior Cervical Discectomy

    OpenAIRE

    Salih Gulsen

    2015-01-01

    BACKGROUND: Loss of cervical lordosis is a significant factor in the development of degeneration of the spine with aging. This degenerative changings of the cervical spine would cause pressure effect on the cervical root and/or medulla spinalis. AIM: Our goal is to understand the effect of the PEEK cage on cervical lordosis in the early postoperative period. Also, to interpret the effects of one- level, two- level, three-level and four- level disc pathologies on cervical lordosis. MAT...

  3. A Prospective Study of the Functional Outcome of Anterior Cervical Discectomy With Fusion in Single Level Degenerative Cervical Disc Prolapse

    Science.gov (United States)

    Kamani, Mayur M; Shetty, Vikram; Rai, H. Ravindranath; Hegde, Deepak

    2016-01-01

    Introduction Cervical spondylotic myelo-radiculopathy is a form of spinal cord dysfunction syndrome and usually accompanies age related degeneration of the spine. Aim To determine the functional outcome of anterior cervical discectomy with fusion and plating in single level degenerative cervical disc prolapse. Materials and Methods A total of 20 patients diagnosed with degenerative single level cervical disc prolapse who presented to the Department of Orthopaedic Surgery, Justice KS Hegde Charitable Hospital, Mangalore from the period of November 2012 to May 2014 were enrolled in the study. Complete clinical and radiological evaluation of the patients was done. A trial of conservative management was tried in all these patients for a period of two months. They were taken up for surgery only when conservative management had failed. Scoring of neck function before the surgery was done as per the Modified Japanese Orthopaedic Association (MJOA) score. All patients underwent anterior cervical discectomy and fusion (ACDF) with tricortical iliac crest bone grafting. Fixation was performed with titanium locking cervical plates. All patients were reviewed at 6 weeks and 6 months postoperatively. Assessment of neck function was done as per the MJOA scoring during all the reviews. Radiographic assessment was also done during all the reviews. The complications noted were documented. The statistical analysis was done using percentages; the arithmetic mean was calculated using SPSS software (version 16.0). Results Amongst the 20 patients included in the study, 1 patient died postoperatively due to oesophageal rupture. of the remaining 19 patients reviewed and followed up, all of them had improvement of symptoms and were reported to be in the ‘mild category’ as per the MJOA score. One patient developed dysphonia, in the immediate postoperative period due to recurrent laryngeal nerve palsy which recovered in a period of three months postoperative. Conclusion Single level

  4. Clinical application of anterior cervical decompression and fusion under METRx system

    Institute of Scientific and Technical Information of China (English)

    ZHOU Yue; ZHANG Xia; WANG Wei-dong; LI Chang-qing; CHU Tong-wei; ZHANG Zheng-feng; WANG Jian; ZHENG Wen-jie

    2005-01-01

    Objective: To explore the feasibility and effect of anterior cervical decompression and fusion under METRx system. Methods: Between Nov. 2001 and Nov. 2003, totally 23 consecutive patients were performed anterior cervical decompression and fusion under METRx system. The clinical outcome was evaluated by Odom standard. Results: Decompression and fusion along with internal fixation was obtained in all the 23 patients with minimal tissue damage and operation-caused scar. There were no wound infection, neurological injuries, throat discomfort and other complications. The total rate of excellent and good outcome in patients with degenerative cervical diseases was 94%. Conclusion: Cervical decompression and fusion can be performed under METRx system with its own advantages, such as minimal tissue damage and operation-caused scar, less throat discomfort.

  5. The NEtherlands Cervical Kinematics (NECK) Trial. Cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in the treatment of cervical disc herniation; A double-blind randomised multicenter study

    NARCIS (Netherlands)

    M.P. Arts (Mark); R. Brand (René); B.W. Koes (Bart); W.C. Peul (Wilco); M.E. van den Akker (Elske)

    2010-01-01

    textabstractBackground. Patients with cervical radicular syndrome due to disc herniation refractory to conservative treatment are offered surgical treatment. Anterior cervical discectomy is the standard procedure, often in combination with interbody fusion. Accelerated adjacent disc degeneration is

  6. Multisegmental cervical ossification of the posterior longitudinal ligament: Anterior vs posterior approach

    OpenAIRE

    Jain Subodh; Salunke Pravin; Vyas K; Behari Sanjay; Banerji Deepu; Jain Vijendra

    2005-01-01

    Aims : To determine the surgical approach in patients with multisegmental (four or more segments) OPLL of the cervical spine. Methods and Materials : Data of 27 patients who had undergone either an anterior (corpectomy with excision of OPLL and interbody fusion=14 patients) or posterior approach (laminectomy=12, laminoplasty=1 patient) for the multisegmental cervical OPLL was analyzed retrospectively. The patients in each group were statistically similar in respect to preoperative factors su...

  7. Simultaneously Combined Anterior-Posterior Approaches for Subaxial Cervical Circumferential Reconstruction in a Sitting Position.

    Science.gov (United States)

    Han, Yue; Xia, Qun; Hu, Yong-cheng; Zhang, Ji-dong; Lan, Jie; Ma, Xin-long

    2015-11-01

    The purpose of this article is to introduce and analyze the feasibility of simultaneously combined anterior-posterior approaches for subaxial cervical circumferential reconstruction in sitting position. A retrospective case review was performed for above surgery procedure. A 79-year-old man was confirmed subaxial cervical fracture and dislocation with facet locked by radiological examination, and the involved levels were C5-6. According to American Spinal Injury Association (ASIA) classification, the impairment scale was grade B. And the Subaxial Cervical Spine Injury and Severity Score (SLIC) were 9. The patient was restricted in sitting position with traction on a halo in extension to immobilize the head during the operation. A posterior laminectomy and pedicle screws insertion to the involved cervical spine was performed firstly. And then the anterior discectomy and strut graft were accomplished through an anterior cervical approach. The final fixation was finished by clamping the strut graft with pedicle screw system. Total blood loss was 600 ml and the total operating time was 150 min. The patient was followed up for 6 months. The symptom of neck pain improved distinctly and no evidence about implant failure was noted. Neurological status improvement was confirmed and the ASIA scale was improved to grade C. We believed that the simultaneously combined anterior-posterior approach in sitting position was safe and more advantageous for appropriate cases. PMID:26790982

  8. Avaliação retrospectiva de artrodese cervical com enxerto autólogo versus hidroxiapatita Estudio retrospectivo de la artrodesis cervical con autoinjerto versus hidroxiapatita Retrospective study of cervical arthrodesis with autograft versus hydroxyapatite graft

    Directory of Open Access Journals (Sweden)

    Yoshinobu Nagasse

    2010-12-01

    Full Text Available OBJETIVO: os autores realizaram um estudo e compararam o resultado radiográfico no uso de hidroxiapatita e enxerto de crista ilíaca (autólogo no tratamento cirúrgico de hérnia discal cervical em um nível, sendo realizada artrodese cervical anterior com placa. MÉTODOS: foi realizado estudo retrospectivo com pacientes submetidos à artrodese cervical comparando-se dois grupos de dez pacientes: um em que foi utilizado enxerto de hidroxiapatita e outro em que foi utilizado enxerto de crista ilíaca (autólogo. Radiografias pós-operatórias foram mensuradas e comparadas, à busca de perdas de alinhamento angular. RESULTADOS: os dois tipos de enxerto demonstraram manter alinhamento em taxas similares, sendo observada consolidação óssea em todos os pacientes. O estudo não mostrou fragmentação do enxerto de hidroxiapatita ou soltura do material de síntese. CONCLUSÃO: nesta pequena série de casos não foi observada diferença significativa entre os resultados da artrodese cervical anterior com enxerto de hidroxiapatita em relação ao enxerto autólogo de ilíaco.OBJETIVOS: los autores realizaram un estudio y compararon el resultado radiográfico en el uso del hidroxiapatita y injerto de cresta ilíaca (autólogo, en el tratamiento quirúrgico de hernia discal cervical en un nivel, siendo realizada artrodesis cervical anterior con placa. MÉTODOS: fue realizado un estudio retrospectivo con pacientes, que habían sido sometidos a la artrodesis cervical con injerto de hidroxiapatita o injerto de cresta iliaca b.z autologa. Las radiografías postoperatorias habían sido mensuradas y comparadas, buscando para las pérdidas de alineación angular. RESULTADOS: los dos tipos de injerto habían demostrado manutención de alineación similares, donde la consolidación fue observada en todos los pacientes. El estudio no demostró la fragmentación del injerto de hidroxiapatita o de soltar el material de síntesis. CONCLUSIÓN: en esta peque

  9. Surgical results and MRI findings of cervical myelopathy treated with anterior decompression and fusion

    International Nuclear Information System (INIS)

    We reviewed 19 patients with cervical myelopathy treated with anterior decompression and fusion. Etiology of cervical myelopathy was cervical disc herniation (CDH) in 13 patients and cervical spondylosis (CSM) in 6. Clinical recovery rate (%) was calculated from preoperative cervical myelopathy score (JOA) and the score at follow-up. Correlation between the clinical recovery rate and MRI findings (area and flatness at the narrowest part of the spinal cord), age at surgery, duration of myelopathy and pre-operative clinical score were analyzed separately in the CDH and CSM groups. Clinical recovery rate averaged 69% in the CDH group and 75% in the CSM group. In the CDH group, average clinical recovery rate in patients younger than 60 years was 80 and in patients over 60 years was 60. There was a significant negative correlation between the clinical recovery rate and age at surgery (p<0.05). No significant correlation was found between the clinical recovery rate and other factors investigated. (author)

  10. Risk Factors for the Development of Adjacent Segment Disease Following Anterior Cervical Arthrodesis

    OpenAIRE

    Ezgi Akar; Mehmet Ufuk Akmil; Merih İş

    2015-01-01

    Aim: The aim of this study was to clinically and radiologically evaluate the efficacy of anterior cervical discectomy and fusion (ACDF) in the treatment of adjacent level degeneration. Methods: We retrospectively evaluated 89 patients (55 females, 34 males) who underwent ACDF. Adjacent segment degeneration findings were evaluated by investigating new osteophyte formation, growth of existing osteophytes, ossification of the anterior longitudinal ligament, presence of inter...

  11. Cervical nerve root decompression by lateral approach as salvage operation after failed anterior transdiscal surgery: technical case report

    OpenAIRE

    Cornelius, Jan Frédérick; George, Bernard

    2009-01-01

    Cervical nerve root compression caused by disco-osteophytic changes is classically operated by anterior transdiscal approach with disc replacement. If compression persists or recurs, reoperation via the same surgical route may be difficult, because of scar tissue and/or implants. An alternative approach may be necessary. We recommend the lateral cervical approach (retrojugular) as salvage operation in such cases. We report a patient with cervical nerve root compression operated by anterior tr...

  12. Total Disc Arthroplasty and Anterior Cervical Discectomy and Fusion in Cervical Spine: Competitive or Complimentary? Review of the Literature

    OpenAIRE

    Jawahar, Ajay; Nunley, Pierce

    2012-01-01

    Anterior cervical discectomy and arthrodesis has come to represent standard of care for patients with persistent radicular and/or myelopathic symptoms that have failed to improve with conservative treatments. One potential complication of the procedure is the accelerated degeneration of the vertebrae and the intervertebral discs adjacent to the level fused and the effects of fusion on those levels. The concern that fusion may be a contributing factor to accelerated adjacent segment degenerati...

  13. Esophageal, pharyngeal and hemorrhagic complications occurring in anterior cervical surgery: Three illustrative cases

    OpenAIRE

    Víctor Rodrigo Paradells; Juan Bosco Calatayud Pérez; Francisco Javier Díaz Vicente; Luciano Bances Florez; Marta Claramonte de la Viuda; Francisco Javier Villagrasa

    2014-01-01

    Background: The number of esophageal and pharyngeal perforations occurring in anterior cervical surgeries ranges from 0.25% to 1% and 0.2% to 1.2%, respectively. Symptoms usually appear postoperatively and are attributed to: Local infection, fistula, sepsis, or mediastinitis. Acute postoperative hematoma, although very rare (

  14. Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease

    NARCIS (Netherlands)

    Jacobs, Wilco; Willems, Paul C.; van Limbeek, Jacques; Bartels, Ronald; Pavlov, Paul; Anderson, Patricia G.; Oner, Cumhur

    2011-01-01

    Background The number of surgical techniques for decompression and solid interbody fusion as treatment for cervical spondylosis has increased rapidly, but the rationale for the choice between different techniques remains unclear. Objectives To determine which technique of anterior interbody fusion g

  15. Biomechanics of Hybrid Anterior Cervical Fusion and Artificial Disc Replacement in 3-Level Constructs: An In Vitro Investigation

    OpenAIRE

    Liao, Zhenhua; Fogel, Guy R.; Pu, Ting; Gu, Hongsheng; Liu, Weiqiang

    2015-01-01

    Background The ideal surgical approach for cervical disk disease remains controversial, especially for multilevel cervical disease. The purpose of this study was to investigate the biomechanics of the cervical spine after 3-level hybrid surgery compared with 3-level anterior cervical discectomy and fusion (ACDF). Material/Methods Eighteen human cadaveric spines (C2-T1) were evaluated under displacement-input protocol. After intact testing, a simulated hybrid construct or fusion construct was ...

  16. The Effect of the PEEK Cage on the Cervical Lordosis in Patients Undergoing Anterior Cervical Discectomy

    Directory of Open Access Journals (Sweden)

    Salih Gulsen

    2015-03-01

    CONCLUSION: We achieved better cervical lordotic angles at the postoperative period by implanting one-level, two-level, three-level or four-level PEEK cage filled with demineralized bone matrix. Also, the causes of cervical root and or medulla spinalis impingement were different in group1 and 2. While extruded cervical disc impingement was the first pathology in group 1, osteophyte formation was the first pathology in group 2.

  17. Postoperative Cervical Haematoma Complicated by Ipsilateral Carotid Thrombosis and Aphasia after Anterior Cervical Fusion: A Case Report

    Directory of Open Access Journals (Sweden)

    Kingsley R. Chin

    2013-01-01

    Full Text Available Hematoma alone is the most common vascular complication reported after anterior cervical decompression and fusion (ACDF. We present this case to report the occurrence of postoperative cervical hematoma complicated by ipsilateral carotid thrombosis and aphasia after an uncomplicated C4–6 ACDF. This is a case of a 65-year-old woman who underwent revision fusions of the C4-5 and C6-7 levels complicated by postoperative cervical hematoma and carotid thrombosis. The patient's history, clinical examination, imaging findings, and treatment are reported. The revision fusions were performed and deemed routine. Approximately eight hours later 200 mL of blood was evacuated from a postoperative cervical hematoma. The patient became unresponsive and disoriented a few hours after evacuating the hematoma. Computed tomography and magnetic resonance imaging of the brain were normal, but magnetic resonance angiography demonstrated total occlusion of the left carotid artery. Thrombectomy was performed and the patient was discharged without residual deficits. At the latest followup she is fully functional and asymptomatic in her neck. We suggest, after evacuating a cervical hematoma, an evaluation of the carotids be made with MRA or cerebral angiography, as this may demonstrate a clot before the patient develops symptoms.

  18. MRI of anterior spinal artery syndrome of the cervical spinal cord

    International Nuclear Information System (INIS)

    Cervical spinal cord lesions in the anterior spinal artery syndrome were delineated on magnetic resonance images (MRI) in four patients. The lesion was always seen anteriorly in the cervical cord. On T2-weighted images, the lesions appeared hyperintense relative to the normal spinal cord, while on T1-weighted images, two chronic lesions appeared hypointense, with local atrophy of the cord. In one case, repeated T1-weighted images showed no signal abnormality 4 days after the ictus, but the lesion became hypointense 18 days later, when contrast enhancement was also recognized after injection of Gd-DTPA; this sequence of intensity changes was similar to that of cerebral infarction. The extent of the lesion seen MRI correlated closely with neurological findings in all cases. Although the findings may not be specific, MRI is now the modality of choice for confirming the diagnosis in patients suspected of having an anterior spinal artery syndrome. (orig.)

  19. A systematic study of techniques for elective cervical nodal irradiation with anterior or opposed anterior and posterior beams

    International Nuclear Information System (INIS)

    Purpose: To assess target coverage and dose homogeneity using conventional radiotherapy (RT) and intensity-modulated RT (IMRT) with anterior and posterior beams for elective irradiation of the cervical lymph nodes in patients with head and neck cancer. Materials and methods: A planning study was performed in six patients who had undergone radical RT for head and neck cancer. RT plans to irradiate the cervical lymph nodes using a single anterior field, or opposed anterior and posterior fields, with 6 or 10 MV photons were compared. Plans using IMRT for missing-tissue compensation were also studied. An algorithm was developed to guide clinicians to the most appropriate treatment technique depending on the nodal groups to be irradiated. Results: With 6 MV single field (SF) irradiation significant under-dose (minimum dose <70% of prescription dose) was seen in nodal groups II and V, due to their posterior position. With SF 10 MV the mean dose to level II was higher (p<0.001) and dose homogeneity to levels Ib and II was improved. Using opposed fields (OF), minimum doses to the nodes in levels II and V were improved. OF using 10 MV showed significant advantage over 6 MV with reduction of maximum doses to levels II, III and V. SF 10 MV IMRT improved maximum doses to levels Ib and II compared to SF 6 MV IMRT. OF IMRT gave the best dose distributions with optimal mean dose and dose homogeneity. Beam energy made no difference with OF IMRT. Conclusions: The optimal technique for elective cervical node irradiation depends on the lymph node levels within the PTV. If irradiation of the level II or V nodes is required, then the OF IMRT technique with either 6 or 10 MV gives the best dose distributions. In the absence of IMRT, then OF conventional techniques are best. If the aim is to irradiate levels III and IV or level IV only, then 6 MV SF non-IMRT is the simplest technique

  20. [Anterior approach of cervical spine in Pott's disease. Apropos of 7 cases].

    Science.gov (United States)

    Achouri, M; Hilmani, S; Lakhdar, H; Ait Ben Ali, S; Naja, A; Ouboukhlik, A; el Kamar, A; el Azhari, A; Boucetta, M

    1997-01-01

    This study reports 7 cases of cervical Pott's disease, gathered during 6 years in the department of neuro-surgery of Ibn Rochd U.H.C. 4 females and 3 males, aged between 9 and 52 years were included. All the patients complained of cervicobrachial pain and weakness of the limbs. Clinical features were: deterioration of general status, rachidian syndrome and neurological impairement with motor and sensitive deficit. Radiological analysis found a destructive and extensive lesion, cervical kyphosis from 10 degrees to 60 degrees, retropharyngeal abscess and intraspinal canal extension of infection. Diagnosis was confirmed by histological study in all cases. In addition to antituberculous therapy and preoperative cervical traction in 4 cases, all the patients had spinal fusion using an anterior approach. Post operative immobilization in a cervical collar varied from 9 to 12 months. All 7 patients had full neurological recovery, 6 patients had an excellent bony fusion and cervical kyphosis was corrected. For the remaining patient, the bone graft was mobilized without neurological disorders. This study confirms anterior arthrodesis efficiency. This procedure in conjunction with preoperative traction, allowed stabilization of the spine and healing of vertebral lesions with excellent kyphosis correction. PMID:9452797

  1. Acquired Pharyngeal Diverticulum after Anterior Cervical Fusion Operation Misdiagnosed as Typical Zenker Diverticulum.

    Science.gov (United States)

    Park, Jong Myung; Kim, Chang Wan; Kim, Do Hyung

    2016-08-01

    A pharyngeal diverticulum is a rare complication of an anterior cervical discectomy and fusion (ACDF). We present a case of a pharyngeal diverticulum after an ACDF, which was misdiagnosed as a typical Zenker diverticulum. A 54-year-old woman presented with dysphagia and a sense of irritation in the neck following C5 through C7 cervical fusion 3 years prior. The patient underwent open surgery to resect the diverticulum with concurrent cricopharyngeal myotomy. An ACDF-related diverticulum is difficult to distinguish from a typical Zenker diverticulum. PMID:27525244

  2. Dynamic Cervical Implant versus Anterior Cervical Diskectomy and Fusion: A Prospective Study of Clinical and Radiologic Outcome.

    Science.gov (United States)

    Richter, Heiko; Seule, Martin; Hildebrandt, Gerhard; Fournier, Jean-Yves

    2016-07-01

    Objective To evaluate clinical and radiologic outcome in patients treated with a dynamic cervical implant (DCI) or anterior cervical diskectomy and fusion (ACDF). Study Design A prospective comparative cohort study. Methods The study included 60 patients with one- or two-level cervical degenerative disk disease (DDD) undergoing treatment with either DCI (n = 30) or ACDF (n = 30). Clinical and radiologic outcomes were assessed 3 and 12 months after surgery. Clinical scoring systems included the Visual Analog Scale for Neck (VAS-N) and Arm pain (VAS-A), the Neck Pain and Disability Scale (NPAD), and the European Quality of Life Scale (EQ-5D). Results Both the DCI and ACDF group showed significant clinical improvement 12 months after surgery using the VAS-N (p = 0.034 and p clinical outcome comparing both groups at the 3- and 12-month follow-up. The fusion rate at 12 months after surgery was 39.4% and 80.0% in the DCI and ACDF groups, respectively. Radiolucency was found in 90.9% in the DCI group at 12-month follow-up. Conclusion The clinical results for DCI treatment are equivalent to those for ACDF in the treatment of one- and two-level cervical DDD at 12 months after surgery. Further studies are necessary to investigate the high rates of radiolucency and fusion associated with DCI treatment. PMID:27088592

  3. Anterior cervical discectomy with arthroplasty versus arthrodesis for single-level cervical spondylosis: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Aria Fallah

    Full Text Available OBJECTIVE: To estimate the effectiveness of anterior cervical discectomy with arthroplasty (ACDA compared to anterior cervical discectomy with fusion (ACDF for patient-important outcomes for single-level cervical spondylosis. DATA SOURCES: Electronic databases (MEDLINE, EMBASE, Cochrane Register for Randomized Controlled Trials, BIOSIS and LILACS, archives of spine meetings and bibliographies of relevant articles. STUDY SELECTION: We included RCTs of ACDF versus ACDA in adult patients with single-level cervical spondylosis reporting at least one of the following outcomes: functionality, neurological success, neck pain, arm pain, quality of life, surgery for adjacent level degeneration (ALD, reoperation and dysphonia/dysphagia. We used no language restrictions. We performed title and abstract screening and full text screening independently and in duplicate. DATA SYNTHESIS: We used random-effects model to pool data using mean difference (MD for continuous outcomes and relative risk (RR for dichotomous outcomes. We used GRADE to evaluate the quality of evidence for each outcome. RESULTS: Of 2804 citations, 9 articles reporting on 9 trials (1778 participants were eligible. ACDA is associated with a clinically significant lower incidence of neurologic failure (RR = 0.53, 95% CI = 0.37-0.75, p = 0.0004 and improvement in the Neck pain visual analogue scale (VAS (MD = 6.56, 95% CI = 3.22-9.90, p = 0.0001; Minimal clinically important difference (MCID = 2.5. ACDA is associated with a statistically but not clinically significant improvement in Arm pain VAS and SF-36 physical component summary. ACDA is associated with non-statistically significant higher improvement in the Neck Disability Index Score and lower incidence of ALD requiring surgery, reoperation, and dysphagia/dysphonia. CONCLUSIONS: There is no strong evidence to support the routine use of ACDA over ACDF in single-level cervical spondylosis. Current trials lack long-term data required to

  4. Anterior cervical discectomy and fusion: Comparison of titanium and polyetheretherketone cages

    OpenAIRE

    Cabraja Mario; Oezdemir Soner; Koeppen Daniel; Kroppenstedt Stefan

    2012-01-01

    Abstract Background Titanium (TTN) cages have a higher modulus of elasticity when compared with polyetheretherketone (PEEK) cages. This suggests that TTN-cages could show more frequent cage subsidence after anterior cervical discectomy and fusion (ACDF) and therefore might lead to a higher loss of correction. We compared the long term results of stand-alone PEEK- and TTN-cages in a comparable patient collective that was operated under identical operative settings. Methods From 2002 to 2007 15...

  5. Fibular Allograft After Anterior Cervical Corpectomy: Long Term Follow-Up

    OpenAIRE

    McKoy, Brodie E; Wingate, Jeffrey K; Poletti, Steven C; Johnson, Donald R.; Stanley, Mark D; Glaser, John A.

    2002-01-01

    The purpose of this study was to provide clinical and radiographic evaluation after a minimum of two years in patients who had an anterior cervical corpectomy and a fibular allograft strut. Nineteen patients returned for a follow-up visit which included independent radiographic evaluation as well as completing a Visual Analogue Scale and Oswestry and Short-Form 36 questionnaires. The categories of fusion were as follows: 1) definitely fused (84%) 2) questionably fused (11%) 3) definitely not ...

  6. Factors influencing surgical outcome after anterior stabilization of the cervical spine with heterogeneous material

    OpenAIRE

    Petridis, Athanasios K.; Sabrina Sechting; Michael Budde; Alexandros Doukas; Homajoun Maslehaty; Hubertus Maximilian Mehdorn

    2012-01-01

    Intervertebral fusion through an anterior approach with polymethylacrylate is a well-established neurosurgical technique in the treatment of cervical spine degeneration. However, questions still remain concerning the post-surgical outcome. Factors influencing surgical outcome that could help to predict which patients need further post-surgical treatment and what to expect after surgery are the subject of numerous studies. In the present study, we retrospectively collected data from patients w...

  7. Kinematic Changes in Swallowing After Surgical Removal of Anterior Cervical Osteophyte Causing Dysphagia: A Case Series

    OpenAIRE

    Jeong, Hyeonghui; Seo, Han Gil; Han, Tai Ryoon; Chung, Chun Kee; Oh, Byung-Mo

    2014-01-01

    This retrospective case series included five patients who underwent surgical resection of the cervical anterior osteophyte due to dysphagia. Videofluoroscopic swallowing studies (VFSSs) were performed before and after surgery on each patient, and kinematic analysis of the video clips from the VFSS of a 5-mL liquid barium swallow was carried out. Functional oral intake improved after surgery in 3/4 patients who had required a modified diet before surgery. Kinematic analysis showed increases in...

  8. Anterior Cervical Osteophytes Causing Dysphagia and Paradoxical Vocal Cord Motion Leading to Dyspnea and Dysphonia

    OpenAIRE

    Seo, Joon Won; Park, Ji Woong; Jang, Jae Chil; Kim, Jae Wook; Lee, Yang Gyun; Kim, Yun Tae; Lee, Seok Min

    2013-01-01

    Anterior cervical osteophytes are common and usually asymptomatic in elderly people. Due to mechanical compressions, inflammations, and tissues swelling of osteophytes, patients may be presented with multiple complications, such as dysphagia, dysphonia, dyspnea, and pulmonary aspiration. Paradoxical vocal cord motion is an uncommon disease characterized by vocal cord adductions during inspiration and/or expiration. This condition can create shortness of breath, wheezing, respiratory stridor o...

  9. Systematic review of anterior interbody fusion techniques for single- and double-level cervical degenerative disc disease

    NARCIS (Netherlands)

    Jacobs, W.; Willems, P.C.P.H.; Kruyt, M.; Limbeek, J. van; Anderson, P.G.; Pavlov, P.; Bartels, R.H.M.A.; Oner, C.

    2011-01-01

    STUDY DESIGN: A systematic review of randomized controlled trials. OBJECTIVE: To determine which technique of anterior cervical interbody fusion (ACIF) gives the best outcome in patients with cervical degenerative disc disease. SUMMARY OF BACKGROUND DATA: The number of surgical techniques for decomp

  10. Risk Factors for the Development of Adjacent Segment Disease Following Anterior Cervical Arthrodesis

    Directory of Open Access Journals (Sweden)

    Ezgi Akar

    2015-06-01

    Full Text Available Aim: The aim of this study was to clinically and radiologically evaluate the efficacy of anterior cervical discectomy and fusion (ACDF in the treatment of adjacent level degeneration. Methods: We retrospectively evaluated 89 patients (55 females, 34 males who underwent ACDF. Adjacent segment degeneration findings were evaluated by investigating new osteophyte formation, growth of existing osteophytes, ossification of the anterior longitudinal ligament, presence of intervertebral disc space narrowing, sagittal alignment and range of motion (ROM using serial radiographs and magnetic resonance imaging. Results: The mean age of the 89 patients was 41.3 (24-76 years. The mean follow-up duration was 34.3 (12-64 months. Radiographic evidence of adjacent segment degeneration was observed in 12 patients (13.4%. Nine (75% patients had new complaints. Of the patients who had degenerative changes, 7 were (58% were male, 5 (42% were female; the mean age was 46 (30- 62 years. It was observed that the level of fusion and the number of fusion did not increase the adjacent segment degeneration. All of 12 patients were observed to have a non lordotic cervical spine and increased ROM. Conclusion: Development of degeneration at the level adjacent to region anterior cervical discectomy and fusion performed is higher compared to non-adjacent levels. The level of fusion and the number of fusion levels have no effect on the development of degeneration. (The Medical Bulletin of Haseki 2015; 53:120-3

  11. Cervical ossification of the posterior longitudinal ligament: Anterior versus posterior approach

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    Dasheng Lin

    2012-01-01

    Full Text Available Background: The optimal approach to provide satisfactory decompression and minimize complications for ossification of the posterior longitudinal ligament (OPLL involving multiple levels (3 levels or more remains controversial. The purpose of this study was to compare the results of two surgical approaches for cervical OPLL involving multiple levels; anterior direct decompression and fixation, and posterior indirect decompression and fixation. We present a retrospective review of 56 cases followed at a single Institution. Materials and Methods: We compared patients of multiple levels cervical OPLL that were treated at a single institution either with anterior direct decompression and fixation or with posterior indirect decompression and fixation. The clinical records of the patients with a minimum duration of follow-up of 2 years were reviewed. The associated complications were recorded. Results: Fifty-six patients constitute the clinical material. 26 cases were treated by anterior corpectomy and fixation and 30 cases received posterior laminectomy and fixation. The two populations were similar. It was found that both anterior and posterior decompression and fixation can achieve satisfactory outcomes, and posterior surgery was accomplished in a shorter period of time with lesser blood loss. Although patients had comparable preoperative Japanese Orthopaedics Association (JOA scores, those with a canal occupancy by OPLL more than 50% and managed anteriorly had better outcomes. However, for those with more severe stenosis, anterior approach was more difficult and associated with higher risks and complications. Despite its limitations in patients with high occupancy OPLLs, through the multiple level laminectomy, posterior fixation can achieve effective decompression, maintaining or restoring stability of the cervical spine, and thereby improving neural outcome and preventing the progression of OPLL. Conclusions: The posterior indirect decompression

  12. Anterior cervical pedicle screw and plate fixation using fluoroscope-assisted pedicle axis view imaging: a preliminary report of a new cervical reconstruction technique.

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    Yukawa, Yasutsugu; Kato, Fumihiko; Ito, Keigo; Nakashima, Hiroaki; Machino, Masaaki

    2009-06-01

    Anterior procedures in the cervical spine are feasible in cases having anterior aetiologies such as anterior neural compression and/or severe kyphosis. Halo vests or anterior plates are used concurrently for cases with long segmental fixation. Halo vests are bothersome and anterior plate fixation is not adequately durable. We developed a new anterior pedicle screw (APS) and plate fixation procedure that can be used with fluoroscope-assisted pedicle axis view imaging. Six patients (3 men and 3 women; mean age, 54 years) with anterior multisegmental aetiology were included in this study. Their original diagnoses comprised cervical myelopathy and/or radiculopathy (n = 4), posterior longitudinal ligament ossification (n = 1) and post-traumatic kyphosis (n = 1). All patients underwent anterior decompression and strut grafting with APS and plate fixation. Mean operative time was 192 min and average blood loss was 73 ml. Patients were permitted to ambulate the next day with a cervical collar. Local sagittal alignment was characterised by 3.5 degrees of kyphosis preoperatively, which improved to 6.8 degrees of lordosis postoperatively and 5.2 degrees of lordosis at final follow-up. Postoperative improvement and early bony union were observed in all cases. There was no serious complication except for two cases of dysphagia. Postoperative imaging demonstrated screw exposure in one screw, but no pedicle perforation. APS and plate fixation is useful in selected cases of multisegmental anterior reconstruction of cervical spine. However, the adequate familiarity and experience with both cervical pedicle screw fixation and the imaging technique used for visualising the pedicle during surgery are crucial for this procedure. PMID:19343377

  13. Fibular allograft and anterior plating for dislocations/fractures of the cervical spine

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    Ramnarain A

    2008-01-01

    Full Text Available Background: Subaxial cervical spine dislocations are common and often present with neurological deficit. Posterior spinal fusion has been the gold standard in the past. Pain and neck stiffness are often the presenting features and may be due to failure of fixation and extension of fusion mass. Anterior spinal fusion which is relatively atraumatic is thus favored using autogenous grafts and cages with anterior plate fixation. We evaluated fresh frozen fibular allografts and anterior plate fixation for anterior fusion in cervical trauma. Materials and Methods: Sixty consecutive patients with single-level dislocations or fracture dislocations of the subaxial cervical spine were recruited in this prospective study following a motor vehicle accident. There were 38 males and 22 females. The mean age at presentation was 34 years (range 19-67 years. The levels involved were C5/6 ( n = 36, C4/5 ( n = 15, C6/7 ( n = 7 and C3/4 ( n = 2. There were 38 unifacet dislocations with nine posterior element fractures and 22 were bifacet dislocations. Twenty-two patients had neurological deficit. Co-morbidities included hypertension ( n = 6, non-insulin-dependent diabetes mellitus ( n = 2 and asthma ( n = 1. All patients were initially managed on skull traction. Following reduction further imaging included Computerized Tomography and Magnetic Resonance Imaging. Patients underwent anterior surgery (discectomy, fibular allograft and plating. All patients were immobilized in a Philadelphia collar for eight weeks (range 7-12 weeks. Eight patients were lost to follow-up within a year. Follow-up clinical and radiological examinations were performed six-weekly for three months and subsequently at three-monthly intervals for 12 months. Pain was analyzed using the visual analogue scale (VAS. The mean follow-up was 19 months (range 14-39 months. Results: Eight lost to followup, hence 52 patients were considered for final evaluation. The neurological recovery was 1.1 Frankel

  14. Anterior Cervical Corpectomy Non-Fusion Model Produced by a Novel Implant.

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    Dong, Jun; Lu, Meng; Liang, Baobao; Zhai, Xu; Qin, Jie; He, Xijing

    2016-01-01

    BACKGROUND Anterior cervical corpectomy and fusion are frequently used in the treatment of cervical spinal disease. However, the range of motion (ROM) of the operative level is unavoidably lost due to fusion. This study aims to establish an anterior cervical corpectomy goat non-fusion model and to evaluate the ROM of adjacent and operative levels. MATERIAL AND METHODS Six adult-male goats (in vivo group) and twelve adult-male goat cervical spine specimens (randomly divided equally into intact group or in vitro group) were included. The non-fusion model was established by implanting a novel implant at C4 level. Imagiological examinations for the in vivo group were performed to inspect the position of the implant and spinal cord status. Specimens were harvested six months after the operation. Biomechanical testing was conducted to obtain the ROM in flexion-extension, lateral bending, and axial rotation at upper adjacent level (C2-3), operative levels (C3-4 and C4-5) and at C2-5. Specimens in the intact group were first tested as intact and then tested as fixed and became the fixation group. RESULTS Imagiological examinations revealed that the position of the implant and the spinal cord status were good. The specimens in the in vivo and in vitro groups had significantly decreased C2-3 ROM, increased C3-4 and C4-5 ROM and similar C2-5 ROM compared with the fixation group. CONCLUSIONS This study presents a novel method for potential non-fusion treatment strategies for cervical spinal disease. However, improvement of this model and additional studies are needed. PMID:27049839

  15. Long term results of anterior corpectomy and fusion for cervical spondylotic myelopathy.

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    Rui Gao

    Full Text Available BACKGROUND: Results showed good clinical outcomes of anterior corpectomy and fusion (ACCF for patients with cervical spondylotic myelopathy (CSM during a short term follow-up; however, studies assessing long term results are relatively scarce. In this study we intended to assess the long term clinical and radiographic outcomes, find out the factors that may affect the long term clinical outcome and evaluate the incidence of adjacent segment disease (ASD. METHODS: This is a retrospective study of 145 consecutive CSM patients on ACCF treatment with a minimum follow-up of 5 years. Clinical data were collected from medical and operative records. Patients were evaluated by using the Japanese Orthopedic Association (JOA scoring system preoperatively and during the follow-up. X-rays results of cervical spine were obtained from all patients. Correlations between the long term clinical outcome and various factors were also analyzed. FINDINGS: Ninety-three males and fifty-two females completed the follow-up. The mean age at operation was 51.0 years, and the mean follow-up period was 102.1 months. Both postoperative sagittal segmental alignment (SSA and the sagittal alignment of the whole cervical spine (SACS increased significantly in terms of cervical lordosis. The mean increase of JOA was 3.8 ± 1.3 postoperatively, and the overall recovery rate was 62.5%. Logistic regression analysis showed that preoperative duration of symptoms >12 months, high-intensity signal in spinal cord and preoperative JOA score ≤ 9 were important predictors of the fair recovery rate (≤ 50%. Repeated surgery due to ASD was performed in 7 (4.8% cases. CONCLUSIONS: ACCF with anterior plate fixation is a reliable and effective method for treating CSM in terms of JOA score and the recovery rate. The correction of cervical alignment and the repeated surgery rate for ASD are also considered to be satisfactory.

  16. Anterior Cervical Surgery Cervical Disc Experience%颈椎前路手术治疗颈椎间盘突出症体会

    Institute of Scientific and Technical Information of China (English)

    吴向东; 刘绍武; 唐佩福

    2012-01-01

    Objective:Observation of the anterior cervical surgical treatment of cervical disc herniation .Methods:52cases of cervical disc herniation, anterior cervical decompression, bone graft and application of cervical locking anterior plate internal fixation. Results:46 cases after 2~ 18months, anaverage of 8.2 months of follow-up of all cases of graft to achieve bone fusion, the integration time of 12 ~ 16 weeks, with an average of 12.6 weeks, 100% of the fusion rate; MRI examination of spinal cord deformation. The compression performance of spinal cord function tests, with the exception of three cases of unsatisfactory outside. The results were satisfactory in all cases bone graft. Conclusion:Indications to choose the right anterior cervical decompression surgery bone graft and plate system is simple and can provide a fixed segmental stability, conducive to the recovery of neurological function, applicable to the treatment of cervical disc herniation, cervical trauma. Anterior cervical surgery for two cervical disc, three vertebrae. Power and restricted anterior cervical fixation materials was no significant differencein clinical therapy.%目的:观察颈椎前路手术治疗颈椎间盘突出症的疗效.方法:对52例颈椎间盘突出症,行颈椎前路减压、植骨并应用锁定型颈椎前路钢板内固定.结果:46例经过2~18个月、平均8.2月的随访,所有病例植骨均达到骨性融合,融合时间12~16周,平均12.6周,融合率100%;MRI检查无脊髓变形、受压表现,脊髓功能检查,除3例不理想外.所有病例植骨疗效满意.结论:适应症选择正确,颈椎前路手术减压植骨、钢板系统操作简单,可提供有效的固定节段稳定性,利于神经功能恢复,适用于颈椎间盘突出症、颈椎外伤的治疗.颈椎前路手术适用于2个颈椎间盘,3个椎体.动力性和限制性颈椎前路内固定材料在临床治疗疗效上无明显差别.

  17. Comparative study on the effect of anterior and posterior decompression in the treatment of multi-segmental cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    Liang Li; Mei-Lin Jiang; Xiao-Jun Yang

    2016-01-01

    Objective: To analyze and compare the clinical efficacy of anterior and posterior decompression in the treatment of multi-segmental cervical spondylotic myelopathy (MCSM), providing certain guidance for the clinical treatment. Methods:A total of 72 patients with MCSM who were admitted in our hospital from September, 2012 to October, 2014 were included in the study and divided into the anterior group (n=37) and the posterior group (n=35) according to different surgical methods. The patients in the anterior group were given anterior cervical discectomy fusion (ACDF) and anterior cervical corpectomy fusion (ACCF), while the patients in the posterior group were given laminoplasty (LP). The general materials, surgical materials, and postoperative functional recovery in the two groups were compared. Results:The comparison of gender, age, course, preoperative JOA score, follow-up time, and affected segment between the two groups was not statistically significant. The operation time in the anterior group was significantly longer than that in the posterior group, but the intraoperative amount of bleeding was significantly less than that in the posterior group. The postoperative spinal cord function in the two groups was significantly improved when compared with before operation;moreover, the improved degree in the anterior group was more obvious. The postoperative cervical physiological curvature in the anterior group was significantly increased, but in the posterior group was significantly reduced. The comparison of the occurrence rate of postoperative complications between the two groups was not statistically significant. Conclusions:The anterior and posterior surgeries in the treatment of MCSM can significantly improve the postoperative spinal cord function, among which the anterior surgery can effectively recover the cervical physiological curvature. It is recommended that an appropriate surgical method should be reasonably selected by comprehensively considering the

  18. Cervical total disc replacement is superior to anterior cervical decompression and fusion: a meta-analysis of prospective randomized controlled trials.

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    Yujie Zhang

    Full Text Available Despite being considered the standard surgical procedure for symptomatic cervical disc disease, anterior cervical decompression and fusion invariably accelerates adjacent segment degeneration. Cervical total disc replacement is a motion-preserving procedure developed as a substitute to fusion. Whether cervical total disc replacement is superior to fusion remains unclear.We comprehensively searched PubMed, EMBASE, Medline, and the Cochrane Library in accordance with the inclusion criteria to identify possible studies. The retrieved results were last updated on December 12, 2014. We classified the studies as short-term and midterm follow-up.Nineteen randomized controlled trials involving 4516 cases were identified. Compared with anterior cervical decompression and fusion, cervical total disc replacement had better functional outcomes (neck disability index [NDI], NDI success, neurological success, neck pain scores reported on a numerical rating scale [NRS], visual analog scales scores and overall success, greater segmental motion at the index level, fewer adverse events and fewer secondary surgical procedures at the index and adjacent levels in short-term follow-up (P 0.05.Cervical total disc replacement presented favorable functional outcomes, fewer adverse events, and fewer secondary surgical procedures. The efficacy and safety of cervical total disc replacement are superior to those of fusion. Longer-term, multicenter studies are required for a better evaluation of the long-term efficacy and safety of the two procedures.

  19. Multisegmental cervical ossification of the posterior longitudinal ligament: Anterior vs posterior approach

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    Jain Subodh

    2005-01-01

    Full Text Available Aims : To determine the surgical approach in patients with multisegmental (four or more segments OPLL of the cervical spine. Methods and Materials : Data of 27 patients who had undergone either an anterior (corpectomy with excision of OPLL and interbody fusion=14 patients or posterior approach (laminectomy=12, laminoplasty=1 patient for the multisegmental cervical OPLL was analyzed retrospectively. The patients in each group were statistically similar in respect to preoperative factors such as age, duration of symptoms, preoperative modified Japanese orthopedic association score, OPLL thickness, effective canal diameter, and antero-posterior cord compression ratio. The clinical outcome was assessed by the Harsh grading system and recovery rate was assessed by Hirabayashi method. Results : There was no statistical difference in the outcome, and recovery rate. Nine patients developed complications after anterior approach in contrast to one after posterior approach. Conclusions : In patients with multisegmental cervical OPLL, there was no significant difference in the short-term recovery rate and outcome between two groups. The immediate postoperative complications were less in patients who had undergone posterior approach. From our analysis, it appears that the posterior approach is probably the preferred method of treatment in a multisegmental OPLL in absence of preoperative kyphosis.

  20. A radiological evaluation of allografts (ethylene oxide sterilized cadaver bone and autografts in anterior cervical fusion.

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    Parthiban J

    2002-01-01

    Full Text Available Serial roentgenograms of 40 patients who had 70 cervical intervertebral spaces grafted with ethylene oxide sterilized cadaver bone and 28 patients who received 44 iliac crest auto grafts for anterior cervical spine fusion, were studied. The radiological evaluation was made on the basis of settlement of intervertebral spaces, fusion rate, delayed union, non-union, graft collapse and extrusion of the graft. Indigenous methodologies were designed for the assessment of settlement of grafted intervertebral spaces in percentage. Disc space settlement was more common in autografts (93% cases than in allografts (80% cases. The average percentage of settlement of intervertebral disc space (S% was 22 in autografts and 28 in allografts during the first four months. By the end of eight months, allograft disc spaces settle more. No significant difference was noted in fusion rate at the end of one year viz. allografts (90% cases and autografts (93% cases. Autograft and allograft (ethylene oxide sterilized cadaver bone are equally useful in anterior cervical spine fusions.

  1. Follow-up radiographs of the cervical spine after anterior fusion with titanium intervertebral disc

    International Nuclear Information System (INIS)

    Purpose: We examined the postoperative changes of the cervical spine after treatment of cervical nerve root compression with anterior cervical discectomy and fusion with a new titanium intervertebral disc. Patients and Methods: 37 patients were examined prior to, as well as 4 days, 6 weeks, and 7 months after surgery. Lateral view X-rays and functional imaging were used to evaluate posture and mobility of the cervical spine, the position of the implants, and the reactions of adjacent bone structures. Results: Implantation of the titanium disc led to post-operative distraction of the intervertebral space and slight lordosis. Within the first 6 months a slight loss of distraction and re-kyphosis due to impression of the implants into the vertebral end-plates were found in all patients. We noted partial infractions into the vertebral end-plates in 10/42 segments and slight mobility of the implants in 14/42 segments. Both groups of patients showed reactive spondylosis and local symptoms due to loosening of the implants. The pain subsided after onset of bone bridging and stable fixation of the loosened discs. Conclusions: The titanium intervertebral disc provides initial distraction of the fusioned segments with partial recurrence of kyphosis during the subsequent course. Loosening of the implants with local symptoms can be evaluated with follow-up X-rays and functional imaging. (orig.)

  2. Esophageal perforation after anterior cervical spine surgery: a systematic review of the literature.

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    Halani, Sameer H; Baum, Griffin R; Riley, Jonathan P; Pradilla, Gustavo; Refai, Daniel; Rodts, Gerald E; Ahmad, Faiz U

    2016-09-01

    OBJECTIVE Esophageal perforation is a rare but well-known complication of anterior cervical spine surgery. The authors performed a systematic review of the literature to evaluate symptomatology, direct causes, repair methods, and associated complications of esophageal injury. METHODS A PubMed search that adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines included relevant clinical studies and case reports (articles written in the English language that included humans as subjects) that reported patients who underwent anterior spinal surgery and sustained some form of esophageal perforation. Available data on clinical presentation, the surgical procedure performed, outcome measures, and other individual variables were abstracted from 1980 through 2015. RESULTS The PubMed search yielded 65 articles with 153 patients (mean age 44.7 years; range 14-85 years) who underwent anterior spinal surgery and sustained esophageal perforation, either during surgery or in a delayed fashion. The most common indications for initial anterior cervical spine surgery in these cases were vertebral fracture/dislocation (n = 77), spondylotic myelopathy (n = 15), and nucleus pulposus herniation (n = 10). The most commonly involved spinal levels were C5-6 (n = 51) and C6-7 (n = 39). The most common presenting symptoms included dysphagia (n =63), fever (n = 24), neck swelling (n = 23), and wound leakage (n = 18). The etiology of esophageal perforation included hardware failure (n = 31), hardware erosion (n = 23), and intraoperative injury (n = 14). The imaging modalities used to identify the esophageal perforations included modified contrast dye swallow studies, CT, endoscopy, plain radiography, and MRI. Esophageal repair was most commonly achieved using a modified muscle flap, as well as with primary closure. Outcomes measured in the literature were often defined by the time to oral intake following esophageal repair. Complications included

  3. Clinical and radiologic comparison of dynamic cervical implant arthroplasty versus anterior cervical discectomy and fusion for the treatment of cervical degenerative disc disease.

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    Li, Zhonghai; Yu, Shunzhi; Zhao, Yantao; Hou, Shuxun; Fu, Qiang; Li, Fengning; Hou, Tiesheng; Zhong, Hongbin

    2014-06-01

    This study compared the clinical and radiological outcomes of dynamic cervical implant (DCI; Scient'x, Villers-Bretonneux, France) arthroplasty versus anterior cervical discectomy and fusion (ACDF) for the treatment of cervical degenerative disc disease. This prospective cohort study enrolled patients with single-level cervical degenerative disc disease who underwent DCI arthroplasty or ACDF between September 2009 and June 2011. Patients were followed up for more than 2years. Clinical evaluation included the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), Neck Disability Index (NDI), Japan Orthopedic Association (JOA) score, and visual analog scale (VAS) scores for neck and arm pain. Radiological assessments included segmental range of motion (ROM), overall ROM (C2-C7), disc height (DHI), and changes in adjacent disc spaces. The VAS, SF-36, JOA, and NDI scores improved significantly after surgery in both the DCI and ACDF groups. The VAS, JOA, and SF-36 scores were not significantly different between the DCI and ACDF groups at the final follow-up. The segmental ROM at the treated level and overall ROM increased significantly after surgery in the DCI group, but the ROM in the adjacent cephalad and caudal segments did not change significantly. The mean DHI at the treated level was significantly restored after surgery in both groups. Five patients (12.8%) in the DCI group showed new signs of adjacent segment degeneration. These results indicate that DCI is an effective, reliable, and safe procedure for the treatment of cervical degenerative disc disease. However, there is no definitive evidence that DCI arthroplasty has better intermediate-term results than ACDF. PMID:24411326

  4. Comparison of inpatient vs. outpatient anterior cervical discectomy and fusion: a retrospective case series

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    Friedman Jonathan A

    2009-03-01

    Full Text Available Abstract Background Spinal surgery is increasingly being done in the outpatient setting. We reviewed our experience with inpatient and outpatient single-level anterior cervical discectomy and fusion with plating (ACDF+P. Methods All patients undergoing single-level anterior cervical discectomy and fusion with plating between August 2005 and May 2007 by two surgeons (RPB or JAF were retrospectively reviewed. All patients underwent anterior cervical microdiscectomy, arthrodesis using structural allograft, and titanium plating. A planned change from doing ACDF+P on an inpatient basis to doing ACDF+P on an outpatient basis was instituted at the midpoint of the study. There were no other changes in technique, patient selection, instrumentation, facility, or other factors. All procedures were done in full-service hospitals accommodating outpatient and inpatient care. Results 64 patients underwent ACDF+P as inpatients, while 45 underwent ACDF+P as outpatients. When outpatient surgery was planned, 17 patients were treated as inpatients due to medical comorbidities (14, older age (1, and patient preference (2. At a mean follow-up of 62.4 days, 90 patients had an excellent outcome, 19 patients had a good outcome, and no patients had a fair or poor outcome. There was no significant difference in outcome between inpatients and outpatients. There were 4 complications, all occurring in inpatients: a hematoma one week post-operatively requiring drainage, a cerebrospinal fluid leak treated with lumbar drainage, syncope of unknown etiology, and moderate dysphagia. Conclusion In this series, outpatient ACDF+P was safe and was not associated with a significant difference in outcome compared with inpatient ACDF+P.

  5. Outcome of single level anterior cervical discectomy and fusion using nano-hydroxyapatite/polyamide-66 cage

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    Xi Yang

    2014-01-01

    Full Text Available Background: Cages have been widely used for the anterior reconstruction and fusion of cervical spine. Nonmetal cages have become popular due to prominent stress shielding and high rate of subsidence of metallic cages. This study aims to assess fusion with n-HA/PA66 cage following one level anterior cervical discectomy. Materials and Methods: Forty seven consecutive patients with radiculopathy or myelopathy underwent single level ACDF using n-HA/PA66 cage. We measured the segmental lordosis and intervertebral disc height on preoperative radiographs and then calculated the loss of segmental lordosis correction and cage subsidence over followup. Fusion status was evaluated on CT scans. Odom criteria, Japanese Orthopedic Association (JOA and Visual Analog Pain Scales (VAS scores were used to assess the clinical results. Statistically quantitative data were analyzed while Categorical data by χ2 test. Results: Mean correction of segmental lordosis from surgery was 6.9 ± 3.0° with a mean loss of correction of 1.7 ± 1.9°. Mean cage subsidence was 1.2 ± 0.6 mm and the rate of cage subsidence (>2 mm was 2%. The rate of fusion success was 100%. No significant difference was found on clinical or radiographic outcomes between the patients (n=27 who were fused by n-HA/PA66 cage with pure local bone and the ones (n=20 with hybrid bone (local bone associating with bone from iliac crest. Conclusions: The n-HA/PA66 cage is a satisfactory reconstructing implant after anterior cervical discectomy, which can effectively promote bone graft fusion and prevent cage subsidence.

  6. BMP-4 Polymorphisms in the Susceptibility of Cervical Spondylotic Myelopathy and its Outcome after Anterior Cervical Corpectomy and Fusion

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    Dawei Wang

    2013-07-01

    Full Text Available Background: To investigate the association between single nucleotide polymorphisms (SNPs of bone morphogenic proteins-4 (BMP-4 gene and the susceptibility of cervical spondylotic myelopathy (CSM and its outcome after surgical treatment. Method: A total of 499 patients with CSM and 602 healthy volunteers were recruited. 425 CSM patients received anterior cervical corpectomy and fusion (ACF and were follow-up until 12 months. The SNPs of BMP-4 were determined. Results: For 6007C > T polymorphism, the cases had a significant lower prevalence of TT genotype than controls. With the CC genotype as reference, the TT genotype carriages significantly influence the CSM risk. The T allele carriage represented a higher risk for CSM as well. The TT of 6007C>T polymorphisms is also associated with higher chance to gain improvement from ACF surgery. The T allele carriage of 6007C>T had markedly higher chance to have a better post-operative outcome compared with C allele carriage. The genotype and allele distributions of -5826G>A polymorphism did not show positive association with risk and outcome of CSM in this study. Conclusion: BMP-4 genetic polymorphisms may be used as a molecular marker for the CSM susceptibility and its postoperative outcome in those underwent surgical treatment.

  7. Spontaneous resolution of an isolated cervical anterior spinal artery aneurysm after subarachnoid hemorrhage

    Science.gov (United States)

    Pahl, Felix Hendrik; de Oliveira, Matheus Fernandes; Rotta, Marcus Alexandre Cavalcanti; Dias, Guilherme Marcos Soares; Rezende, André Luiz; Rotta, José Marcus

    2014-01-01

    Background: Isolated cervical anterior spinal artery aneurysms are extremely rare. Subarachnoid hemorrhage (SAH) secondary to such lesions have been described only in six cases to the best of our knowledge. Case Description: We describe an unusual clinical picture of SAH due to rupture of anterior spinal artery aneurysm in a patient with previous normal angiogram. Due to the location of the aneurysm and clinical status of the patient, conservative management was proposed, and she was discharged to further follow-up. Monthly routine angiograms revealed resolution of the aneurysm 90 days after bleeding, which was highly suggestive of vascular dissection. Conclusion: We highlight the need to consider these aneurysms in the differential diagnosis of SAH, especially when occurring in the posterior fossa and when angiography findings are inconclusive. PMID:25317354

  8. Anterior versus posterior approach for four-level cervical spondylotic myelopathy.

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    Lin, Dasheng; Zhai, Wenliang; Lian, Kejian; Kang, Liangqi; Ding, Zhenqi

    2013-11-01

    The purpose of this study was to compare the results of 2 surgical strategies for 4-level cervical spondylotic myelopathy: a hybrid procedure using anterior cervical diskectomy and fusion (ACDF) combined with segmental corpectomy versus posterior laminectomy and fixation. Between 2002 and 2010, fifty-one patients with consecutive 4-level cervical spondylotic myelopathy were treated surgically, with 27 patients undergoing the hybrid procedure and 24 undergoing posterior laminectomy and fixation. Radiologic data were compared between the 2 groups, including cervical curvature and cervical range of motion (ROM) in the sagittal plane. Pre- and postoperative neurological status was evaluated using the Japanese Orthopaedic Association (JOA) scoring system and the Nurick grading system. Mean ROM at last follow-up was not significantly different between the 2 groups (P>.05). In the hybrid group, mean JOA score and Nurick grade improved from 9.6±1.4 and 2.74±0.45 respectively, preoperatively, to 13.9±1.3 and 0.86±0.38 respectively, postoperatively. In the fixation group, mean JOA score and Nurick grade improved from 9.4±1.2 and 2.81±0.42 respectively, preoperatively, to 13.1±1.5 and 1.32±0.36 respectively, postoperatively. The JOA scores and Nurick grades at last follow-up were significantly different between the 2 groups (Pcervical kyphosis, preoperative JOA score and Nurick grade were not significantly different between the 2 groups (P>.05); however, JOA scores and Nurick grades at last follow-up showed better improvement in the hybrid group than in the fixation group (Pcervical lordosis, the preoperative and last follow-up JOA score and Nurick grade were not significantly different between the 2 groups (P>.05). PMID:24200449

  9. A comparative effectiveness study of patient-rated and radiographic outcome after 2 types of decompression with fusion for spondylotic myelopathy: anterior cervical discectomy versus corpectomy

    OpenAIRE

    Burkhardt, Jan-Karl; Mannion, Anne F; Marbacher, Serge; Dolp, Patrick A; Fekete, Tamas F; Jeszenszky, Dezsö; Porchet, François

    2013-01-01

    OBJECT: Both anterior cervical discectomy with fusion (ACDF) and anterior cervical corpectomy with fusion (ACCF) are used to treat cervical spondylotic myelopathy; however, there is currently no evidence for the superiority of one over the other in terms of patient-rated outcomes. This comparative effectiveness study compared the patient-rated and radiographic outcomes of 2-level ACDF versus 1-level ACCF. METHODS: This single-center study was nested within the EuroSpine Spine Tango data ac...

  10. Combined anterior and posterior surgery for treatment of cervical fracture-dislocation in patients with ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    L(U) Guo-hua; WANG Bing; KANG Yi-jun; LU Chang; MA Ze-min; DENG You-wen

    2009-01-01

    To discuss the pathological characteristics of cervical spinal fracture complicating ankylosing spondyli-tis-(AS) and the effect of combined anterior and posterior operation. Methods: Eighteen AS patients with traumatic cervical fracture-dislocation were treated operatively from January 2000 to January 2006. The symptom duration of AS was 14.5 years on average. Three cases had undergone osteotomy in lumbar spine. There were 4 cases of Grade A, 3 cases of Grade B, 9 cases of Grade C and 2 cases of Grade D accord-ing to Frankel's score. There were 15 cases of Grade Ⅲ dislocation and 3 cases of Grade Ⅱ. All patients underwent surgical procedures by combined anterior and posterior approach.Results: There were 4 anterior-posterior procedures, 8 anterior-posterior-anterior procedures and 6 posterior-an-terior procedures. Seven patients had one stage operation and 11 cases underwent two stage surgeries. There was certain extent of neorological improvement in 14 incomplete paraplegic patients, but no improvement in 4 complete paraplegic patients. The follow-up period was 21.2 months on average and the time for bone fusion was 3.6 months. There were 4 complications during operation and a long-term complication in follow-up. Conclusions: The study suggests that anterior com-bined with posterior approach makes the spine stable and relieves the pressure immediately. It is a reasonable surgical strategy for treatment of cervical spinal fracture-dislocation with AS.

  11. Delayed anterior cervical plate dislodgement with pharyngeal wall perforation and oral extrusion of cervical plate screw after 8 years: A very rare complication

    Directory of Open Access Journals (Sweden)

    Ravindranath Kapu

    2012-01-01

    Full Text Available We report a patient with congenital anomaly of cervical spine, who presented with clinical features suggestive of cervical compressive spondylotic myelopathy. He underwent C3 median corpectomy, graft placement, and stabilization from C2 to C4 vertebral bodies. Postoperative period was uneventful and he improved in his symptoms. Eight years later, he presented with a difficulty in swallowing and occasional regurgitation of feeds of 2 months duration and oral extrusion of screw while having food. On oral examination, there was a defect in the posterior pharyngeal wall through which the upper end of plate with intact self-locking screw and socket of missed fixation screw was seen. This was confirmed on X-ray cervical spine. He underwent removal of the plate system and was fed through nasogastric tube and managed with appropriate antibiotics. This case is presented to report a very rare complication of anterior cervical plate fixation in the form of very late-onset dislodgement, migration of anterior cervical plate, and oral extrusion of screw through perforated posterior pharyngeal wall.

  12. Delayed surgical treatment for a traumatic bilateral cervical facet joint dislocation using a posterior-anterior approach: a case report

    Directory of Open Access Journals (Sweden)

    Shimada Takashi

    2013-01-01

    Full Text Available Abstract Introduction There have been few reports of patients with bilateral cervical facet dislocations that remain untreated for eight weeks or more. We report the case of a 76-year-old man with an old bilateral cervical facet joint dislocation fracture that was treated by posterior-anterior reduction and fixation. Case presentation A 76-year-old Asian man was involved in a road traffic accident. He presented with neck pain and arm pain on his right side, but motor weakness and paralysis were not observed. He was treated conservatively; however, instability and spondylolisthesis at the C5 to C6 joint increased eight weeks after the injury. We performed a posterior-anterior reduction and fixation. After surgery, bony union was achieved, and his neck pain and arm pain disappeared. Conclusion We recommend reduction and fixation surgery if a patient has an old bilateral facet joint dislocation fracture in the cervical spine.

  13. Use of autologous bone graft in anterior cervical decompression: morbidity & quality of life analysis.

    LENUS (Irish Health Repository)

    Heneghan, Helen M

    2009-01-01

    BACKGROUND: Autologous iliac crest graft has long been the gold standard graft material used in cervical fusion. However its harvest has significant associated morbidity, including protracted postoperative pain scores at the harvest site. Thus its continued practice warrants scrutiny, particularly now that alternatives are available. Our aims were to assess incidence and nature of complications associated with iliac crest harvest when performed in the setting of Anterior Cervical Decompression (ACD). Also, to perform a comparative analysis of patient satisfaction and quality of life scores after ACD surgeries, when performed with and without iliac graft harvest. METHODS: All patients who underwent consecutive ACD procedures, with and without the use of autologous iliac crest graft, over a 48 month period were included (n = 53). Patients were assessed clinically at a minimum of 12 months postoperatively and administered 2 validated quality of life questionnaires: the SF-36 and Cervical Spine Outcomes Questionnaires (Response rate 96%). Primary composite endpoints included incidence of bone graft donor site morbidity, pain scores, operative duration, and quality of life scores. RESULTS: Patients who underwent iliac graft harvest experienced significant peri-operative donor site specific morbidity, including a high incidence of pain at the iliac crest (90%), iliac wound infection (7%), a jejunal perforation, and longer operative duration (285 minutes vs. 238 minutes, p = 0.026). Longer term follow-up demonstrated protracted postoperative pain at the harvest site and significantly lower mental health scores on both quality of life instruments, for those patients who underwent autologous graft harvest CONCLUSION: ACD with iliac crest graft harvest is associated with significant iliac crest donor site morbidity and lower quality of life at greater than 12 months post operatively. This is now avoidable by using alternatives to autologous bone without compromising clinical

  14. Measuring surgical outcomes in cervical spondylotic myelopathy patients undergoing anterior cervical discectomy and fusion: assessment of minimum clinically important difference.

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    Brenda M Auffinger

    Full Text Available OBJECT: The concept of minimum clinically important difference (MCID has been used to measure the threshold by which the effect of a specific treatment can be considered clinically meaningful. MCID has previously been studied in surgical patients, however few studies have assessed its role in spinal surgery. The goal of this study was to assess the role of MCID in patients undergoing anterior cervical discectomy and fusion (ACDF for cervical spondylotic myelopathy (CSM. METHODS: Data was collected on 30 patients who underwent ACDF for CSM between 2007 and 2012. Preoperative and 1-year postoperative Neck Disability Index (NDI, Visual-Analog Scale (VAS, and Short Form-36 (SF-36 Physical (PCS and Mental (MCS Component Summary PRO scores were collected. Five distribution- and anchor-based approaches were used to calculate MCID threshold values average change, change difference, receiver operating characteristic curve (ROC, minimum detectable change (MDC and standard error of measurement (SEM. The Health Transition Item of the SF-36 (HTI was used as an external anchor. RESULTS: Patients had a significant improvement in all mean physical PRO scores postoperatively (p<0.01 NDI (29.24 to 14.82, VAS (5.06 to 1.72, and PCS (36.98 to 44.22. The five MCID approaches yielded a range of values for each PRO: 2.00-8.78 for PCS, 2.06-5.73 for MCS, 4.83-13.39 for NDI, and 0.36-3.11 for VAS. PCS was the most representative PRO measure, presenting the greatest area under the ROC curve (0.94. MDC values were not affected by the choice of anchor and their threshold of improvement was statistically greater than the chance of error from unimproved patients. CONCLUSION: SF-36 PCS was the most representative PRO measure. MDC appears to be the most appropriate MCID method. When MDC was applied together with HTI anchor, the MCID thresholds were: 13.39 for NDI, 3.11 for VAS, 5.56 for PCS and 5.73 for MCS.

  15. One stage anterior-posterior approach for traumatic atlantoaxial instability combined with subaxial cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    WANG Chang-sheng; LIU Mou-jun; LIN Jian-hua; XU Wei-hong; LUO Hong-bin

    2011-01-01

    Objectives: To explore the clinical features of traumatic atlantoaxial instability combined with subaxial cervical spinal cord injury (CSCI), and to analyze the feasibility, indication and therapeutic effects of anterior-posterior approach in such cases.Methods: From March 2004 to September 2009, 16cases with this trauma were admitted and surgically treated in our department. Before surgery, skull traction was performed. Posterior atlantoaxial pedicle screw internal fixation and bone graft fusion were conducted to manage traumatic atlantoaxial instability. As for subaxial CSCI, anterior cervical corpectomy or discectomy decompression, bone grafting and internal fixation with steel plates were applied.Results: All operations were successful. The average operation time was 3 hours and operative blood loss 400 ml. Satisfactory reduction of both the upper and lower cervical spine and complete decompression were achieved. All patients were followed up for 12 to 36 months. Their clinical symptoms were improved by various levels. The Japanese Orthopaedic Association (JOA) scores ranged from 10to 16 one year postoperatively, 13.95±2.06 on average (improvement rate= 70.10% ). X-rays, spiral CT and MRI confirmed normal cervical alignments, complete decompression and fine implants' position. There was no breakage or loosening of screws, nor exodus of titanium mesh or implanted bone blocks. The grafted bone achieved fusion 3-6 months postoperatively and no atlantoaxial instability was observed.Conclusions: Traumatic atlantoaxial instability may combine with subaxial CSCI, misdiagnosis of which should be especially alerted and avoided. For severe cases, one stage anterior-posterior approach to decompress the upper and lower cervical spine, together with reposition, bone grafting and fusion, as well as internal fixation can immediately restore the normal alignments and stability of the cervical spine and effectively improve the spinal nervous function, thus being an ideal

  16. Screw fixation to the posterior cortical shell does not influence peak torque and pullout in anterior cervical plating

    OpenAIRE

    Pitzen, T.; Barbier, D.; Tintinger, F.; Steudel, W; Strowitzki, M.

    2002-01-01

    There is no consensus over whether screw fixation for anterior cervical plating should include the posterior cortical shell of the vertebral bodies or not. Thus, the purpose of this study was to investigate the function of the posterior cortical shell with respect to maximal screw torque and pullout force. Twenty-four fresh frozen human cervical vertebrae coming from six spinal segments C4–C7 were used. They were scanned for bone mineral density (BMD) and then assigned to two groups with comp...

  17. Estudio electromiográfico de los patrones musculares en sujetos con mordida abierta anterior

    OpenAIRE

    Moreno Hay, Isabel

    2011-01-01

    En este estudio se propone analizar el efecto de la mordida abierta anterior en el patrón muscular del aparato estomatognático mediante pruebas electromiográficas estáticas y dinámicas; y cómo las relaciones oclusales que caracterizan a este tipo de maloclusiones determinan el funcionamiento del sistema neuromuscular y la aparición de un electromiograma característico. La descripción de las características electromiográficas de los sujetos con mordida abierta anterior contribuirían a un...

  18. In vitro comparison of bioresorbable and titanium anterior cervical plates in the immediate postoperative condition.

    Science.gov (United States)

    Freeman, Andrew L; Derincek, Alihan; Beaubien, Brian P; Buttermann, Glenn R; Lew, William D; Wood, Kirkham B

    2006-12-01

    Bioresorbable plates have recently been used with anterior cervical discectomy and fusion (ACDF). Compared with metallic plates, bioresorbable plates provide segmental stabilization with minimal imaging artifact, eventual resorption, and increased load sharing. The objectives of the present study were to determine whether a bioresorbable plate can withstand simulated physiologic static and cyclic loading, to compare the reduction in flexibility provided by bioresorbable and titanium plates, and to quantify load sharing between the plate and spine with graft. Sixteen human cervical motion segments were tested to +/-2.5 Nm in flexion-extension, lateral bending, and axial rotation. Range of motion (ROM) was measured (1) in the intact state, (2) with ACDF without plating, (3) after addition of either a bioresorbable or titanium plate, and (4) after 500 cycles of combined flexion-extension and axial torsion. Load sharing was evaluated by applying the same fixed rotation both without and with the plate, and was calculated as the moment resisted by the uninstrumented ACDF expressed as a percentage of the plated ACDF state. No plate failures or graft migration occurred during testing. Compared with the uninstrumented ACDF, bioresorbable plates reduced mean ROM by 49% in flexion-extension and 25% in lateral bending, with very little change in torsion. Titanium plates reduced uninstrumented ACDF ROM by 69% in flexion-extension, 45% in lateral bending, and 27% in torsion. Differences between bioresorbable and titanium plates were significant in flexion-extension and lateral bending. Cyclic loading did not significantly change ROM for either plate. More moment was shared in lateral bending by the spine/graft with bioresorbable plates (78%) compared with titanium plating (63%). Bioresorbable plates contained an intervertebral graft, provided some stabilization, remained intact throughout the simulated immediate postoperative loading, and shared more load with the graft and

  19. Osteosíntesis cervical posterior con placa en lesiones cervicales

    OpenAIRE

    Sánchez Martín, Miguel María

    2002-01-01

    El propósito del presente estudio es analizar retrospectivamente los resultados a largo plazo de las lesiones de la columna cervical baja tratadas mediante estabilización posterior con placas atornilladas de Roy-Cmille a las masas laterales. Pacientes y métodos: Se estudian 15 pacientes, de los cuales sólo 14 completos con lesiones traumáticas (13) y 1 no traumática (1 paciente con inestabilidad sobre artrosis por doble Cloward) durante un periodo postoperatorio medio de 8 años (6-12). Salvo ...

  20. Postoperative dysphagia correlates with increased morbidity, mortality, and costs in anterior cervical fusion.

    Science.gov (United States)

    Joseph, Jacob R; Smith, Brandon W; Mummaneni, Praveen V; La Marca, Frank; Park, Paul

    2016-09-01

    Anterior cervical fusion (ACF) after discectomy and/or corpectomy is a common procedure with traditionally good patient outcomes. Though typically mild, postoperative dysphagia can result in significant patient morbidity. In this study, we examine the relationship between postoperative dysphagia and in-hospital outcomes, readmissions, and overall costs. The University HealthSystem Consortium (UHC) database was utilized to perform a retrospective cohort study of all adults who underwent a principal procedure of ACF of the anterior column (International Classification of Diseases, Ninth Revision [ICD-9] procedure code 81.02) between 2013 and 2015. Patients with a diagnosis of dysphagia (ICD-9 78720-78729) were compared to those without. Patient demographics, length of stay, in-hospital mortality, 30-day readmissions, and direct costs were recorded. A total of 49,300 patients who underwent ACF were identified. Mean age was 54.5years and 50.2% were male. Dysphagia was documented in 3,137 patients (6.4%) during their hospital stay. Patients with dysphagia had an average 2.1 comorbidities, while patients without dysphagia had 1.5 (p<0.01). Mean length of stay was 6.38days in patients with dysphagia, and 2.13days in those without (p<0.01). In-hospital mortality was 0.10% in patients without dysphagia, and 0.61% in those with dysphagia (p<0.01). Direct costs were $13,099 in patients without dysphagia, and $21,245 in those with dysphagia (p<0.01). Thirty-day readmission rate was 2.9% in patients without dysphagia, and 5.3% in those with dysphagia (p=0.01). In summary, dysphagia in patients who undergo ACF correlates with significantly increased length of stay, 30-day readmissions, and in-hospital mortality. Direct costs are similarly increased as a result. PMID:27234612

  1. Recurrence of cervical myelopathy secondary to a strut graft fracture 20 years after anterior decompression and fusion: a case report.

    Science.gov (United States)

    Kida, Kazunobu; Takaya, Shogo; Tadokoro, Nobuaki; Kumon, Masashi; Kiyasu, Katsuhito; Kato, Tomonari; Takemasa, Ryuichi; Ikeuchi, Masahiko; Tani, Toshikazu

    2015-08-01

    This study reports on a 70-year-old man with recurrent cervical myelopathy 20 years after anterior decompression and fusion of C4-7 using a free vascularised strut graft. The recurrent myelopathy was secondary to a kyphotic deformity of a fractured graft and residual ossification of the posterior longitudinal ligament with stenosis at C3/4. Intraoperative spinal cord-evoked potentials indicated that spinal cord traction secondary to progressive kyphosis of the cervical spine after the graft fracture was the cause. The patient underwent laminoplasty at C3 and laminectomy at C4 to decompress the stenosis at C3/4 as well as posterior cervical spinal fusion at C3-7 with pedicle screws and a lateral mass screw and a bone graft to prevent further progression of the kyphosis. At postoperative 18 months, the patient's Japanese Orthopaedic Association score had improved to 14 from 8, and he could walk without support. PMID:26321562

  2. Long-term results of anterior cervical corpectomy and fusion with nano-hydroxyapatite/polyamide 66 strut for cervical spondylotic myelopathy

    Science.gov (United States)

    Zhang, Yuan; Deng, Xu; Jiang, Dianming; Luo, Xiaoji; Tang, Ke; Zhao, Zenghui; Zhong, Weiyang; Lei, Tao; Quan, Zhengxue

    2016-05-01

    To assess the long-term clinical and radiographic outcomes of anterior cervical corpectomy and fusion (ACCF) with a neotype nano-hydroxyapatite/polyamide 66 (n-HA/PA66) strut in the treatment of cervical spondylotic myelopathy (CSM). Fifty patients with CSM who underwent 1- or 2-level ACCF with n-HA/PA66 struts were retrospectively investigated. With a mean follow-up of 79.6 months, the overall mean JOA score, VAS and cervical alignment were improved significantly. At last follow-up, the fusion rate was 98%, and the subsidence rate of the n-HA/PA66 strut was 8%. The “radiolucent gap” at the interface between the n-HA/PA66 strut and the vertebra was further noted to evaluate the osteoconductivity and osseointegration of the strut, and the incidence of it was 62% at the last follow-up. Three patients suffered symptomatic adjacent segment degeneration (ASD). No significant difference was detected in the outcomes between 1- and 2-level corpectomy at follow-ups. In conclusion, the satisfactory outcomes in this study indicated that the n-HA/PA66 strut was an effective graft for cervical reconstruction. Moreover, the osteoconductivity and osseointegration of the strut is still need to be optimized for future clinical application owing to the notably presence of “radiolucent gap” in present study.

  3. Application of anterior decompression and reconstruction using titanium mesh with locking plates in the management of cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    Maolin He; Zengming Xiao; Shide Li; Qianfen Chen

    2008-01-01

    Objective:To observe the clinical effect of anterior decompression and reconstruction using titanium mesh with locking plates in the treatment of cervical spondylotic myelopathy.Methods:One hundred and twenty patients with cervical spondylotic myelopathy were treated by anterior decompression and reconstruction using titanium mesh with locking plates.There were 66 men and 54 women ranges in age from 37 to 72 Years(mean age, 58.3 years).The mean Japanese orthopedic surgery association(JOA) scale was 9.6 points before operation.Patients were followed up clinically and radiographically.Results:Having stood surgery well, the operation time ranged between 60-100 min and bleeding during operation ranged between 20-200 ml.There were no case of postoperative infection, recurrent laryngeal nerve palsy, or esophageal or tracheal laceration or rupture.The average follow-up period was 14.3 months(range, 12 to 24 months) in 96 who were followed up.At the last follow-up visit the mean JOA scale had improved to 14.4 points, reflecting an improve ment of 4.8 points.The results were considered to be excellent in 87 patients, good in 25, fair in 6, and poor in 2.No hardware-related complications or adjacent segment degenerative changes were encountered during the follow-up periods.Stable bone union was observed in all cases and the average time required for fusion was 5.7 months.Conclusion:Titanium mesh filled with autologous bone graft can avoid the complications associated with harvesting bone from the iliac crest donor site.When combined with cervical anterior locking plate, it can obtain satisfatory clinical results for the treatment of cervical spondylotic myelopathy.

  4. Avaliação da dor e morbidade local da retirada do enxerto ósseo da crista ilíaca para artrodese cervical anterior Evaluación del dolor y morbilidad local del injerto extraído de la cresta ilíaca para artrodesis cervical anterior Evaluation of the pain and local morbidity of the insertion taken out from the iliac crest to the anterior cervical arthrodesis

    Directory of Open Access Journals (Sweden)

    Rafael Barreto Silva

    2010-12-01

    Full Text Available OBJETIVO: avaliar as possíveis complicações associadas à retirada de enxerto da crista ilíaca anterior em cirurgia para artrodese cervical anterior, em especial a dor residual. MÉTODOS: foi realizado estudo retrospectivo com análise de prontuários e aplicação de questionário via telefone com 20 pacientes no período compreendido entre Agosto de 2008 e Novembro de 2009. Todos os pacientes foram submetidos à mesma técnica cirúrgica para extração do enxerto, sendo operados pela mesma equipe no Hospital de Clinicas da Unicamp (HC Unicamp. As variantes analisadas foram dor residual, taxa de infecção, lesão neurológica ou vascular e ocorrência de fratura da asa do ilíaco. Os dados foram colocados em uma tabela e as médias e porcentagens foram calculadas. RESULTADOS: dos 20 pacientes, 12 homens e 8 mulheres, com média de idade de 51,75 anos (29-74 e follow-up médio de 11,83 meses (2-29, não houve nenhuma lesão grave, como fratura, lesão arterial ou neurológica. Houve um caso de infecção superficial (5% e 25% dos pacientes queixaram-se de desconforto leve e dificuldade para deambular não incapacitante. CONCLUSÃO: a retirada de enxerto da crista ilíaca anterior está associada a muitas complicações, sendo importante o conhecimento de outras opções de enxerto e exposição ao paciente das possíveis complicações. Por meio deste levantamento, não verificamos nenhuma complicação grave, e o percentual de pacientes com dor residual acompanha os achados na literatura, podendo ser diminuído com uma dissecção cuidadosa da crista ilíaca.OBJETIVO: evaluar las posibles compilaciones asociadas a la retirada del injerto de la cresta ilíaca anterior en cirugía para artrodesis cervical anterior, principalmente los dolores residuales. MÉTODOS: fue realizado un estudio retrospectivo con análisis de prontuarios y con aplicación de cuestionario por teléfono para 20 pacientes entre agosto de 2008 y noviembre de 2009

  5. Anterior cervical discectomy and fusion: Comparison of titanium and polyetheretherketone cages

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    Cabraja Mario

    2012-09-01

    Full Text Available Abstract Background Titanium (TTN cages have a higher modulus of elasticity when compared with polyetheretherketone (PEEK cages. This suggests that TTN-cages could show more frequent cage subsidence after anterior cervical discectomy and fusion (ACDF and therefore might lead to a higher loss of correction. We compared the long term results of stand-alone PEEK- and TTN-cages in a comparable patient collective that was operated under identical operative settings. Methods From 2002 to 2007 154 patients underwent single-level ACDF for degenerative disc disease (DDD. Clinical and radiological outcome were assessed in 86 eligible patients after a mean of 28.4 months. 44 patients received a TTN- and 42 patients a PEEK-cage. Results Solid arthrodesis was found in 93.2% of the TTN-group and 88.1% of the PEEK-group. Cage subsidence was observed in 20.5% of the TTN- and 14.3% of the PEEK-group. A significant segmental lordotic correction was achieved by both cage-types. Even though a loss of correction was found at the last follow-up in both groups, it did not reach the level of statistical significance. Statistical analysis of these results revealed no differences between the TTN- and PEEK-group. When assessed with the neck disability index (NDI, the visual analogue scale (VAS of neck and arm pain and Odom’s criteria the clinical data showed no significant differences between the groups. Conclusions Clinical and radiological outcomes of ACDF with TTN- or PEEK-cages do not appear to be influenced by the chosen synthetic graft. The modulus of elasticity represents only one of many physical properties of a cage. Design, shape, size, surface architecture of a cage as well as bone density, endplate preparation and applied distraction during surgery need to be considered as further important factors.

  6. A microsurgical anterior cervical approach and the immediate impact of mechanical retractors: A case control study

    Directory of Open Access Journals (Sweden)

    Rodrigo Ramos-Zúñiga

    2015-01-01

    Full Text Available Introduction: A microsurgical anterior cervical approach with discectomy and fusion (MACDF is one of the most widely used procedures for treating radicular disorders. This approach is highly successful; however, it is not free from complications. These can be associated with soft tissue injuries. Aim of the Study: The recognition of the risks for these complications should be identified for timely prevention and safe treatment. Materials and Methods: Study Design: Retrospective case control study. This study includes a retrospective case series of 37 patients, paying special attention to immediate complications related to the use of mechanical retraction of soft tissue (dysphagia, dysphonia, esophageal lesions and local hematoma; and a comparative analysis of the outcomes after changes in the retraction method. Results: All selected cases had a positive neurological symptom response in relation to neuropathic pain. Dysphagia and dysphonia were found during the first 72 h in 94.1% of the cases in which automatic mechanical retraction was used for more than one hour during the surgical procedure. A radical change was noted in the reduction of the symptoms after the use of only manual protective blades without automatic mechanical retraction: 5.1% dysphagia and 0% dysphonia in the immediate post-operative period, P = 0.001. Conclusions: Soft tissue damage due to the use of automatic retractors in MACDF is not minor and leads to general discomfort in the patient in spite of good neurological results. These problems most often occur when automatic retractors are used continuously for more than 1 hour, as well as when they are used in multiple levels. Dysphagia, dysphonia and local pain decreased with the use of transient manual blades for retraction, and with intermittent release following minimally invasive principles.

  7. Recurrent laryngeal nerve injury following reoperative anterior cervical discectomy and fusion: a meta-analysis.

    Science.gov (United States)

    Erwood, Matthew S; Hadley, Mark N; Gordon, Amber S; Carroll, William R; Agee, Bonita S; Walters, Beverly C

    2016-08-01

    OBJECTIVE Recurrent laryngeal nerve (RLN) injury is one of the most frequent complications of anterior cervical discectomy and fusion (ACDF) procedures. The frequency of RLN is reported as 1%-11% in the literature. (4 , 15) The rate of palsy after reoperative ACDF surgery is not well defined. This meta-analysis was performed to review the current medical evidence on RLN injury after ACDF surgery and to determine a relative rate of RLN injury after reoperative ACDF. METHODS MEDLINE, PubMed, and Google Scholar searches were performed using several key words and phrases related to ACDF surgery. Included studies were written in English, addressed revisionary ACDF surgery, and studied outcomes of RLN injury. Statistical analysis was then performed using a random-effects model to calculate a pooled rate of RLN injury. The heterogeneity of the studies was assessed using Cochran's Q statistic and I(2) statistic, and a funnel plot was constructed to evaluate publication bias. RESULTS The search initially identified 345 articles on this topic. Eight clinical articles that met all inclusion criteria were included in the meta-analysis. A total of 238 patients were found to have undergone reoperative ACDF. Thirty-three of those patients experienced an RLN injury. This analysis identified a rate of RLN injury in the literature after reoperative ACDF of 14.1% (95% confidence interval [CI] 9.8%-19.1%). CONCLUSIONS The rate of RLN palsy of 14.1% was greater than any published rate of RLN injury after primary ACDF operations, suggesting that there is a greater risk of hoarseness and dysphagia with reoperative ACDF surgeries than with primary procedures as reported in these studies. PMID:27015129

  8. Influência do macheamento do orifício piloto nos parafusos cervicais anteriores Influencia del taladramiento del agujero piloto en tornillos cervicales anteriores Influence of tapping the pilot hole in anterior cervical screws

    Directory of Open Access Journals (Sweden)

    Patrícia Silva

    2013-01-01

    de 3,5 mm, y en el lado izquierdo el implante fue colocado sin el taladramiento del agujero piloto. Se realizaron ensayos mecánicos para evaluar la fuerza de retirada y el estudio histomorfométrico de la interfase hueso-implante en la fase aguda y ocho semanas después de la colocación del implante. El torque de inserción se midió durante la colocación del implante. RESULTADOS: La fuerza de torsión de la inserción y la resistencia a la extracción fueron más altas en los implantes colocados sin el taladramiento del agujero piloto. La interfaz hueso-implante presentó mayor área de contacto con el hueso y mayor área de hueso dentro de la rosca del implante en los tornillos implantados sin taladramiento previo. No se observaron diferencias en el hueso fuera del paso de la rosca del implante. CONCLUSIONES: El taladramiento del agujero piloto reduce el par de torsión de inserción y la resistencia a la extracción del implante en las fases aguda y crónica, y reduce el área de contacto hueso-implante y el área ósea en el interior del paso de la rosca.OBJECTIVE: Experimentally analyze the influence of the pilot hole tapping on the mechanical properties and the bone-implant interface of anterior cervical screw. METHODS: Eight shorn Santa Inês sheep were used in the study. In cervical segments C2-C7 of the column 2.5mm pilot holes were made on both sides of the vertebra. On the right side of the vertebra tapping was done before the insertion of the cortical screw of 3.5mm, and on the left side the implant was placed without tapping the pilot hole. Mechanical assays were performed to assess the strength of pullout as well as a histomorphometric study of bone-implant interface during the acute phase and eight weeks after implant placement. The insertion torque was measured during implant placement. RESULTS: The insertion torque and pullout strength were higher for implants placed without tapping the pilot hole. The bone-implant interface showed greater area of

  9. Plastia de ligamento cruzado anterior con injerto de tendones isquiotibiales sin desinserción tibial

    Directory of Open Access Journals (Sweden)

    Jorge César Paz Usó

    2009-01-01

    Full Text Available Después de una lesión de ligamento cruzado anterior, muchos pacientes no pueden seguir desempeñando sus actividades cotidianas o deportivas habituales. Algunos pacientes sufren roturas meniscales secundarias y gonartrosis. El objetivo de este trabajo es mostrar una técnica quirúrgica de simple ejecución, que permite un pronto restablecimiento de los pacientes a sus actividades cotidianas. A 96 pacientes del Hospital Regional 1° de Octubre, ISSSTE, se les realizó plastia de ligamento cruzado anterior por artroscopia mediante técnica de injerto de tendones isquiotibiales sin desinserción de la tibia (técnica de Lipscomb. Se utilizó únicamente un tornillo interferencial biodegradable como sujeción. El tiempo de evolución del estudio fue de noviembre de 2002 a octubre de 2006. Las edades fluctuaron entre 16 y 52 años. Hubo 86 (89.5% hombres, con daño meniscal agregado en 57 casos (53%. El tiempo de recuperación para regresar a sus actividades laborales fue de dos meses en promedio. Es una técnica quirúrgica simple, rápida y barata, con insumos mínimos que puede realizarse en cualquier centro hospitalario, con manejo ambulatorio y rápida recuperación.

  10. Anterior Cervical Fusion with Cervical Hollow Threaded Fixator for Cervical Spondylotic Myelopathy%脊髓型颈椎病前路减压椎间融合器临床应用

    Institute of Scientific and Technical Information of China (English)

    刘利乐; 曹盛俊; 王文军; 陈志伟

    2001-01-01

    Objectives: To evaluate the effect of anterior cervica l fusion with cervical hol low threaded fixator (CHTF,Synthys) for cervical spondylotc myelopathy as substi tute for the conventional anterior fusion. Methods: 18 patients with cervi cal spondylofie myelopathy were treated with the new method and followed up afte r surgery.Results:6 months to 1 year postoperatively, the clinical symptom s were obviously improved, the stability of cervical segmental unit was satisfact ory and the normal lordosis was obtained. There were no stenosis of the cervical canal and no displacement of the cervical body. The average time for the cervic al fusion was 4.5 months.%目的 探讨脊髓型颈椎病(CSM)前路减压,颈椎空心螺纹内固定器(CHTF)椎间融合,代替 传统的前路减压,植骨融合的方法。方法 对18例CMS采用环锯减压再潜行扩大减压,植入C HTF无磁性医用钛合金空心螺纹内固定器椎间融合,随访疗效,进行分析。结果 植入CHTF 术后随访6个月至1年,症状改善明显,稳定性好,生理曲度恢复达正常,无椎间隙高度丢 失,无CHTF滑脱、移位。术后平均4.5个月椎间隙融合。

  11. Tratamento das luxações traumáticas da coluna cervical por meio da abordagem anterior Treatment of traumatic dislocations of the cervical spine through anterior approach

    OpenAIRE

    Defino, Helton L. A.; Fábio Gomes Figueira; Lauro Schledorn de Camargo; Fabiano Ricardo de Tavares Canto

    2007-01-01

    Foram estudados 20 pacientes portadores de luxação traumática uni ou bifacetária da coluna cervical tratados pela artrodese e fixação anterior. Os pacientes foram avaliados por meio de parâmetros clínicos, radiológicos e funcionais. Os pacientes foram seguidos por um período que variou de 1 a 14 anos. A consolidação radiológica da artrodese foi observada em todos os pacientes e 1 paciente apresentou soltura tardia de um dos parafusos. A angulação no plano sagital do segmento vertebral lesado ...

  12. Application of a stand-alone anchored spacer in noncontiguous anterior cervical arthrodesis with radiologic analysis of the intermediate segment.

    Science.gov (United States)

    Shi, Sheng; Liu, Zu-De; You, Wen-Jie; Ouyang, Yue-Ping; Li, Xin-Feng; Qian, Lie; Zhong, Gui-Bin

    2016-03-01

    The purpose of this study was to describe the clinical features of noncontiguous cervical degenerative disc disease (cDDD), investigate the efficacy and complications of a stand-alone anchored spacer (SAAS) for patients with noncontiguous cDDD, and present radiologic analysis of the intermediate segment (IS) after skip-level fusion. Nineteen consecutive patients with noncontiguous cDDD who underwent skip-level anterior cervical discectomy and fusion (ACDF) with SAAS from January 2010 to December 2012 were enrolled in this study. Clinical outcomes were assessed preoperatively and at 24 months postoperatively using the Japanese Orthopaedic Association score, Neck Disability Index, and Visual Analog Scale. Overall cervical alignment (OCA) of the cervical spine, and the range of motion (ROM), intervertebral disc height (IDH), disc signal intensity and disc protrusion of IS were measured and compared before and after surgery. Clinical outcomes significantly improved compared to preoperative scores. The OCA was corrected and maintained at 24 months postoperatively compared with preoperative values (p0.05). However, decreased signal intensity on T2-weighted MRI was evidenced in three mobile IS at final follow-up (20.0%). Skip-level ACDF with SAAS may be an efficacious option for the treatment of noncontiguous cDDD. PMID:26597607

  13. Avaliação retrospectiva de artrodese cervical com enxerto autólogo versus hidroxiapatita Estudio retrospectivo de la artrodesis cervical con autoinjerto versus hidroxiapatita Retrospective study of cervical arthrodesis with autograft versus hydroxyapatite graft

    OpenAIRE

    Yoshinobu Nagasse; Clóvis Yamazato; Fábio Mastromauro de Oliveira; Iberê Ribeiro; José Olympio Catão Bastos Junior; René Kusabara

    2010-01-01

    OBJETIVO: os autores realizaram um estudo e compararam o resultado radiográfico no uso de hidroxiapatita e enxerto de crista ilíaca (autólogo) no tratamento cirúrgico de hérnia discal cervical em um nível, sendo realizada artrodese cervical anterior com placa. MÉTODOS: foi realizado estudo retrospectivo com pacientes submetidos à artrodese cervical comparando-se dois grupos de dez pacientes: um em que foi utilizado enxerto de hidroxiapatita e outro em que foi utilizado enxerto de crista ilíac...

  14. Transfer of the Brachialis to the Anterior Interosseous Nerve as a Treatment Strategy for Cervical Spinal Cord Injury: Technical Note

    OpenAIRE

    Hawasli, Ammar H.; Chang, Jodie; Reynolds, Matthew R; Wilson Z. Ray

    2014-01-01

    Study Design Technical report. Objective To provide a technical description of the transfer of the brachialis to the anterior interosseous nerve (AIN) for the treatment of tetraplegia after a cervical spinal cord injury (SCI). Methods In this technical report, the authors present a case illustration of an ideal surgical candidate for a brachialis-to-AIN transfer: a 21-year-old patient with a complete C7 spinal cord injury and failure of any hand motor recovery. The authors provide detailed de...

  15. Radiograms Obtained during Anterior Cervical Decompression and Fusion Can Mislead Surgeons into Performing Surgery at the Wrong Level

    OpenAIRE

    Chikato Mannoji; Masao Koda; Takeo Furuya; Yuzuru Okamoto; Tamiyo Kon; Kazuhisa Takahashi; Masashi Yamazaki; Masazumi Murakami

    2014-01-01

    A 68-year-old woman who suffered from C5 nerve palsy because of a C4-5 disc herniation was referred to our hospital. We conducted anterior cervical decompression and fusion (ACDF) at the C4-5 level. An intraoperative radiogram obtained after exposure of the vertebrae showed that the level at which we were going to perform surgery was exactly at the C4-5 level. After bone grafting and temporary plating, another radiogram was obtained to verify the correct placement of the plate and screws, and...

  16. Tratamento das luxações traumáticas da coluna cervical por meio da abordagem anterior Treatment of traumatic dislocations of the cervical spine through anterior approach

    Directory of Open Access Journals (Sweden)

    Helton L. A. Defino

    2007-01-01

    Full Text Available Foram estudados 20 pacientes portadores de luxação traumática uni ou bifacetária da coluna cervical tratados pela artrodese e fixação anterior. Os pacientes foram avaliados por meio de parâmetros clínicos, radiológicos e funcionais. Os pacientes foram seguidos por um período que variou de 1 a 14 anos. A consolidação radiológica da artrodese foi observada em todos os pacientes e 1 paciente apresentou soltura tardia de um dos parafusos. A angulação no plano sagital do segmento vertebral lesado apresentou alteração no período pré-operatório, sendo obtido redução no pós-operatório imediato e manutenção da mesma após um ano do tratamento cirúrgico. A avaliação clínica e funcional de acordo com o SF-36 e escala de dor e trabalho de Denis demonstrou bons resultados clínicos sendo as principais queixas pós-operatórias decorrentes do grau da lesão neurológica. O hematoma da ferida operatória, que necessitou de drenagem cirúrgica foi a única complicação observada em um paciente. A realização da artrodese e fixação anterior para o tratamento das luxações traumáticas uni ou bifacetárias da coluna cervical apresentou bons resultados clínicos, radiológicos, funcionais e baixo índice de complicações, justificando nossa preferência por esse método de tratamento para esse tipo de lesão da coluna cervical.Twenty patients presenting with single-or bi-faceted traumatic dislocation of the cervical spine treated by means of arthrodesis and anterior fixation have been studied. Patients were assessed by clinical, X-ray, and functional parameters. The patients were followed up during a period ranging from 1 to 14 years. Union of the arthrodesis, as evidenced by X-ray, was noticed in all patients, with one patient presenting with late loosening of one of the screws. Angulations at sagittal plane of the injured vertebral segment showed a change preoperatively, with reduction being achieved at the early postoperative

  17. Mid- to Long-Term Outcomes of Cervical Disc Arthroplasty versus Anterior Cervical Discectomy and Fusion for Treatment of Symptomatic Cervical Disc Disease: A Systematic Review and Meta-Analysis of Eight Prospective Randomized Controlled Trials.

    Directory of Open Access Journals (Sweden)

    Yan Hu

    Full Text Available This study aimed to investigate the mid- to long-term outcomes of cervical disc arthroplasty (CDA versus anterior cervical discectomy and fusion (ACDF for the treatment of 1-level or 2-level symptomatic cervical disc disease.Medline, Embase, and the Cochrane Central Register of Controlled Trials databases were searched to identify relevant randomized controlled trials that reported mid- to long-term outcomes (at least 48 months of CDA versus ACDF. All data were analyzed by Review Manager 5.3 software. The relative risk (RR and 95% confidence intervals (CIs were calculated for dichotomous variables. The weighted mean difference (WMD and 95%CIs were calculated for continuous variables. A random effect model was used for heterogeneous data; otherwise, a fixed effect model was used.Eight prospective randomized controlled trials (RCTs were retrieved in this meta-analysis, including 1317 and 1051 patients in CDA and ACDF groups, respectively. Patients after an ACDF had a significantly lower rate of follow-up than that after CDA. Pooled analysis showed patients in CDA group achieved significantly higher rates of overall success, Neck Disability Index (NDI success, neurological success and significantly lower rates of implant/surgery-related serious adverse events and secondary procedure compared with that in ACDF group. The long-term functional outcomes (NDI, Visual Analog Scale (VAS neck and arm pain scores, the Short Form 36 Health Survey physical component score (SF-36 PCS, patient satisfaction and recommendation, and the incidence of superior adjacent segment degeneration also favored patients in CDA group with statistical difference. Regarding inferior adjacent segment degeneration, patients in CDA group had a lower rate without statistical significance.This meta-analysis showed that cervical disc arthroplasty was superior over anterior discectomy and fusion for the treatment of symptomatic cervical disc disease in terms of overall success, NDI

  18. Difference in canal encroachment by the fusion mass between anterior cervical discectomy and fusion with bone autograft and anterior plating, and stand-alone cage.

    Science.gov (United States)

    Lee, Soo Eon; Chung, Chun Kee; Kim, Chi Heon

    2016-07-01

    We conducted a prospective randomized study comparing stand-alone cage and bone autograft and plate implants in anterior cervical discectomy and fusion (www.clinicaltrials.gov, NCT01011569). Our interim analysis showed autologous bone graft with plating was superior to a stand-alone cage for segmental lordosis. During this analysis, we noted a difference in canal encroachment by the fusion mass between the two fusion groups. A narrow cervical spinal canal is an important factor in the development of cervical spondylotic myelopathy, therefore this unexpected potential risk of spinal cord compression necessitated another interim analysis to investigate whether there was a difference in canal encroachment by the fusion mass between the two groups. Patients had a minimum 1year of follow-up. The Neck Disability Index, neck and arm pain Visual Analog Scales and lateral radiographs, including bone fusion patterns, were evaluated. Twenty-seven (16 males, 11 females, mean age 54.8years) and 31 (24 males, seven females, mean age 54.5years) patients were in the cage and plate group, respectively. Both groups improved after surgery. Fusion began at 2.6months and 1.3months and finished at 6.7months and 4.0months in 24 (88.9%) and 28 (90.3%) patients in the cage and plate group, respectively. Encroachment into the spinal canal by the fusion mass was significantly different between the fusion types, occuring in 21 (77.8%) patients in the cage group versus six (19.4%) in the plate group (p=0.003). There was a high incidence of spinal canal encroachment by the fusion mass in the stand-alone cage group, possibly limiting use in narrow spinal canals. PMID:27234609

  19. Influência do macheamento do orifício piloto nos parafusos cervicais anteriores Influencia del taladramiento del agujero piloto en tornillos cervicales anteriores Influence of tapping the pilot hole in anterior cervical screws

    OpenAIRE

    Patrícia Silva; João Paulo Chieregato Matheus; Rodrigo César Rosa; Maximiliano Aguiar Porto; Francisco José Albuquerque Paula; Antonio Carlos Shimano; Helton Luiz Aparecido Defino

    2013-01-01

    OBJETIVO: Analisar experimentalmente a influência do macheamento do orifício piloto nas propriedades mecânicas e na interface osso-implante do parafuso cervical anterior. MÉTODOS: Oito carneiros da raça Santa Inês deslanados foram utilizados no estudo. Nos segmentos vertebrais cervicais de C2-C7 foram realizados orifícios piloto de 2,5mm, de ambos os lados da vértebra. No lado direto da vértebra foi realizado o macheamento previamente a inserção do parafuso cortical de 3,5mm, e no lado esquer...

  20. Single-level cervical radiculopathy: clinical outcome and cost-effectiveness of four techniques of anterior cervical discectomy and fusion and disc arthroplasty.

    Science.gov (United States)

    Bhadra, Arup K; Raman, A S; Casey, Adrian T H; Crawford, R J

    2009-02-01

    Although there are several accepted methods of surgical treatment for single-level cervical radiculopathy, the choice depend on the surgeon's preference. The techniques may vary in peri-operative morbidity, short- and long-term outcome, but no study so far has analyzed their cost-effectiveness. This study might give some insight in balancing cost and effectiveness and deciding the right technique. Sixty consecutive patients (15 each group), mean age 36 (range 24-76 years) with single-level cervical disc disease underwent surgical treatment with four different techniques in two centers over the period of 1999-2005. The four groups were--(1) plate and tricortical autograft, (2) plate, cage, and bone substitute, (3) cage only, and (4) disc arthroplasty. The data was collected prospectively according to our protocol and subsequently analyzed. The clinical outcome was assessed comparing visual analog scale (VAS) of neck pain and, short form 12 (SF12) questionnaire both pre- and postoperatively. The radiological assessment was done for fusion rate and postoperative related possible complications at 3 months, 6 months, 1 year, and final follow-up. The cost analysis was done calculating the operative time, hospital stay, implant cost together. The mean follow-up period was 31 months (range 28-43 months). The clinical outcome in terms of VAS of neck and arm pain and SF12 physical and mental score improvement (P=0.001) were comparable with all four techniques. The radiological fusion rate was comparable to current available data. As the hospital stay was longer (average 5 days) with plate and autograft group, the total cost was maximum (average 2,920 pound sterling) with this group. There was satisfactory clinical and radiological outcome with all four techniques. Using the cage alone was the most cost-effective technique, but the disc arthroplasty was comparable to the use of cage and plate. Anterior cervical discectomy and fusion is an established surgical treatment for

  1. Zero-P zero incisura anterior cervical interbody fusion fixation system (ACIF) in anterior cervical decompression and fusion applications%ACIF 在颈前路减压融合术的应用

    Institute of Scientific and Technical Information of China (English)

    汪冉; 王炤; 赵志芳

    2012-01-01

    目的 探讨Zero-P 零切迹颈椎前路椎间融合固定系统(ACIF)在颈前路融合术中的临床疗效.方法 回顾分析自2009-01-2010-12 对36 例颈椎患者采用的颈前路椎间盘切除减压Zero-P椎间融合术治疗.采用日本骨科学会(JOA)及视觉模拟评分(VAS)评分,观察术前、术后3 天、3 个月、12 个月疗效.结果 所有患者采用JOA 评分,术前(8.57±1.03)分,随访终末评分:(14.3±1.22)分.VAS 评分:(6.73±1.12)分,随访终末评分(2.03±1.06)分.术后12 个月植骨融合率为100%,手术前Cobb 角为11.2°(-5.5°~17.1°),随访终末Cobb 角为15.7°(0°~19.1°).术前与术后差异均有统计学意义(P<0.05).术后均无感染、喉返神经、喉上神经及椎动脉损伤,切口均一期愈合,无翻修手术者.结论 Zero-P零切迹颈椎前路椎间融合固定系统(ACIF)能使融合节段获得即刻稳定,融合率高,疗效满意,具有创伤小、神经损伤风险小、可预防临近节段的骨化、操作简便的优点.%Objective To explore the Zero-P zero ineisura anterior cervical interbocly fusion fixation system (ACIF.J in cervical anterior fusion in clinical efficacy. Methods Retrospective analysis from January 2009 to December 2010 in 36 eases of cervical spondylosls with anterior cervical discectomy ir.tervertebral fusion for the treatment of decompression of Zero —P. Using the Japanese Orthopaedic Association (Japanese orthopaedics association ,JOA.) and visual analogue scale (visualanalogous scale,VASJ score, observation of prcoperatlve,postoperative 3days,3 months, 3.2 months, curative effect. Results All the patients with JO A score, preoperative (8.57 + 1.03), follow—up final score: (14.3 + 1.22,) points. The score of VAS: (6.73 + 1.12), follow—up final score (2.03+1.06) points. 12 months after bone grafting fusion rate of 300%, before the operation of Cobb angle is 11.2 degrees (-5.5° to 17.3.°), follow-up of terminal Cobb( s angle 3.5.7° (0° to 19.1

  2. Follow-up radiographs of the cervical spine after anterior fusion with titanium intervertebral disc; Roentgen-Verlaufsuntersuchung der Halswirbelsaeule nach anteriorer Fusion mit Titaninterponaten

    Energy Technology Data Exchange (ETDEWEB)

    Biederer, J.; Hutzelmann, A.; Heller, M. [Kiel Univ. (Germany). Klinik fuer Diagnostische Radiologie; Rama, B. [Paracelsus Klinik, Osnabrueck (Germany). Klinik fuer Neurochirurgie

    1999-08-01

    Purpose: We examined the postoperative changes of the cervical spine after treatment of cervical nerve root compression with anterior cervical discectomy and fusion with a new titanium intervertebral disc. Patients and Methods: 37 patients were examined prior to, as well as 4 days, 6 weeks, and 7 months after surgery. Lateral view X-rays and functional imaging were used to evaluate posture and mobility of the cervical spine, the position of the implants, and the reactions of adjacent bone structures. Results: Implantation of the titanium disc led to post-operative distraction of the intervertebral space and slight lordosis. Within the first 6 months a slight loss of distraction and re-kyphosis due to impression of the implants into the vertebral end-plates were found in all patients. We noted partial infractions into the vertebral end-plates in 10/42 segments and slight mobility of the implants in 14/42 segments. Both groups of patients showed reactive spondylosis and local symptoms due to loosening of the implants. The pain subsided after onset of bone bridging and stable fixation of the loosened discs. Conclusions: The titanium intervertebral disc provides initial distraction of the fusioned segments with partial recurrence of kyphosis during the subsequent course. Loosening of the implants with local symptoms can be evaluated with follow-up X-rays and functional imaging. (orig.) [German] Ziel: An Patienten mit zervikalen Kompressionssyndromen wurden Stellung und Funktion der Halswirbelsaeule nach Diskektomie und Fusion mit einem neuartigen Titaninterponat untersucht. Patienten und Methoden: Bei 37 Patienten (42 Segmente) wurden praeoperativ sowie 4 Tage, 6 Wochen und 7 Monate postoperativ mit seitlichen Uebersichts- und Funktionsaufnahmen Stellung und Mobilitaet der HWS beurteilt. Erfasst wurden Lageveraenderungen des Titaninterponates und die Reaktion der angrenzenden Wirbelkoerperabschlussplatten. Ergebnisse: Das Titaninterponat bewirkte postoperativ eine

  3. 颈前路减压植骨治疗脊髓型颈椎病%Treatment of Anterior Cervical Decompression and Fusion with Cervical Spinal Cord

    Institute of Scientific and Technical Information of China (English)

    余润泽; 喻德富; 章杰斌; 陶学顺; 王家顺; 吕建军

    2011-01-01

    Objective To observe the cervical spinal column fusion anterior cervical decompression and clinical efficacy. Methods 21 cases of single or double in patients with cervical myclopathy were selected,Central Bank of antcrior cervical discectomy and decompression saws,implantation of autologous iliac bone fusion columnar neck immobilization were performed.The patients were followed up by cervical spine X-ray observations,fell,clinical functional evaluation of nerve function recovery.Results 21 patients were followed up for 12 to 24 months( mean 16 months ). Recovery after surgery,bone fusion,the basic life of patients were satisfactory, Some patients returned to work.Neurological function according to the Japanese Orthopacdic Association(JOA) evaluation system,excellent in 16 cases,good in 2 cases,in 2 cases,1 patient;JOA score improved from(9.3±2.1) points up to postoperative(15.4±1.6) points.Conclusion Anterior decompression and fusion was a single,double cervical myclopathy effective treatment,with complete decompression,shorter operation time,trauma,neurological recovery was good,and with low cost advantage.%目的 观察脊髓型颈稚病颈前路减压柱状植骨融合的临床疗效.方法 21例单或双节段脊髓型颈椎病患者,行颈前路环锯椎间盘切除减压,自体柱状髂骨植入融合,颈托外固定.术后随访观察颈椎X线片、自我感觉、临床功能评价、神经功能恢复情况.结果 21例患者全部获得随访,随访时间12~24个月(平均16个月).术后恢复满意,植骨全部融合,患者生活基本可自理,部分患者重返工作.神经功能改善依据日本矫形外科学会(JOA)评定标准,优16例,良2例,中2例,无效1例;JOA评分由术前(9.3±2.1)分上升至术后的(15.4±1.6)分.结论 前路减压植骨是单、双节段脊髓型颈椎病的有效治疗方法,具有减压彻底,手术时间短,创伤小,神经恢复好,费用低等优点;术后需较长期外固定.

  4. Impact of Age and Duration of Symptoms on Surgical Outcome of Single-Level Microscopic Anterior Cervical Discectomy and Fusion in the Patients with Cervical Spondylotic Radiculopathy

    Directory of Open Access Journals (Sweden)

    Farzad Omidi-Kashani

    2014-01-01

    Full Text Available We aim to evaluate the impact of age and duration of symptoms on surgical outcome of the patients with cervical spondylotic radiculopathy (CSR who had been treated by single-level microscopic anterior cervical discectomy and fusion (ACDF. We retrospectively evaluated 68 patients (48 female and 20 male with a mean age of 41.2±4.3 (ranged from 24 to 72 years old in our Orthopedic Department, Imam Reza Hospital. They were followed up for 31.25±4.1 months (ranged from 25 to 65 months. Pain and disability were assessed by Visual Analogue Scale (VAS and Neck Disability Index (NDI questionnaires in preoperative and last follow-up visits. Functional outcome was eventually evaluated by Odom’s criteria. Surgery could significantly improve pain and disability from preoperative 6.2±1.4 and 22.2±6.2 to 3.5±2.0 and 8.7±5.2 (1–21 at the last follow-up visit, respectively. Satisfactory outcomes were observed in 89.7%. Symptom duration of more and less than six months had no effect on surgical outcome, but the results showed a statistically significant difference in NDI improvement in favor of the patients aged more than 45 years (P=0.032, although pain improvement was similar in the two groups.

  5. Estudo experimental da influência da altura do enxerto ósseo intersomático na estabilidade da fixação monossegmentar anterior da coluna cervical Experimental study of the impact of intersomatic bone graft height on the stability of anterior monosegmental fixation of the cervical spine

    OpenAIRE

    Jorge Alfredo Léo; Antonio Carlos Shimano; Gilberto de Araújo Pereira; Helton Luiz Aparecido Defino

    2008-01-01

    OBJETIVO: Estudar experimentalmente a influência da altura do enxerto ósseo intersomático da coluna cervical na estabilidade mecânica da fixação cervical anterior. MÉTODOS: Foram realizados ensaios mecânicos utilizando a coluna cervical de suínos (C3-C4). Foram formados três grupos experimentais compostos por 20 segmentos da coluna cervical (C3-C4), de acordo com o grau de instabilidade produzido e a fixação do segmento vertebral. Grupo I: retirada do disco intervertebral e colocação de enxer...

  6. Reparación del ligamento cruzado anterior en rodillas con alto potencial de crecimiento. Estudio experimental

    OpenAIRE

    Calvente Nomdedeu, Alejandro

    2005-01-01

    RESUMEN INTRODUCCIÓN La rotura del ligamento cruzado anterior en individuos con fisis abiertas, aparece en edades cada vez más tempranas, con frecuencia creciente. Una reparación anatómica, con un riesgo mínimo de lesión fisaria, sería la técnica ideal. OBJETIVOS Principal: 1ª Parte: estudiar el efecto de la perforación transfisaria femoral distal en individuos con alto potencial de crecimiento y el posible efecto protector del injerto tendinoso. 2ª Parte: investigar las variacion...

  7. Pelvic Floor Support Defect in Apical Anterior Vaginal Prolapse with Cervical Hypertrophy. Review with Case Report in a 20-year-old Cadaver.

    Science.gov (United States)

    Chhetri, Kalpana

    2015-10-01

    Apical anterior vaginal wall prolapse (AVWP) with central defect is uncommon in young non hysterectomized patients causing considerable mortality after the fourth decade of life. Its high propensity to recurrence poses the greatest challenge to pelvic reconstructive surgeons. Approximately 40% of women with prolapse have hypertrophic cervical elongation and the extent of elongation increases with greater degrees of prolapse. Women with prolapse either have inherent hypertrophic elongation of the cervix which predisposes them to prolapse or the downward traction in prolapse leads to cervical elongation. The Pelvic Organ Prolapse Quantification (POP-Q) examination includes measurement of the location of the posterior fornix (point D) with the assumption that this measurement is associated with cervical elongation. Multifocal site involvement with apical and perineal descent primarily afflicts elderly, postmenopausal women after the fourth decade while cervical hypertrophic elongation with prolapse is observed in younger women less than 40 years of age. A review of the anatomical implication of the association of cervical hypertrophy in prolapse is carried out in this article. We observed a combination of distension type anterior vaginal prolapse with apical descent and cervical hypertrophy in a 20-year-old cadaver during routine dissection for undergraduate medical students at Sikkim Manipal Institute of Medical Sciences in 2013. Distension type anterior vaginal prolapse with central defect is rarer as most reported cases are of the displacement type, paravaginal defect. Hypertrophic cervical elongation is either the cause or consequence of prolapse and its identification before reconstructive surgery is paramount as uterine suspension in the face of cervical elongation is contraindicated. Inappropriate identification of all support defects and breaking of tissues is the primary cause of failure of laparoscopic pelvic reconstructive surgery. PMID:26557506

  8. The Postoperative Application of Percutanous Dilatational Tracheostomy for Patients with Serious Cervical Spinal Cord Injury Undergoing Anterior or Combined Anterior-posterior Cervical Spine Fixation%经皮扩张气管切开术在重度颈髓损伤颈椎前路或前后路联合手术后人工气道中的应用

    Institute of Scientific and Technical Information of China (English)

    李强; 安卫红; 白宇; 刘飞; 么改琦; 朱曦

    2013-01-01

    Objective To investigate the feasibility of percutanous dilatational tracheostomy on patients undergoing anterior and anterior-posterior cervical spine fixation.Methods A retrospective analysis was done on 17 patients with cervical spinal cord injury who were admitted to ICU of Peking University Third Hospital from January 2012 to March 2013,including 12 cases of anterior and 5 cases of combined anterior-posterior cervical spine fixation.All patients received percutanous dilatational tracheostomy after anterior or anterior-posterior cervical spine fixation.The duration between the percutanous dilatational tracheostomy and the anterior/anterior-posterior cervical spine fixation were 5 to 11 days.Results The procedure of percutanous dilatational tracheostomy was smooth in all 17 cases,with no intraoperative impairment to the vital organs,no postoperative heavy blood loss and no fistula infection.No concurrent anterior and anterior-posterior cervical incision infection occurred.Conclusions Percutanous dilatational tracheostomy is a safe and efficient way of building the artificial airway 5 days after the anterior and anterior-posterior cervical spine fixation.%目的 探讨颈椎前路和颈椎前后路联合颈椎切开复位内固定手术后行经皮扩张气管切开术的安全性. 方法 回顾性分析2012年1月~2013年3月颈脊髓损伤17例,行颈前路(12例)或颈前后路(5例)切开复位内固定手术,术后5 ~11d行经皮扩张气管切开术. 结果 17例经皮扩张气管切开术均过程顺利,无颈前部重要器官损伤、术后局部大量出血、造瘘区域感染、颈前路手术切口及切口深层感染. 结论 颈前路手术5日后行经皮扩张气管切开术是安全高效的建立人工气道的方法.

  9. Design of the PROCON trial : a prospective, randomized multi-center study comparing cervical anterior discectomy without fusion, with fusion or with arthroplasty

    NARCIS (Netherlands)

    Bartels, R.H.M.A.; Donk, R.; Wilt, G.J. van der; Grotenhuis, J.A.; Venderink, D.

    2006-01-01

    BACKGROUND: PROCON was designed to assess the clinical outcome, development of adjacent disc disease and costs of cervical anterior discectomy without fusion, with fusion using a stand alone cage and implantation of a Bryan's disc prosthesis. Description of rationale and design of PROCON trial and d

  10. Locally aggressive aneurysmal bone cyst of C4 vertebra treated by total en bloc excision and anterior plus posterior cervical instrumentation

    Directory of Open Access Journals (Sweden)

    Himanshu N Parmar

    2015-01-01

    Full Text Available We are presenting a case of cervical (C4 aneurysmal bone cyst in a 13-year-old girl, came to the outpatient department with neck pain and stiffness since 6 months and normal neurology. We did an en bloc excision of locally aggressive tumor through anterior plus posterior approach and stabilization by lateral mass screw fixation and anterior cervical instrumentation. Involvement of several adjacent cervical vertebrae by an aneurysmal bone cyst is rare, and conventional treatment with curettage and bone grafting is most likely to carry a high rate of recurrence and spinal instability. We recommend complete excision of the tumor and instrumentation in a single stage to avoid instability.

  11. Análise de fatores associados à lesão do nervo laríngeo recorrente em cirurgias de discectomia cervical via anterior Análisis de factores asociados a la lesión del nervio laríngeo recurrente en cirugías de discectomía cervical por vía anterior Analysis of factors associated with laryngeal nerve injury in anterior disc herniation surgery

    Directory of Open Access Journals (Sweden)

    Erasmo Abreu Zardo

    2011-01-01

    cirúrgico, e dificuldades técnicas que possam aumentar o tempo cirúrgico podem estar associados com lesão do NLR. Novos estudos avaliando as variáveis acima estudadas devem ser considerados.OBJETIVO: Estudiar los posibles factores asociados con la lesión del NLR postcirugía de hernia de disco cervical con abordaje anterior. MÉTODOS: En el periodo de Junio/2009 hasta Junio/2010 evaluamos 30 pacientes sometidos a tratamiento quirúrgico de hernia de disco por via anterior en el Hospital São Lucas de la PUC-RS. En el preoperatorio, fue realizada la medida de la circunferencia cervical (en el nivel del cartílago cricoides y de la altura cervical (del ángulo de la mandíbula borde superior de la clavicula. En el perioperatorio evaluamos el tiempo de intubación, el tiempo quirúrgico, el lado del abordaje, el número de niveles operados, bien como el tipo de incisión (transversal/longitudinal y el uso de halo craneano. Se realizó una evaluación videoendoscópica de laringe (VEL, en la búsqueda de lesión del NLR en el preoperatorio y en el décimo dia después de la cirugía. Pacientes que presentaron un resultado anormal de la VEL (asimetría de movimiento de las dobladuras al verbalizar las vocales A, E, I, O y U fueron considerados con lesión del NLR y fueran reevaluadosmensualmente hasta la recuperación espontánea o en el periodo máximo de 6 meses, cuando la lesión fue considerada definitiva. RESULTADOS: Encontramos 3/30 (10% casos de lesiones no definitivas del NLR que se recuperaron en hasta 120 dias postoperatorios. Los pacientes con lesión del NLR presentaban una mayor circunferencia del cuello, tiempo quirúrgico y número de niveles operados con relación a los pacientes sin lesión del NLR. También, pacientes con lesión del NLR presentaban una menor longitud del cuello. Dos lesiones ocurrieron en el abordaje por el lado derecho y una por el lado izquierdo. Todos los pacientes con lesión tuvieron incisión transversal y no hicieron

  12. [Somatotopic Representation of the Anterior Horn within Cervical Enlargement: Reappraisal of Known Doctrine Based on Clinicopathological Findings Seen in Hirayama Disease].

    Science.gov (United States)

    Hirayama, Keizo

    2016-05-01

    Clinical features (weakness and amyotrophy of intrinsic hand muscles and obliquely distributed amyotrophy of forearm muscles, figure 1), needle electromyographic findings (distribution of neurogenic activities, figure 2), and pathological findings (ischemic necroses of the anterior horns between C6 and T1, figure 3) of Hirayama disease suggest that understanding of somatotopic representation of the anterior horn innervating arm muscles in the cervical enlargement of spinal cord differs from the known doctrine. Anterior horn cells of the intrinsic hand muscles are located between C7 and T1, those of forearm muscles and triceps brachii muscle as elbow extensor are, contrary to the known doctrine, located in C5 and C6, and those of elbow flexors such as biceps brachii and brachioradialis are located in C4 and above (figure 5). Development of dexterity in human hand may reflect development of cervical enlargement in accord with larger areas representing the hand and fingers on cerebral motor cortex. PMID:27156506

  13. Embarazo ectópico ístmico-cervical complicado con placenta increta: reporte de un caso

    Directory of Open Access Journals (Sweden)

    Jamilton Figueroa Solano

    2012-07-01

    Full Text Available Paciente femenina de 37 años de edad, quien ingresa con diagnóstico de embarazo ectópico ístmico-cervical; indicando tratamiento conservador farmacológico con Metotrexato. Posteriormente presentó sangrado genital en abundante cantidad y descompensación hemodinámica. Se le realizó ultrasonido transvaginal control con persistencia de una imagen con similares dimensiones a la del ingreso por lo que se decide realizar laparotomía exploradora e histerectomía total, con reporte histopatológico de embarazo ístmico y placenta increta. La evolución posterior a la cirugía fue satisfactoria. El objetivo del siguiente caso es presentar y discutir el hallazgo de una patología infrecuente como lo es el embarazo ectópico ístmico-cervical. Palabras clave: Embarazo ectópico, embarazo ístmico, acretismo placentario, metotrexato. Isthmian-cervical ectopic pregnancy and placenta increta: a case report Abstract A 37 years old female patient, who was admitted with diagnosis of Isthmian-cervical ectopic pregnancy; indicating conservative pharmacotherapy with methotrexate. Afterwards the patient presented profuse genital bleeding and hemodynamic decompensation. A control transvaginal ultrasound was performed showing persistence of an image with similar dimensions to admission images, deciding to perform a scaning laparotomy and following total hysterectomy, with histopathological reports of Isthmian pregnancy and placenta increta. The Patient’s clinical evolution after surgery was successful. The purpose of the following case is to present and discuss the discovery of a disease as rare as the Isthmian-cervical ectopic pregnancy.

  14. Design of the PROCON trial: a prospective, randomized multi – center study comparing cervical anterior discectomy without fusion, with fusion or with arthroplasty

    Directory of Open Access Journals (Sweden)

    Grotenhuis J André

    2006-11-01

    Full Text Available Abstract Background PROCON was designed to assess the clinical outcome, development of adjacent disc disease and costs of cervical anterior discectomy without fusion, with fusion using a stand alone cage and implantation of a Bryan's disc prosthesis. Description of rationale and design of PROCON trial and discussion of its strengths and limitations. Methods/Design Since proof justifying the use of implants or arthroplasty after cervical anterior discectomy is lacking, PROCON was designed. PROCON is a multicenter, randomized controlled trial comparing cervical anterior discectomy without fusion, with fusion with a stand alone cage or with implantation of a disc. The study population will be enrolled from patients with a single level cervical disc disease without myelopathic signs. Each treatment arm will need 90 patients. The patients will be followed for a minimum of five years, with visits scheduled at 6 weeks, 3 months, 12 months, and then yearly. At one year postoperatively, clinical outcome and self reported outcomes will be evaluated. At five years, the development of adjacent disc disease will be investigated. Discussion The results of this study will contribute to the discussion whether additional fusion or arthroplasty is needed and cost effective. Trial registration Current Controlled Trials ISRCTN41681847

  15. Avaliação da dor e morbidade local da retirada do enxerto ósseo da crista ilíaca para artrodese cervical anterior Evaluación del dolor y morbilidad local del injerto extraído de la cresta ilíaca para artrodesis cervical anterior Evaluation of the pain and local morbidity of the insertion taken out from the iliac crest to the anterior cervical arthrodesis

    OpenAIRE

    Rafael Barreto Silva; Paulo Tadeu Maia Cavali; Ivan Guidolin Veiga; Marcelo Italo Risso-Neto; Wagner Pasqualini; Marcus Alexandre Mello Santos; Alexander Junqueira Rossato; Maurício Antonelli Lehoczki; Elcio Landim

    2010-01-01

    OBJETIVO: avaliar as possíveis complicações associadas à retirada de enxerto da crista ilíaca anterior em cirurgia para artrodese cervical anterior, em especial a dor residual. MÉTODOS: foi realizado estudo retrospectivo com análise de prontuários e aplicação de questionário via telefone com 20 pacientes no período compreendido entre Agosto de 2008 e Novembro de 2009. Todos os pacientes foram submetidos à mesma técnica cirúrgica para extração do enxerto, sendo operados pela mesma equipe no Ho...

  16. Segmental anterior cervical decompression with fusion for treating multilevel cervical myelopathy%颈前路分节段减压融合治疗多节段颈椎病

    Institute of Scientific and Technical Information of China (English)

    林昊; 何仿; 李健; 崔庆元; 陈小强; 田纪伟

    2011-01-01

    Objective To evaluate the clinical value of the segmental anterior cervical decompression with fusion for treating multilevel cervical myelopathy.Methods 24 patients of multilevel cervical myelopathy with 3 or 4 consecutive segments were treated with segmental anterior cervical decompression with fusion.All patientst' cervical plain films,magnetic resonance imaging( MRI ) on preoperation and cervical plain films on postoperation were ohserved.The JOA scores of preoperation and 3 months postoperatively were collected.Results 24 cases were followed up from 3 months to 48 months, average 28 months.All patients improved their functional status in different degree.No complications such as graft nonunion and graft suhsidence occurred.The mean preoperative JOA score of all patients was ( 8.20 ±2.26 ),the postoperative of 3 months was ( 13.50 ± 1.28 ) , the average JOA recovery rate was 60.2%.Fusion rate was 100%.Conclusions The segmental anterior cervical decompression with fusion for treating multilevel cervical myelopathy appears to be effective in decompressing spinal cord, improving nerve functional status and restoring lordosis to the cervical spine with high fusion rate and fewer complications.%目的 评价颈前路分节段减压植骨融合术治疗多节段颈椎病的临床疗效.方法 对24例连续3或4个节段病变的颈椎病患者采用分节段减压融合术治疗.均行术前X线、MRI和术后X线片检查.均于术前及术后3个月进行JOA评分.结果 24例均获随访,时间3~48(28±20)个月.患者功能均有不同程度的改善.无植骨块不愈合、内置物下沉等并发症发生.JOA评分术前平均为(8.20±2.26)分,术后3个月平均为(13.50±1.28),改善率为60.2%,植骨融合率100%.结论 颈椎前路分节段减压融合术具有减压彻底、术后神经功能恢复好、恢复颈椎曲度、融合率高、并发症少等优点.

  17. The Impact of Preoperative Depression and Health State on Quality-of-Life Outcomes after Anterior Cervical Diskectomy and Fusion.

    Science.gov (United States)

    Alvin, Matthew D; Miller, Jacob A; Lubelski, Daniel; Nowacki, Amy S; Scheman, Judith; Mathews, Manu; McGirt, Matthew J; Benzel, Edward C; Mroz, Thomas E

    2016-06-01

    Study Design Retrospective cohort study. Objective We sought to assess the predictive value of preoperative depression and health state on 1-year quality-of-life outcomes after anterior cervical diskectomy and fusion (ACDF). Methods We analyzed 106 patients who underwent ACDF. All patients had either bilateral or unilateral cervical radiculopathy. Preoperative and 1-year postoperative health outcomes were assessed based on the visual analog scale, Pain Disability Questionnaire (PDQ), Patient Health Questionnaire (PHQ-9), and EuroQol-5 Dimensions (EQ-5D) questionnaire. Univariable and multivariate regression analyses were performed to assess for preoperative predictors of 1-year change in health status according to the EQ-5D. Results Compared with preoperative health states, the ACDF cohort showed statistically significant improved PDQ (78.5 versus 57.9), PHQ-9 (9.7 versus 5.3), and EQ-5D (0.55 versus 0.68) scores at 1 year postoperatively and surpassed the minimum clinically important difference for the EQ-5D of 0.1 units (all p ≤ 0.01). Multivariate linear regression indicated that anxiolytic use and higher EQ-5D preoperative scores were associated with less 1-year postoperative improvement in health status. Although not statistically significant, clinically important effects of preoperative depression, as measured by the PHQ-9, were observed on postoperative QOL outcome (-0.006, 95% confidence interval -0.014 to 0.001). Conclusions Of patients who undergo ACDF with similar preoperative QOL health states, those with a greater degree of depression may have lower improvements in postoperative QOL compared with those with less depression. Patients with anxiety and better preoperative health states also attain less 1-year QOL improvements. PMID:27190731

  18. Anterior cervical discectomy with or without fusion with ray titanium cage: a prospective randomized clinical study

    DEFF Research Database (Denmark)

    Hauerberg, J.; Kosteljanetz, M.; Bøge-Rasmussen, Torben;

    2008-01-01

    BACKGROUND DATA: Although an interbody fusion after anterior decompressive surgery for hard or soft disc herniation is widely accepted, there is no scientific evidence that convincingly demonstrates that insertion of graft material for interbody fusion is necessary after discectomy and decompression of the...... by fusion with a Ray titanium cage (40 patients) or to discectomy alone (46 patients). Clinical and radiologic follow-up was performed 3, 12, and 24 months after surgery. RESULTS: There was no statistically significant difference between the 2 groups concerning self-reported satisfaction or severity...

  19. Diffusion-weighted MRI 3T nella valutazione di pazienti con carcinoma dell'endometrio e della cervice uterina: confronto con FDG PET-TC con mezzo di contrasto iodato

    OpenAIRE

    Pizzuti, Laura Micol

    2010-01-01

    In questo studio ho valutato 40 pazienti con carcinoma dell'endometrio e della cervice uterina sottoponendole ad esame RM con mdc ev (gadolinio) con l'aggiunta di sequenze di diffusione (DWI) ed ad esame PET-TC con mdc iodato. Ho poi dimostrato la correlazione tra i valori delle mappe di ADCmin., che si ottengono dalle sequenze DWI ed i valori delle SUVmax che misurano l'iperaccumulo di FDG nel sito tumorale. Nel lavoro ho notato una correlazione inversa che esiste tra questi due parametri ch...

  20. Accessory articulation of elongated anterior transverse process: a rare anatomical variant of the cervical spine depicted with CT and post-processing techniques.

    Science.gov (United States)

    Bilreiro, C; Saraiva, J; Duarte Silva, L; Brito, J; Grande, P

    2016-03-01

    There are several described anatomical variants of the cervical spine, ranging from common to extremely rare, which may have different clinical implications. We present the case of an extremely rare anatomical variant of the cervical spine, in a symptomatic patient, consisting of a unilateral accessory articulation between the 5th and 6th cervical vertebrae, due to elongated anterior transverse processes. Our search found only three cases in the English literature describing similar findings to the case here reported. Our case is, to our knowledge, the first report of this anatomical variant imaged with computed tomography including post-processing images (volume rendering technology and multiplanar reformations), which contribute greatly to a better understanding and depiction of the anatomical variant. PMID:26251024

  1. Preliminary results in anterior cervical discectomy and fusion with an experimental bioabsorbable cage – clinical and radiological findings in an ovine animal model

    OpenAIRE

    Daentzer, Dorothea; Floerkemeier, Thilo; Bartsch, Ivonne; Masalha, Waseem; Welke, Bastian; Hurschler, Christof; Kauth, Theresa; Kaltbeitzel, Daniel; HOPMANN, Christian; Kujat, Bernd; Kalla, Katharina

    2013-01-01

    Background Bioabsorbable implants are not widely used in spine surgery. This study investigated the clinical and radiological findings after anterior cervical discectomy and fusion (ACDF) in an ovine animal model with an experimental bioabsorbable cage consisting of magnesium and polymer (poly-ϵ-caprolactone, PCL) in comparison to a tricortical bone graft as the gold standard procedure. Materials and Methods 24 full-grown sheep had ACDF of C3/4 and C5/6 with an experimental bioabsorbable impl...

  2. Surgical treatment of dysphagia after anterior cervical interbody fusion%前路颈椎融合术后吞咽困难的外科治疗

    Institute of Scientific and Technical Information of China (English)

    Fogel GR; McDonnell MF

    2005-01-01

    BACKGROUND CONTEXT: Dysphagia is a frequent complication after anterior cervical interbody fusion (ACIF). Although dysphagia usually improves over 6 months, it remains a significant and persistent problem for some patients. The etiology is poorly understood but has been reported to be associated with vocal cord paralysis, dislodgement of instrumentation and unidentified causes, such as hematoma, adhesion formation and denervation of the pharyngeal plexus. A surgical treatment of dysphagia after ACIF has not been reported.

  3. Biomechanical stability of a bioabsorbable self-retaining polylactic acid/nano-sized β-tricalcium phosphate cervical spine interbody fusion device in single-level anterior cervical discectomy and fusion sheep models

    Directory of Open Access Journals (Sweden)

    Cao L

    2012-11-01

    Full Text Available Lu Cao,1 Ping-Guo Duan,1 Xi-Lei Li,1 Feng-Lai Yuan,3 Ming-Dong Zhao,2 Wu Che,1 Hui-Ren Wang,1 Jian Dong11Department of Orthopedic Surgery, Zhongshan Hospital, State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai, China; 2Department of Orthopedic Surgery, Jinshan Hospital, Fudan University, Shanghai, China; 3Affiliated Third Hospital of Nantong University, Wuxi, ChinaPurpose: The aim of this study was to investigate the biomechanical stability provided by a novel, polylactic acid/nano-sized, β-tricalcium phosphate, bioabsorbable, self-retaining cervical fusion cage (BCFC.Methods: Quasistatic nonconstraining torques (maximum 1.5 NM induced flexion, extension, lateral bending (±1.5 NM, and axial rotation (±1.5 NM on 32 sheep cervical spines (C2–C5. The motion segment C3–C4 was first tested intact; the following groups were tested after complete discectomy: autologous tricortical iliac crest bone graft, Medtronic–Wego polyetheretherketone (PEEK cage, Solis PEEK cage, and BCFC. The autologous bone graft group was tested with an anterior plate. The mean range of motion (ROM was calculated from the load-displacement curves.Results: BCFC significantly decreased ROM in lateral bending and axial rotation compared to other implants, and no significant difference in ROM between two types of PEEK cages and BCFC could be observed in flexion and extension. Anterior cervical plate (ACP significantly decreased ROM in flexion and extension, but no significant difference in ROM between BCFC and bone graft plus ACP could be determined in lateral bending and axial rotation.Conclusion: The BCFC device showed better stability to autologous tricortical iliac crest bone graft and PEEK cages in single-level anterior cervical discectomy and fusion models and thus may be a potential alternative to the current PEEK cages.Keywords: biomechanics, cervical spine, cages, bioabsorbable, sheep

  4. Clinical outcome of anterior cervical corpectomy with fusion versus anterior cervical discectomy with fusion for multilevel cervical spondylosis%椎体次全切除与椎间隙减压治疗多节段颈椎病的疗效比较

    Institute of Scientific and Technical Information of China (English)

    宋科冉; 袁文; 王新伟; 张颖

    2011-01-01

    Objective To compare the clinical effect and radiological results between anterior cervical corpectomy with fusion (ACCF) and anterior cervical discectomy with fusion (ACDF) in the treatment of nulttilevel cervical spondylosis.Methods A total of 118 patients with multilevel cervical spondylosis who underwent ACCF or ACDF from June 2002 to June 2007 were analyzed respectively. And the patients were divided into Group A (2-level treated with ACCF, n = 33), Group B (2-level treated with ACDF,n =30), Group C (3-level treated with ACCF, n=28), Group D (3-level treated with ACDF,n=27) The clinical outcomes were compared between Group A and Group B, and also between Group C and Group D.Results Compared with Group B, Group A had shorter operation time and a higher postoperative 3 months fusion rate, and the differences were statistically significant ( P <0. 05 ). Compared with Group D, Group C had more blood loss in operation lower fusion rate and lower increased height of fusion segment of postoperative 3 months, and the differences were statistically significant ( P <0. 05 ); but the postoperative curvature of fusion segment of Group C was better than that of Group D and the differences were statistically significant ( P < 0. 05). Tne differences of other datas between Group A and Group B or Group C and Group D were not statistially significant ( P > 0. 05 ). Conclusion For patients with 2-level cervical spondylosis, ACCF and ACDF are both effective operation types; but the ACCF has a better field of vision than ACDF. For patients with 3-level cervical spondylosis, both operation types can be used; and the postoperative curvature of fusion segment of ACDF was worse than ACCF, but cage subsidence maybe occur after ACCF.%目的 比较椎体次全切除减压植骨融合术(anterior cervical corpectomy with fusion,ACCF)和经椎间隙减压植骨融合术(anterior cervical discectomy with fusion,ACDF)治疗多节段颈椎病的临床疗效及影像学结果.方法

  5. 保留椎体后壁的椎体次全切除术治疗脊髓型颈椎病%Anterior Cervical Corpectomy and Fusion with Preserved Posterior Vertebral Wall for Cervical Spondylotic Myelopathy

    Institute of Scientific and Technical Information of China (English)

    郑军; 申才良; 董福龙; 巩陈; 汪卫兵

    2011-01-01

    Objective:To investigate the effect of anterior cervical corpectomy and fusion with preserved posterior vertebral wall for cervical spondylotic myelopathy (CSM), and to compare the results with preserved posterior vertebral wall with the classical anterior cervical corpectomy with ft,sion. Methods :Forty patients with CSM were randomized into two groups, anterior cervical eorpeetomy with fusion (n = 20) and anterior cervical eorpeetomy and fusion with preserved posterior vertebral wall (n=20). The values of operation time, surgical bleeding, the numbers and types of complications, disc height, segmental lordosis, and fusion tale were compared hetween two groups. Results: The average operation time and surgical hleeding decreased significantly in the anterior cervical corpectomy and fusion with preserved posterior vertebral wall group. Improvements in segmental lordosis and disc height were similar in both groups (P>0.05). Both fusion rates after 2 processes reached 100% at 3 months postoperatively. Conclusion: Anterior cervical corpectomy and fusion with preserved posterior vertebral wall is a feasible procedure for anterior decompression and fusion, with a shorter operation time, less surgical bleeding and smaller structural damage to the cervical vertebrae.%目的:探讨保留椎体后壁椎体次全切除术治疗脊髓型颈椎病的疗效,并与传统的椎体次全切除术比较.方法:脊髓型颈椎病患者40例随机均分为2组,分别行传统的椎体次全切除术和保留椎体后壁的椎体次全切除术.比较2组的手术时间、出血量、并发症、节段高度、节段曲度及植骨融合评分等指标变化.结果:保留椎体后壁组较椎体次全切除术组的手术时间短、出血少.2组节段高度和曲度的改善差异均无统计学意义(P>0.05).2种术式术后3个月植骨融合率均为100%.结论:保留椎体后壁的椎体次全切除术具有手术时间短、出血少、对颈椎椎体结构破坏小等优

  6. Embarazo ectópico cervical tratado con metotrexate: Reporte de un caso Ectopic cervical pregnancy treated with methotrexate: A case report

    Directory of Open Access Journals (Sweden)

    Rodolfo Valentín Martínez Camilo

    2000-08-01

    Full Text Available Se presenta el caso de una paciente con embarazo ectópico cervical, a quien se le administró metotrexate sistémico como alternativa al tratamiento quirúrgico. La terapia medicamentosa consistió en la administración de 50 mg de metotrexate por vía endovenosa en días alternos, en un total de 4 dosis, así como el uso de ácido fólico por vía oral a razón de 1 tableta de 5 mg cada 12 horas, en los días en que no se administró metotrexate. Se controló el caso con láminas periféricas evolutivas y ultrasonografía. Se confirmó la destrucción del embarazo por resultados histológicos. Se considera que en el embarazo ectópico cervical, el uso de metotrexate puede ser utilizado como tratamiento conservador. El embarazo ectópico es una afección muy importante en Ginecología,¹ y constituye una entidad en que el óvulo fecundado se implanta en otro sitio que no es la cavidad uterina.² El embarazo cervical es una forma rara de embarazo ectópico, donde el huevo se implanta en el canal cervical y lo distiende a medida que crece.3,4 La hemorragia indolora es su característica clínica habitual5 y al examen físico se observa un cérvix hipertrófico muy vascularizado, con un tejido que sobresale por el orificio externo.6 Como complementario útil para el diagnóstico se puede usar la ultrasonografía, en la que se demuestra de forma directa la presencia de un saco gestacionalThe case of a patient with ectopic cervical pregnancy that was systematically administered methotrexate as an alternative to surgical treatment is presented. Drug therapy consisted in the administration of 4 doses of. 50 mg of methotrexate by endovenous route every other day. Patients received folic acid at doses of 1 tablet of 500 mg every 12 hours when methotrexate was not administered. The case was controlled with evolutive peripheral plates and ultrasonography. The destruction of pregnancy was confirmed by histological results. It is considered that

  7. Artroplastia total de disco cervical com prótese de Bryan: resultados clínicos e funcionais Artroplastía cervical total con prótesis de Bryan: resultados clínicos y funcionales Cervical total disc arthroplasty with Bryan disc: clinical and functional outcomes

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    Eduardo Machado de Menezes

    2012-09-01

    Full Text Available OBJETIVO: Avaliar resultados da artroplastia total disco cervical com a prótese de Bryan para tratamento da cervicobraquialgia (radiculopatia e da mielopatia compressiva. MÉTODOS: No período de 2002 a 2007, a equipe da CECOL operou 65 pacientes. Somente 28 pacientes foram localizados em 2010 para uma nova coleta de dados. Foi feita avaliação pré e pós-operatória, utilizando-se o questionário CSOQ (Cervical Spine Outcomes Questionnaire. Os critérios de Odom foram utilizados somente na avaliação pós-operatória. Ambos foram traduzidos e adaptados para cultura local. RESULTADOS: Houve melhora funcional e sintomática significativa na maioria dos pacientes. A atenuação da dor cervical (axial e braquial (radicular foi semelhante. Os critérios Odom indicaram 82,1% de bons e ótimos resultados, 10% satisfatórios e 7% ruins. Houve apenas uma complicação (3%, que foi revertida com a artrodese anterior. CONCLUSÕES: A artroplastia total de disco cervical demonstrou ser um método seguro e eficaz para tratamento de casos selecionados de hérnia de disco cervical associada a radiculopatia e/ou mielopatia a curto e médio prazo.OBJETIVO: Evaluar los resultados de la artroplastia discal cervical con la prótesis de Bryan para el tratamiento del radiculopatía y compresión de la médula espinal (mielopatía. MÉTODOS: El equipo de CECOL ha operado 65 pacientes en el período de 2002 a 2007. Sólo 28 pacientes fueron localizados en 2010 para una nueva recolección de datos. La evaluación pre y postoperatoria se realizó mediante un cuestionario CSOQ (Cervical Spine Outcomes Questionnaire. Los criterios de Odom sólo fueron utilizados en la evaluación postoperatoria. Ambos fueron traducidos y adaptados a la cultura local. RESULTADOS: Hubo una mejora significativa sintomática y funcional en la mayoría de los pacientes. La atenuación del dolor de cuello (axial y braquial (radicular fue similar. Los criterios Odom demostraron 82,1% de

  8. Adjacent segment disease after anterior cervical decompression and fusion: analysis of risk factors on X-ray and magnetic resonance imaging

    Institute of Scientific and Technical Information of China (English)

    Zhao Yanbin; Sun Yu; Zhou Feifei; Wang Shaobo; Zhang Fengshan; Pan Shengfa

    2014-01-01

    Background Adjacent segment disease (ASD) is common after cervical fusion.The aim of this study was to evaluate the risk factors for ASD on X-ray and magnetic resonance imaging (MRI).Methods Patients included in this study had received revision surgeries after developing symptomatic ASD following anterior decompression and fusion.A control group that had not developed ASD was matched 1:1 by follow-up time and fusion segments.Plate-to-disc distances (PDDs),developmental cervical canal stenosis on X-ray,cervical disc degeneration grading,and cervical disc bulge impingements on preoperative MRI were measured and compared between the ASD group and the control group.Results Thirty-four patients with complete radiographic data were included in the ASD group.The causative segments of ASD included nine cases of C3-4,18 cases of C4-5,three cases of C5-6,and four cases of C6-7.The ASD occurred at the upper adjacent segments in 26 patients and at the lower adjacent segments in eight patients.PDD distributions were similar between the ASD group and the control group.Developmental cervical canal stenosis was a risk factor for ASD,with an odd ratio value of 2.88.Preoperative cervical disc degenerations on MRI were similar between the ASD group and the control group.In the upper-level ASD group,the disc bulge impingement was (19.7±9.7)%,which was significantly higher than that of the control group of (11.8±4.8)%.Conclusions ASD was more likely to develop above the index level of fusion.Developmental cervical canal stenosis and greater disc bulge impingement may be risk factors for the development of ASD.

  9. 颈椎前路手术20例并发症治疗分析%Treatment for Surgical Complications of Anterior Cervical Spine

    Institute of Scientific and Technical Information of China (English)

    郑军; 杨效宁; 曹雷

    2011-01-01

    Objective To investigate the reasons of and prevention for surgical complications of anterior cervical spine. Methods The clinical data of 20 patients with surgical complications in 201 patients who underwent anterior cervical surgery from May 2000 to May 2009 were analyzed retrospectively. Results The patients with complications were followed up for 3 months to 10 years with an average of 5. 5 years. The rate of 11 patients with short-term complications was 15%, and the rate of nine patients with long-term complications was 4. 48%. Conclusion The key of a successful surgery for anterior cervical spine inludes full realization of type of cervical spinal cord injury, careful evaluation of the patient's general condition, skilled operation, and good post-operative care.%目的 探讨颈椎手术并发症原因及预防措施,以提高手术成功率.方法 对2000年5月-2009年5月实施颈椎前路手术的脊髓型颈椎病患者201例中20例发生并发症患者的临床资料及随访情况进行回顾性分析.结果 20例并发症患者获得随访时间3个月~10年,平均5.5年.近期并发症11例,发生率5.47%;远期并发症9例,发生率4.48%.结果 充分认识脊髓的损伤类型,仔细评估患者的全身情况,熟练的手术操作,良好的术后护理是手术成功的关键.

  10. Estudo experimental da influência da altura do enxerto ósseo intersomático na estabilidade da fixação monossegmentar anterior da coluna cervical Experimental study of the impact of intersomatic bone graft height on the stability of anterior monosegmental fixation of the cervical spine

    Directory of Open Access Journals (Sweden)

    Jorge Alfredo Léo

    2008-06-01

    Full Text Available OBJETIVO: Estudar experimentalmente a influência da altura do enxerto ósseo intersomático da coluna cervical na estabilidade mecânica da fixação cervical anterior. MÉTODOS: Foram realizados ensaios mecânicos utilizando a coluna cervical de suínos (C3-C4. Foram formados três grupos experimentais compostos por 20 segmentos da coluna cervical (C3-C4, de acordo com o grau de instabilidade produzido e a fixação do segmento vertebral. Grupo I: retirada do disco intervertebral e colocação de enxerto intersomático. Grupo II: retirada do disco intervertebral, colocação de enxerto intersomático e fixação anterior com placa. Grupo III: retirada do disco intervertebral, secção dos ligamentos posteriores e cápsulas articulares bilateralmente, colocação do enxerto intersomático e fixação anterior com placa. Cada grupo experimental foi dividido em dois subgrupos, de acordo com a altura do enxerto ósseo utilizado (3,0mm ou 6,0mm. Os segmentos vertebrais foram submetidos a ensaios mecânicos de flexão, flexão lateral e torção em máquina universal de ensaio. Os parâmetros analisados foram força máxima (N e o momento (Nm para produzir uma deflexão preestabelecida. RESULTADOS: Não foi observada em todos os grupos experimentais diferença estatística dos valores da força máxima (N e do momento (Nm, entre as diferentes alturas (3,0mm e 6,0mm do enxerto ósseo intersomático. Conclusões: A estabilidade mecânica imediata da artrodese cervical monossegmentar anterior não sofreu influência da altura do enxerto ósseo intersomático nos ensaios de flexão, flexão lateral e torção.OBJECTIVE: To perform an experimental study of the impact of intersomatic bone graft height of the cervical spine on the mechanical stability of anterior cervical fixation. METHODS: Mechanical assays were performed using swine cervical spine (C3-C4. Three experimental groups were formed with 20 cervical spine segments (C3-C4 according to the degree

  11. Anterior cervical locking plate combined with bone graft for cervical vertebral fractures%颈前路带锁钢板联合植骨手术治疗颈椎骨折

    Institute of Scientific and Technical Information of China (English)

    王家明

    2011-01-01

    目的探讨和评价颈前路带锁钢板联合钛网植骨治疗颈椎损伤的应用价值。方法自2003年6月至2009年5月经住院手术的13例颈椎骨折的患者行颈椎前路椎体次全切除术减压,同时带锁钢板内固定联合钛网植骨或自体髂骨植骨融合。结果全部病例得到随访,平均18个月,内固定牢靠无松脱,植骨融合,椎体高度无丢失。结论颈前路带锁钢板联合钛网植骨可即刻恢复节段高度,重建节段稳定性,手术操作简单,并发症少,解决了颈椎损伤重建的难题。%Objective To evaluate the efficacy of anterior cervical locking plate combined with bone graft for cervical vertebral fractures. Methods Totally 13 patients with cervical vertebral fracture hospitalized from June 2003 to May 2009 were treated with internal fixation of steel plate combined with fusion of titanium mesh or iliac bone autograft after the resection of anterior cervical vertebra. Results All cases were followed up for an average of 18 months. The internal fixation was stable, the bone graft fusion was well and the height of vertebra body was close to normal. Conclusion The operation can be used to recover the height and stability of vertebra body. It is an easy operation with few complications and it is conducive to the reconstruction of injured cervical vertebra.

  12. Construction and accuracy assessment of patient-specific biocompatible drill template for cervical anterior transpedicular screw (ATPS insertion: an in vitro study.

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    Maoqing Fu

    Full Text Available BACKGROUND: With the properties of three-column fixation and anterior-approach-only procedure, anterior transpedicular screw (ATPS is ideal for severe multilevel traumatic cervical instabilities. However, the accurate insertion of ATPS remains challenging. Here we constructed a patient-specific biocompatible drill template and evaluated its accuracy in assisting ATPS insertion. METHODS: After ethical approval, 24 formalin-preserved cervical vertebrae (C2-C7 were CT scanned. 3D reconstruction models of cervical vertebra were obtained with 2-mm-diameter virtual pin tracts at the central pedicles. The 3D models were used for rapid prototyping (RP printing. A 2-mm-diameter Kirschner wire was then inserted into the pin tract of the RP model before polymethylmethacrylate was used to construct the patient-specific biocompatible drill template. After removal of the anterior soft tissue, a 2-mm-diameter Kirschner wire was inserted into the cervical pedicle with the assistance of drill template. Cadaveric cervical spines with pin tracts were subsequently scanned using the same CT scanner. A 3D reconstruction was performed of the scanned spines to get 3D models of the vertebrae containing the actual pin tracts. The deviations were calculated between 3D models with virtual and actual pin tracts at the middle point of the cervical pedicle. 3D models of 3.5 mm-diameter screws were used in simulated insertion to grade the screw positions. FINDINGS: The patient-specific biocompatible drill template was constructed to assist ATPS insertion successfully. There were no significant differences between medial/lateral deviations (P = 0.797 or between superior/inferior deviations (P = 0.741. The absolute deviation values were 0.82±0.75 mm and 1.10±0.96 mm in axial and sagittal planes, respectively. In the simulated insertion, the screws in non-critical position were 44/48 (91.7%. CONCLUSIONS: The patient-specific drill template is biocompatible, easy

  13. Artificial cervical vertebra and intervertebral complex replacement through the anterior approach in animal model: a biomechanical and in vivo evaluation of a successful goat model.

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    Jie Qin

    Full Text Available This was an in vitro and in vivo study to develop a novel artificial cervical vertebra and intervertebral complex (ACVC joint in a goat model to provide a new method for treating degenerative disc disease in the cervical spine. The objectives of this study were to test the safety, validity, and effectiveness of ACVC by goat model and to provide preclinical data for a clinical trial in humans in future. We designed the ACVC based on the radiological and anatomical data on goat and human cervical spines, established an animal model by implanting the ACVC into goat cervical spines in vitro prior to in vivo implantation through the anterior approach, and evaluated clinical, radiological, biomechanical parameters after implantation. The X-ray radiological data revealed similarities between goat and human intervertebral angles at the levels of C2-3, C3-4, and C4-5, and between goat and human lordosis angles at the levels of C3-4 and C4-5. In the in vivo implantation, the goats successfully endured the entire experimental procedure and recovered well after the surgery. The radiological results showed that there was no dislocation of the ACVC and that the ACVC successfully restored the intervertebral disc height after the surgery. The biomechanical data showed that there was no significant difference in range of motion (ROM or neural zone (NZ between the control group and the ACVC group in flexion-extension and lateral bending before or after the fatigue test. The ROM and NZ of the ACVC group were greater than those of the control group for rotation. In conclusion, the goat provides an excellent animal model for the biomechanical study of the cervical spine. The ACVC is able to provide instant stability after surgery and to preserve normal motion in the cervical spine.

  14. A novel computed method to reconstruct the bilateral digital interarticular channel of atlas and its use on the anterior upper cervical screw fixation

    Science.gov (United States)

    Wu, Ai-Min; Wang, Wenhai; Xu, Hui; Lin, Zhong-Ke; Yang, Xin-Dong; Wang, Xiang-Yang; Xu, Hua-Zi

    2016-01-01

    Purpose. To investigate a novel computed method to reconstruct the bilateral digital interarticular channel of atlas and its potential use on the anterior upper cervical screw fixation. Methods. We have used the reverse engineering software (image-processing software and computer-aided design software) to create the approximate and optimal digital interarticular channel of atlas for 60 participants. Angles of channels, diameters of inscribed circles, long and short axes of ellipses were measured and recorded, and gender-specific analysis was also performed. Results. The channels provided sufficient space for one or two screws, and the parameters of channels are described. While the channels of females were smaller than that of males, no significant difference of angles between males and females were observed. Conclusion. Our study demonstrates the radiological features of approximate digital interarticular channels, optimal digital interarticular channels of atlas, and provides the reference trajectory of anterior transarticular screws and anterior occiput-to-axis screws. Additionally, we provide a protocol that can help make a pre-operative plan for accurate placement of anterior transarticular screws and anterior occiput-to-axis screws. PMID:26925345

  15. Avaliação radiológica e funcional dos pacientes com fratura da coluna cervical subaxial La evaluación radiológica y funcional de los pacientes con fracturas de la columna cervical subaxial Functional and radiological assessment of patients with subaxial cervical fractures

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    Fabiano Ricardo de Tavares Canto

    2009-12-01

    Full Text Available OBJETIVO: Avaliar 17 pacientes portadores de fratura luxação da coluna cervical (C3 a C7, que foram tratados em um período de dois anos. Os pacientes foram avaliados com parâmetros radiológicos, clínicos e funcionais. MÉTODOS: A indicação do tratamento utilizado em cada paciente foi baseada em seu quadro clínico e neurológico. Todos os pacientes foram tratados pela mesma técnica cirúrgica. O seguimento pós-operatório mínimo foi de seis meses. RESULTADOS: Dez pacientes não apresentavam nenhum comprometimento neurológico e sete pacientes apresentavam algum grau de acometimento neurológico. Na avaliação radiográfica do seguimento ambulatorial, todos os pacientes apresentaram sinais de consolidação da artrodese. Todos ficaram relacionados entre os níveis excelente e regular, de acordo com os critérios de Odom. Treze pacientes apresentaram 20% de limitação pelo questionário Neck Pain Disability Index. Encontrou-se uma complicação de falha no implante para artrodese anterior com um ano e meio de evolução. CONCLUSÃO: O tratamento da fratura-luxação da coluna cervical iniciado o mais rápido possível, pela técnica de descompressão do nível lesado e redução aberta cirúrgica anterior, é um método efetivo, com menor morbidade e com um baixo grau de complicações.OBJETIVO: Habían sido evaluados 17 pacientes que llevaban trauma de la columna cervical (C3 el C7 tratada en un período a dos años. Los pacientes con parámetros radiológicos, clínicos y funcionales fueron evaluados. MÉTODOS: La indicación del tratamiento usado en cada paciente fue basada en el cuadro clínico y neurológico. Los pacientes fueron tratados por la misma técnica quirúrgica. El perseguir postoperatorio mínimo fuera de seis meses. RESULTADOS: Diez pacientes no presentaron ningún comprometimento neurológico y siete pacientes presentaron un cierto grado de acometimento neurológico. En la evaluación radiográfica, los pacientes

  16. 生物活性玻璃联合颈椎椎间融合器在颈椎前路椎间融合中的应用%Anterior cervical discectomy and fusion by cervical cage with bioactive glass

    Institute of Scientific and Technical Information of China (English)

    李宏; 李淳德; 邑晓东; 刘洪

    2014-01-01

    BACKGROUND:Bioactive glass has been largely reported to have perfect clinical results in the bone nonunion and fracture healing, but its effect during spinal fusion progress is rarely reported. OBJECTIVE:To explore the safety and effectiveness of anterior cervical discectomy and fusion by cervical cage with bioactive glass METHODS:A total of 68 cases of cervical spondylosis myelopathy were treated with single level anterior cervical discectomy and fusion. Their clinical data were retrospectively analyzed. Al the cases underwent polyetheretherketone cervical cage with autogenous bone (n=32, control group) or bioactive glass (n=32, experimental group). The bone fusion, neurological functional recovery, intervertebral height, change of cervical curve and wound complications in the two groups was recorded and analyzed. RESULTS AND CONCLUSION:Neurological improvement had no difference between the two groups and there was no complication about wound, such as infection and delayed healing. The average rate of bone fusion was 97%in the control group while 94%in the experiment group 3 months after operation which had no significant differences. Six months after operation, al cases gained bone fusion. The intervertebral height and change of cervical curve both maintained wel in the two groups within 3, 6, 12 months after operation which had no significant differences between the two groups. So, anterior cervical discectomy and fusion by cervical cage with bioactive glass is safe and effective.%背景:已有文献报道生物活性玻璃在骨不连、骨折愈合过程中有较佳的临床疗效,但其在脊柱骨融合过程中的效果鲜有报道。  目的:观察生物活性玻璃联合颈椎椎间融合器在颈椎前路椎间融合中应用的安全性和有效性。  方法:回顾性分析68例颈椎前路单节段椎间融合患者资料,全部病例均采用聚醚醚酮材料椎间融合器,其中内填充自体松质骨植骨32

  17. Safety and Efficiency of Biomimetic Nanohydroxyapatite/Polyamide 66 Composite in Rabbits and Primary Use in Anterior Cervical Discectomy and Fusion

    OpenAIRE

    Hui Xu; Yan Wang; Xiaojing Su; Xuelian Zhang; Xuesong (Sonya) Zhang

    2014-01-01

    This study was conducted to validate the safety and efficiency of biomimetic nanohydroxyapatite/polyamide 66 (n-HA/PA66) composite in animal model (rabbit) and report its application in anterior cervical discectomy and fusion (ACDF) for 4, 12, and 24 weeks. N-HA/PA66 composite was implanted into one-side hind femur defects and the control defects were kept empty as blank controls. A combination of macroscopic and histomorphometric studies was performed up to 24 weeks postoperatively and compa...

  18. Anatomia microcirúrgica do nervo laríngeo recorrente: aplicações no acesso cirúrgico anterior à coluna cervical Microsurgical anatomy of the recurrent laryngeal nerve: applications on the anterior approach to the cervical spine

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    Aluízio Arantes

    2004-09-01

    Full Text Available OBJETIVO: Descrever a anatomia do nervo laríngeo recorrente (NLR bilateralmente, correlacionando-a com os prováveis mecanismos de lesão na abordagem cervical anterior. MÉTODO: Foram examinados 12 cadáveres de adultos provenientes do Laboratório de Microcirurgia da Faculdade de Medicina da UFMG. Os dados foram analisados em termos de freqüência, média e desvio-padrão. RESULTADOS: O NLR esquerdo teve comprimento total médio de 9,4 ± 1,6 cm. Penetra na laringe em 36,3% dos casos na altura de C5, 18,2% de C4, 18,2% de C5-C6, 18,2% de C6 e 9,1% de C4-C5. Recorre em 45,4% dos casos na altura de T3, 18,2% de T3-T4, 18,2% de T4 e 18,2% de T5. O NLR direito teve comprimento total médio de 5 ± 0,3 cm. Penetra na laringe em 44,4% dos casos na altura de C5, em 44,4% de C6 e 11,1% de C3-C4. Recorre em 60% dos casos na altura de T1, 30% de C7 e 10% de T2. CONCLUSÃO: O NLR direito encontra-se mais vulnerável a lesões operatórias por dois aspectos diferentes e complementares: trajetória e comprimento. Devido ao fato de apresentar trajetória mais oblíqua e desprotegida, não se relacionando de forma íntima com o sulco traqueoesofágico, existe maior possibilidade de ocorrerem traumas diretos, como a compressão por retratores ou a secção acidental, principalmente nas abordagens envolvendo níveis vertebrais mais baixos. Da mesma forma, o seu menor comprimento favorece o estiramento de suas fibras durante a tração per-operatória.OBJECTIVE: To present an anatomical description of the recurrent laryngeal nerve (RLN on both sides of the larynx as it relates to the possible lesion mechanisms in anterior cervical spine surgery. METHOD: Twelve adult cadavers were examined from the microsurgical laboratory at the School of Medicine at UFMG, MG, Brazil. The data collected were analyzed in terms of frequency, average and standard deviation. RESULTS: The left RLN had a total average length of 9.4 ± 1.6 cm entering the larynx in 36.3% of the

  19. Papel da videoendoscopia da laringe no diagnóstico de lesão do nervo laríngeo recorrente na abordagem cervical anterior Papel de la videoendoscopía de laringe en el diagnóstico de lesión del nervio laríngeo recurrente en el abordaje cervical por vía anterior The importance of larynx videoendoscopy in diagnosis of recurrent laryngeal nerve injury after anterior approach

    Directory of Open Access Journals (Sweden)

    Alexandre Coutinho Borba

    2010-12-01

    estudiado completamente. OBJETIVO: identificar la prevalencia de lesiones en el NLR en pacientes sintomáticos, o no, a través de la VEL después de la cirugía de la hernia cervical por vía anterior. MÉTODOS: en el período de junio de 2009 a julio de 2010, 30 pacientes sometidos a tratamiento quirúrgico de hernia de disco en el Hospital São Lucas de la PUC-RS fueron seleccionados. Fue realizada la evaluación por VEL en el preoperatorio y en el décimo día después de la cirugía. Pacientes que presentaron resultado anormal en la VEL fueron considerados con lesión del NLR y re-evaluados mensualmente hasta la recuperación espontánea o en el periodo máximo de seis meses, cuando la lesión fue considerada definitiva. RESULTADOS: fueron encontradas evidencias de lesión del NLR en 3/30 (el 10% de los pacientes, siendo que todos se presentaban asintomáticos en el momento del examen. De esas lesiones, 2/30 (el 66,6% ocurrieran después del abordaje quirúrgico por el lado derecho y 1/30 (el 33,3% por el lado izquierdo. No se encontró ninguna lesión definitiva, siendo el período máximo de recuperación de 120 días. CONCLUSIONES: la evaluación por VEL en el periodo postoperatorio puede ser útil para diagnosticar lesiones del NLR, principalmente en pacientes asintomáticos. La falta de sospecha clínica no excluye la posibilidad de lesión del NLR.INTRODUCTION: the recognition of recurrent laryngeal nerve injury (RLN after anterior approach for treatment of disc herniation is important in the clinical evolution of patients, especially in reoperation cases. The importance of larynx videoendoscopy (VEL has not been completely studied. OBJECTIVE: to identify the prevalence of RLN injury in symptomatic or asymptomatic patients with anterior cervical spine surgery, using VEL. METHODS: from June 2009 to July 2010 we selected 30 patients who underwent anterior approach for treatment of disc herniation in Hospital São Lucas, from PUC-RS. VEL was made in the preoperatory

  20. Single-stage Anterior and Posterior Fusion Surgery for Correction of Cervical Kyphotic Deformity Using Intervertebral Cages and Cervical Lateral Mass Screws: Postoperative Changes in Total Spine Sagittal Alignment in Three Cases with a Minimum Follow-up of Five Years.

    Science.gov (United States)

    Ogihara, Satoshi; Kunogi, Junichi

    2015-01-01

    The surgical treatment of cervical kyphotic deformity remains challenging. As a surgical method that is safer and avoids major complications, the authors present a procedure of single-stage anterior and posterior fusion to correct cervical kyphosis using anterior interbody fusion cages without plating, as illustrated by three consecutive cases. Case 1 was a 78-year-old woman who presented with a dropped head caused by degeneration of her cervical spine. Case 2 was a 54-year-old woman with athetoid cerebral palsy. She presented with cervical myelopathy and cervical kyphosis. Case 3 was a 71-year-old woman with cervical kyphotic deformity following a laminectomy. All three patients underwent anterior release and interbody fusion with cages and posterior fusion with cervical lateral mass screw (LMS) fixation. Postoperative radiographs showed that correction of kyphosis was 39° in case 1, 43° in case 2, and 39° in case 3. In all three cases, improvement of symptoms was established without major perioperative complications, solid fusion was achieved, and no loss of correction was observed at a minimum follow-up of 61 months. We also report that preoperative total spine sagittal malalignment was improved after corrective surgery for cervical kyphosis and was maintained at the latest follow-up in all three cases. The combination of anterior fusion cages and LMS is considered a safe and effective procedure in cases of severe cervical kyphotic deformity. Preoperative total spine sagittal malalignment improved, accompanied by correction of cervical kyphosis, and was maintained at last follow-up in all three cases. PMID:26119893

  1. Cáncer cervical en embarazo de la primera mitad con placenta previa. Reporte de un caso

    OpenAIRE

    Walkiria Bermejo Bencomo; Zailik Ventura Balmaseda; María Leonarda Mayedo; Caridad Irene Amador de Varona

    2008-01-01

    El cáncer cervical invasor es una de las causas más frecuentes de muerte en las mujeres de los países en desarrollo. Ocupa el tercer lugar entre las mujeres de todo el mundo. Es raro en mujeres con menos de 30 años y más común en mujeres de 40 años. Se reporta el caso de una paciente de 30 años, atendida en el servicio de Patología de Cuello del Hospital Materno Provincial «Ana Josefa Betancourt de Mora», con el diagnóstico de carcinoma epidermoide infiltrante bien diferenciado de cuello uter...

  2. Papel da videoendoscopia da laringe no diagnóstico de lesão do nervo laríngeo recorrente na abordagem cervical anterior Papel de la videoendoscopía de laringe en el diagnóstico de lesión del nervio laríngeo recurrente en el abordaje cervical por vía anterior The importance of larynx videoendoscopy in diagnosis of recurrent laryngeal nerve injury after anterior approach

    OpenAIRE

    Alexandre Coutinho Borba; Marcus Sofia Ziegler; Erasmo de Abreu Zardo; Joel Abramczuk; Marcelo Severo

    2010-01-01

    INTRODUÇÃO: o reconhecimento da lesão do nervo laríngeo recorrente (NLR) após tratamento cirúrgico de hérnia discal cervical via anterior é importante na evolução clínica do paciente e, em especial, nos casos de reintervenção. O real papel da videoendoscopia da laringe (VEL) de rotina no pós-operatório não tem sido completamente estudado. OBJETIVO: identificar a prevalência de lesões do NLR em pacientes sintomáticos ou não através da VEL após cirurgia de hérnia cervical via anterior. MÉTODOS:...

  3. Anterior cervical reconstruction using interbody fusion cage with cervical compressive mini frame%椎间融合器配合颈椎压力固定器在颈椎前路重建中的应用

    Institute of Scientific and Technical Information of China (English)

    尹华; 李继春; 汤立; 程国林; 朱爱平

    2011-01-01

    目的 探讨颈椎间前路减压椎间融合器配合颈椎压力固定器治疗单间隙颈椎病及单间隙颈椎间盘突出症的短期临床疗效.方法 2008年1月至2009年4月对12例单间隙颈椎病及单间隙颈椎间盘突出症患者行颈前路减压同时采用椎间融合器配合颈椎压力固定器内固定.结果 所有患者获得随访,术后平均随访12 个月( 6~15个月),植骨均在6个月达到临床融合,无颈椎压力固定器松动等不良现象.术后疗效按JOA 评分,术前5~12 分,术后提高4~6分,脊髓功能平均改善率为85.2%.结论 颈椎前路减压术同时采用椎间融合器配合颈椎压力固定器可使颈椎得到即刻稳定,具有便捷省时、加压固定、弹性固定有利于骨性融合等优点.%Objective To retrospect and explore the nearly clinical effect of using interbody fusion cage with cervical compressivemini frame in cervical reconstruction.Methods From January 2008 to April 2009,12 patients with single gap cervical spondylosisor cervical disc herniation were treated through anterior cervical decompression by interbody fusion cage with cervical compressivemini frame.Results All cases were follow-up from 6 to 15 months (average 12 months ).After operation, there was radiographicevidence of fusion in all cases,there was no loosen or shift cervical compressive mini frame.The cases with incomplete paraplegiaimproved 4~6 scores according to JOA neurological criterial postperation.Conclusion Using interbody fusion cage with cervicalcompressive mini frame has many advantages, such as convenience,time efficient, compressive fixation and elastic fixation.

  4. Comparison of anterior decompression and fusion versus laminoplasty in the treatment of multilevel cervical ossification of the posterior longitudinal ligament: a systematic review and meta-analysis

    Science.gov (United States)

    Liu, Weijun; Hu, Ling; Chou, Po-Hsin; Liu, Ming; Kan, Wusheng; Wang, Junwen

    2016-01-01

    Purpose A meta-analysis was conducted to evaluate the clinical outcomes, complications, reoperation rates, and late neurological deterioration between anterior decompression and fusion (ADF) and laminoplasty (LAMP) in the treatment of multilevel cervical ossification of the posterior longitudinal ligament (OPLL). Methods All related studies published up to August 2015 were acquired by searching PubMed and EMBASE. Exclusion criteria were case reports, revision surgeries, combined anterior and posterior surgeries, the other posterior approaches including laminectomy or laminectomy and instrumented fusion, non-English studies, and studies with quality assessment scores of lordosis, complication rate, reoperation rate, and late neurological deterioration were analyzed. All available data was analyzed using RevMan 5.2.0 and Stata 12.0. Results A total of seven studies were included in the meta-analysis. The mean surgical level of ADF was 3.1, and the mean preoperative occupation ratios of ADF and LAMP group were 55.9% and 51.9%, respectively. No statistical difference was observed with regard to preoperative occupation ratio and preoperative JOA score. Although LAMP group had a higher preoperative cervical lordosis than ADF group (Plordosis was observed in LAMP group after operation. ADF group had higher postoperative JOA score (Plordosis, which might be a cause of late neurological deterioration. The complication rates of both groups showed no statistical difference. However, the reoperation rate was significantly higher in ADF group compared with LAMP group. Benefits and risks should be balanced when ADF or LAMP is selected. PMID:27217760

  5. Discover颈人工椎间盘置换术联合颈椎前路减压融合术治疗颈椎病的临床疗效%The clinic effect of discover cervical artificial disc replacement combined with anterior cervical decompression and fusion in treatment of cervical spondylosis

    Institute of Scientific and Technical Information of China (English)

    吴兴林

    2014-01-01

    Objective To explore the clinic effect of discover cervical artificial disc replacement combined with anterior cervical decompression and fusion in treatment of cervical spondylosis. Methods 96 patients were selected from our hospital,and the they were evenly divied into two group by random,experimental group patients were treated with discover cervical artificial disc replacement combined with anterior cervical decompression,the control group patients were treated with anterior cervical decompression and fusion.Compared and analyzed the two groups'cervical spine,the average hospital stay,postoperative cervical fixation time,normal activity recovery time and clinical effect after treatment. Results The experimental group's cervical average activity was (44.6±4.7) degree which was higher than control group,and the difference was significantly(P < 0.05);The experimental group was shorter than control group in average hospital stay,postoperative cervical fixation time,normal activity recovery time,and the difference was significantly(P < 0.05);Experimental group's total effective rate was 97.9% which was higher than the control group(87.5%),and the difference was significantly(P<0.05). Conclusion Discover cervical artificial disc replacement combined with anterior cervical decompression and fusion can reduce the average hospital stay,postoperative cervical fixation time,normal activity recovery time,can ensure the patients's cervical average activity to recover normal,and can improve the clinical effect.%目的:探讨分析Discover颈人工椎间盘置换术联合颈椎前路减压融合术的临床疗效。方法选择我院96例患者,将其随机均分为两组,实验组行Discover颈人工椎间盘置换术联和颈椎前路减压融合术治疗;对照组行颈椎前路减压融合术治疗,比较患者术后颈椎活动度、平均住院时间、术后颈椎固定时间、恢复正常活动时间以及患者临床疗效,并进行统计学分析。

  6. Plastia de ligamento cruzado anterior con injerto de tendones isquiotibiales sin desinserción tibial

    OpenAIRE

    Jorge César Paz Usó

    2009-01-01

    Después de una lesión de ligamento cruzado anterior, muchos pacientes no pueden seguir desempeñando sus actividades cotidianas o deportivas habituales. Algunos pacientes sufren roturas meniscales secundarias y gonartrosis. El objetivo de este trabajo es mostrar una técnica quirúrgica de simple ejecución, que permite un pronto restablecimiento de los pacientes a sus actividades cotidianas. A 96 pacientes del Hospital Regional 1° de Octubre, ISSSTE, se les realizó plastia de ligamento cruzado a...

  7. Therapeutic comparison of uterine artery chemoembolization with internal iliac anterior trunk arterial chemotherapy performed before radical hysterectomy in patients with stages I b2-II a cervical cancer

    International Nuclear Information System (INIS)

    Objective: To compare the short-term and long-term therapeutic response of uterine artery chemoembolization with internal iliac anterior trunk arterial chemotherapy performed before radical hysterectomy in patients with stages I b2-II a cervical cancer. Methods: One hundred and fifty-one patients with stages I b2-II a cervical cancer were treated with preoperative intra-arterial chemotherapy before radical hysterectomy was carried out. Patients in study group (n = 113) received uterine artery chemoembolization (UACE), while patients control group(n = 38) received internal iliac anterior trunk arterial chemotherapy. Radical hysterectomy was carried out in all patients within 2-4 weeks after UACE or chemotherapy. The tumor size was measured before and after the procedure,and the survival rate at 2 and 5 years after treatment was calculated. Results: The mean maximum diameter of the tumors was (4.58 ± 0.37) cm before interventional therapy, and it was (2.11 ± 0.24) cm in two weeks after interventional therapy. The complete response rate of study group and control group was 31.9% and 21.1% respectively. The total effective rate of study group and control group was 94.7% (107/113) and 76.3% (29/38) respectively. The effective rate of study group two weeks after therapy was significantly higher than that of control group. No surgical margin infiltration was observed in both groups. Pathological findings in study group included vascular invasion around surgical margin (n = 3), parametrial invasion (n = 5) and pelvic lymph node metastasis (n = 6), while in control group vascular invasion around surgical margin, parametrial invasion and pelvic lymph node metastasis were found in one, two and one cases respectively. The two-year and five-year survival rate in study group were 80.9% (68/84) and 73.4% (47/64) respectively, while the two-year and five-year survival rate in control group were 81.3% (26/32) and 75.0% (18/24) respectively. No significant difference in survival

  8. Outcomes observed during a 1-year clinical and radiographic follow-up of patients treated for 1- or 2-level cervical degenerative disease using a biodegradable anterior cervical plate.

    Science.gov (United States)

    Chen, Mengcun; Yang, Shuhua; Yang, Cao; Xu, Weihua; Ye, Shunan; Wang, Jing; Feng, Yong; Yang, Wen; Liu, Xianzhe

    2016-08-01

    OBJECTIVE The purpose of this study was to present an initial surgical experience in the management of 1- or 2-level degenerative disc disease of the cervical spine using biodegradable anterior cervical plates (bACPs) in anterior cervical discectomy and fusion (ACDF). The authors also aimed to provide insight into this critical and controversial clinical issue by clarifying outcomes for patients receiving bACPs and by comparing their outcomes with those achieved using a traditional metallic anterior cervical plate (mACP) implant. METHODS A retrospective review was conducted for 2 series of patients who had undergone ACDF using either bACP (31 patients, 38 segments) or mACP (47 patients, 57 segments) instrumentation. The patients were followed up for a mean 13.5 ± 0.9 months (range 12-18 months) in the bACP group and 14.8 ± 1.5 months (range 14-22 months) in the mACP group. Clinical outcomes were determined according to scores on the visual analog scale (VAS), the modified Japanese Orthopaedic Association (mJOA) scoring system, and Odom's criteria. Radiological images were used to assess fusion rates, intervertebral height, Cobb's angle, and the width of prevertebral soft tissue. RESULTS Both VAS and mJOA scores were significantly improved at each follow-up in both groups. Excellent or good results according to Odom's criteria were achieved in 93.5% (29/31) of patients in the bACP group and 93.6% (44/47) of patients in the mACP group. At 6 months postoperatively, the fusion rate was 94.7% (36/38) in the bACP group and 96.5% (55/57) in the mACP group, but subsidence of the intervertebral space at the surgical level was more evident in the bACP group. Angulation, as measured by Cobb's angle, demonstrated obvious healing in both groups, while better maintenance was observed in the mACP group. The local inflammatory reaction was uneventful during follow-up. Dysphonia and dysphagia were observed in both groups during the follow-up. CONCLUSIONS The relatively comparable

  9. Anterior cervical decompression and fusion by microscope for the treatment of cervical spondylotic myelopathy%显微镜下减压融合术治疗脊髓型颈椎病

    Institute of Scientific and Technical Information of China (English)

    宋红浦; 郭峭峰; 张晓文; 张春

    2012-01-01

    目的:探讨显微镜下颈前路减压融合术治疗脊髓型颈椎病的疗效.方法:2005年2月至2010年3月,在显微镜辅助下经颈前路减压融合术治疗脊髓型颈椎病21例,男13例,女8例;年龄32~71岁,平均51.5岁;病程6个月~3年,平均12.5个月.手术操作:在显微镜下应用高速磨钻等工具进行减压操作,脊髓充分减压后取自体髂骨植骨融合加内固定.对手术前后JOA颈椎病评分进行比较并评价其疗效.结果:21例患者均获随访,时间18~24个月,平均20个月.患者脊髓神经功能均有不同程度提高,JOA评分由术前9.26±1.72增加至术后的13.64±1.38 (t=2.452,P=0.000).根据JOA评分评定疗效:优12例,良7例,一般2例.结论:显微镜下颈前路减压融合术具有操作精细、减压充分等优点,治疗脊髓型颈椎病安全、有效.%Objective: To explore clinical effects of anterior cervical decompression and fusion by microscope in treating cervical spondylotic myelopathy. Methods:From February 2005 to March 2010,21 patients with cervical spondylotic myelopathy, 13 males and 8 females with an average age of 51.5 years (ranged, 32 to 71) ,were treated with anterior cervical decompression using high-speed bur,then bone grafting and fusion with auto iliac bone and internal fixation by microscope. According to JOA score of cervical spondylosis to evaluate clinical effects before and after operation. Results: All patients were followed up from 18 to 24 months with an average of 20 months. JOA score improved significantly from preoperative 9.26±1.72 to postoperative 13.64±1.38 (t=2.452,P=0.000). According to JOA score, 12 cases were excellent,7 good and 2 fair. Conclusion : Anterior cervical decompression and fusion by microscope is a refined, safe and effective surgical procedure for cervical spondylotic myelopathy.

  10. 颈前路手术治疗脊髓型颈椎病并颈椎外伤所致急性颈髓损伤19例临床分析%Clinical analysis on 19 cases of anterior cervical surgical treatment of acute cervical spinal cord injury caused by cervical spondylotic myelopathy and cervical trauma

    Institute of Scientific and Technical Information of China (English)

    张明友; 陈德元

    2014-01-01

    目的 探讨颈前路椎体次全切并后纵韧带切除减压植骨融合术治疗脊髓型颈椎病并颈椎外伤所导致的急性颈髓损伤的疗效.方法 回顾性分析采用颈前路椎体次全切并后纵韧带切除减压植骨融合术治疗的脊髓型颈椎病并颈椎外伤所导致的急性颈髓损伤的19例患者病历资料,对患者外伤前(T1)、外伤后(T2)、术后1周内(T3)、术后10个月后(T4)四个时期的颈椎曲度及神经功能评分(JOA)变化进行分析,判断手术疗效.结果 所有患者均获得10~24个月随访,平均(15.2±6.7)个月.T1、T2、T3、T4四个时期的颈椎曲度分别为(28.621±1.850)°、(29.326±2.416)°、(38.384±2.611)°、(37.316±2.521)°.T1、T2、T3、T4四个时期的JOA脊髓型颈椎病评分分别为(12.79±1.316)、(4.00±2.082)、(9.68±3.001)、(11.68±3.334).结论 颈前路椎体次全切并后纵韧带切除减压植骨融合术可达到有效减压效果、可重建颈椎曲度,能提供脊髓型颈椎病并颈椎外伤所导致的颈髓损伤有效康复条件;术后积极康复治疗也是改善神经功能的重要方法.%Objective To explore the effect of anterior cervical corpectomy and posterior longitudinal ligament resection and decompression and fusion for the therapeutic in acute cervical spinal cord injury caused by cervical spondylotic myelopathy and cervical trauma.Methods Retrospective analysis was carried out to 19 cases of acute cervical spinal cord injury caused by cervical spondylotic myelopathy and cervical trauma who used anterior cervical corpectomy and posterior longitudinal ligament resection and decompression and fusion for the therapeutic,and analysis of patients before trauma (T)1,post-traumatic (T2),within 1 week after operation (T3),10 months after operation (T4) these four periods about the changes of cervical curvature and neural function (JOA score) were analyzed,then evaluated the operation curative effect.Results All patients were followed

  11. Cervicoplastia anterior Anterior cervicoplasty

    Directory of Open Access Journals (Sweden)

    Lucas Gomes Patrocínio

    2004-10-01

    Full Text Available Muitos pacientes buscam correção estética da frouxidão da pele do pescoço, depósito de gordura na região submentoneana ou bandas de platisma. Em grande parte dos casos a ação medial, via cervicoplastia anterior é necessária. OBJETIVO: Demonstrar a casuística e avaliar os resultados e complicações com a técnica de cervicoplastia anterior no Serviço de Otorrinolaringologia da Universidade Federal de Uberlândia. FORMA DE ESTUDO: Relato de série. PACIENTES E MÉTODOS: Quarenta e dois pacientes, entre 39 e 65 anos de idade, sendo 40 (95,2% do sexo feminino e 2 (4,8% do masculino, foram submetidos a cervicoplastia anterior. Retrospectivamente foram avaliados resultados e complicações. RESULTADOS: Destes, 34 apresentaram resultados satisfatórios, 4 apresentaram déficit estético notado somente pelo cirurgião, 3 apresentaram déficit estético notado somente pelo paciente e 1 apresentou déficit estético necessitando cirurgia revisional. Ao estudo fotográfico, todos os pacientes apresentaram melhora do perfil cervical, redução das bandas de platisma e da frouxidão da pele, estabilização da musculatura cervical e acentuação do ângulo cervicomental, em graus variados. Houve complicação em 2 casos (discreto serohematoma e cicatriz um pouco alargada. CONCLUSÃO: A cervicoplastia, associada ou não à tração lateral pela ritidoplastia, é uma técnica que produz resultados satisfatórios na grande maioria dos casos.Many patients look for aesthetic correction of the laxity of neck skin, submandibular fat deposit or platisma bands. In a large part of the cases, medial action, through anterior cervicoplasty is necessary. AIM: To demonstrate the casuistic and to evaluate the results and complications with anterior cervicoplasty technique in the Otorhinolaryngology Service of the Federal University of Uberlândia. STUDY DESIGN: Serie report. PATIENTS AND METHODS: Forty-two patients, between 39 and 65 years of age, being 40 (95

  12. Restauraciones Estéticas en el Sector Anterior con Resina Compuesta. Reporte de un Caso.

    Directory of Open Access Journals (Sweden)

    Yecenia Perdomo Pacheco

    2011-10-01

    Full Text Available Las carillas directas se están convirtiendo en una solución para casi todos los problemas estéticos de la odontología actual. Los nuevos materiales de resina compuesta aparecidos en los últimos años han mejorado de forma importante sus propiedades mecánicas y estéticas, sobre todo la estabilidad del color, la textura y el pulido. Es por eso que cuando un paciente tiene una sonrisa con pequeñas alteraciones dentales, el uso de tratamientos conservadores tales como recontorneado gingival y/o gingivoplastia, blanqueamiento dental y restauraciones en resina, proporcionan un tratamiento predecible, con un resultado estético duradero, a un costo moderado.

  13. Cervical radiculopathy.

    Science.gov (United States)

    Iyer, Sravisht; Kim, Han Jo

    2016-09-01

    Cervical radiculopathy is a common clinical scenario. Patients with radiculopathy typically present with neck pain, arm pain, or both. We review the epidemiology of cervical radiculopathy and discuss the diagnosis of this condition. This includes an overview of the pertinent findings on the patient history and physical examination. We also discuss relevant clinical syndromes that must be considered in the differential diagnosis including peripheral nerve entrapment syndromes and shoulder pathology. The natural history of cervical radiculopathy is reviewed and options for management are discussed. These options include conservative management, non-operative modalities such as physical therapy, steroid injections, and operative intervention. While the exact indications for surgical intervention have not yet been elucidated, we provide an overview of the available literature regarding indications and discuss the timing of intervention. The surgical outcomes of anterior cervical decompression and fusion (ACDF), cervical disc arthroplasty (CDA), and posterior cervical foraminotomy (PCF) are discussed. PMID:27250042

  14. 椎体入路经皮内镜髓核摘除术治疗颈椎间盘突出症%Percutaneous endoscopic cervical discectomy via anterior transcorporeal approach for cervical disc herniation

    Institute of Scientific and Technical Information of China (English)

    楚磊; 刘超; 陈亮; 柯珍勇; 陈富; 邓忠良

    2016-01-01

    Objective To evaluate the feasiblility and efifcacy of percutaneous endoscopic cervical discectomy via anterior transcorporeal approach for cervical disc herniation.Methods From September 2013 to July 2014, 9 patients suffering cervical disc herniation received anterior transcorporeal approach for cervical disc herniation in the second Afifliated Hospital of Chongqing Medical University including 4 males, 5 females, with the average age of ( 44.5 ± 12.4 ) years ( range 24 - 68 years ). Levels of herniation: C3-4: 1, C4-5: 3, C5-6: 4, C6-7: 1. Percutaneous endoscopic cervical discectomy via anterior transcorporeal approach for cervical disc herniation: Guide wire was inserted between carotid sheath and tracheal esophageal sheath to the vertebra, then working trocar was applied. Burrs was used to make osseous channel in order to achieve access to the target. Herniated fragments and osteophyte were removed, and spinal cord and nerve roots were decompressed through the osseous channel. Operation time, amount of removed disc fragments and operation-related complications were observed and recorded. Clinical results were evaluated with VAS of shoulders and arms at one day before surgery, and postoperatively 1 day, 1 week, 1 month, 3 months 6 months. The follow-up included AP, lateral and dynamic X-ray of cervical spine, cervical CT and MRI.Results The surgeries were successfully performed for all the 9 patients, with an average operation time of ( 81.5 ± 23.4 ) min and an average amount of herniated disc fragments of ( 0.5 ± 0.2 ) g. One patient developed postoperative headache. One patient reported transient postoperative quadriplegia. Vertebral collapse were observed in 2 patients. The VAS was ( 75 ± 10 ) points before surgery, and respectively ( 32 ± 4 ) points, ( 22 ± 3 ) points, ( 19 ± 2 ) points, ( 16 ± 2 ) points and ( 8 ± 2 ) points at postoperatively 1 day, 1 week, 1 month, 3 months and 6 months. The VAS scores in follow-up were different from the one at

  15. Restauraciones estéticas en el sector anterior con resina compuesta. reporte de un caso.

    OpenAIRE

    Yecenia Perdomo Pacheco

    2011-01-01

    Las carillas directas se están convirtiendo en una solución para casi todos los problemas estéticos de la odontología actual. Los nuevos materiales de resina compuesta aparecidos en los últimos años han mejorado de forma importante sus propiedades mecánicas y estéticas, sobre todo la estabilidad del color, la textura y el pulido. Es por eso que cuando un paciente tiene una sonrisa con pequeñas alteraciones dentales, el uso de tratamientos conservadores tales como recontorneado gingival y/o gi...

  16. 锚定式颈椎椎间融合器在颈椎前路再手术中的应用%Clinical application research on anterior cervical reoperation by using of anchoring cervical intervertebral fusion cage

    Institute of Scientific and Technical Information of China (English)

    鲍达; 马远征

    2014-01-01

    目的:观察既往曾行颈椎前路手术的病例,再次行其他病变椎间盘切除减压并应用锚定式颈椎椎间融合器( anchoring cervical intervertebral fusion cage,ACIFC)行植骨融合的临床疗效。方法2009年1月~2012年6月收治颈椎前路手术后,其他颈椎节段再次发病患者12例,其中男7例,女5例;年龄35~64岁,平均49.6岁。再次手术原因:融合邻近节段退变性疾病8例,非邻近节段再发颈椎病3例,急性颈椎椎间盘突出症1例。均经前路行病变颈椎椎间盘切除减压、ACIFC植骨术,共置入ACIFC 12枚。术后定期行X线片及MRI复查;采用中华医学会骨科学分会( Chinese Orthopaedic Association, COA)40分法及颈椎残障指数( neck disability index, NDI)评分系统评价患者术前、术后颈脊髓神经功能及生活质量。结果随访时间2~4.5年,平均3.5年。12个再手术节段均获骨性融合,融合时间2.5~5个月,平均3.3个月。术前COA评分32.00±2.00分,术后末次随访时37.92±1.08分,差异有统计学意义(P<0.05)。术前NDI评分39.08±3.32,术后末次随访时29.08±2.15,差异有统计学意义(P<0.05)。结论在颈椎前路再手术中应用ACIFC行植骨融合,施术方便、固定确切、融合率高,近期随访结果满意。%Objective To study the clinical application of the anchoring cervical intervertebral fusion cage ( ACIFC ) , which was used in the anterior cervical reoperation.Methods All 12 cases of the cervical spinal diseases in another segments from January 2009 to June 2012 were reviewed, who were operated with anterior cervical decompression and fusion ( ACDF) before.There were total 7 male and 5 female, 35-64 years old (mean 49.6 years old).Adjacent segment disease(ASD), 8 cases, cervical spondylosis, 3 cases and 1 case was acute cervical disc herniation.All patients were treated with anterior dis

  17. Safety and efficacy of rhBMP2 in posterior cervical spinal fusion for subaxial degenerative spine disease: Analysis of outcomes in 204 patients

    OpenAIRE

    Xu, Risheng; Bydon, Mohamad; Sciubba, Daniel M.; Witham, Timothy F.; Wolinsky, Jean-Paul; Gokaslan, Ziya L; Bydon, Ali

    2011-01-01

    Background: Many studies offer excellent demonstration of the ability of bone morphogenic protein (BMP) to enhance fusion rates in anterior as well as posterior lumbar surgery. Recently, BMP has also been shown to increase arthrodesis rates in anterior cervical surgery, albeit with concomitant increases in complication rates. To date, however, few studies have investigated the safety and efficacy of BMP in cervical surgeries approached posteriorly. Methods: We retrospectively reviewed 204 con...

  18. Morphometric study of cervical anterior horn cells and pyramidal tracts in medulla oblongata and the spinal cord in patients with cerebrovascular diseases.

    Science.gov (United States)

    Qiu, Y; Wada, Y; Otomo, E; Tsukagoshi, H

    1991-04-01

    To clarify the effect of damage to the upper motor neurons on lower motor neurons, quantitative studies were made regarding the cross-sectional area and the number of the individual anterior horn cells in the lateral nuclear cell groups of the 5th segment of the cervical spinal cord (C5), and regarding the cross-sectional areas of the pyramidal tract in the medulla, and in the spinal cord at the C5 and L2 levels. The subjects included 45 patients with cerebrovascular disease (CVD), and 50 age-matched controls without neurological disease. The medullary pyramid (MP) and the ventral funiculus (VF), ipsilateral to the hemispheric lesion, were compared with the MP and VF of the other, unaffected, side. The ventro-lateral funiculus (VLF), anterior horn (AH) and C5 anterior horn cell (AHC), contralateral to the lesion, were also compared with the VLF, AH, and AHC of the other, unaffected, side. The AHC area (mean cross-sectional area of anterior horn cells) and the MP area, VF area, VLF area, AH area (mean cross-sectional areas of MP, VF, VLF and AH) associated with the hemispheric lesional side were significantly decreased, compared with those of the unaffected sides and the controls. However, there was no significant difference in AHC number between the affected and unaffected sides in patients with CVD, nor between the affected side and the controls. In order to examine the relationship between a decrease in AHC area and degree of paralysis, CVD patients were divided into two groups according to degree of muscle strength: the severe and mild paralysis groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2072114

  19. Comparison of outcomes and safety of using hydroxyapatite granules as a substitute for autograft in cervical cages for anterior cervical discectomy and interbody fusion

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    Hosein Mashhadinezhad

    2014-03-01

    Full Text Available Background:   After cervical discectomy, autogenetic bone is packed into the cage to increase the rate of union between adjacent vertebral bodies, but donor site–related complications can still occur. In this study we evaluate the use   of hydroxyapatite granules as a substitute for autograft for interbody fusion.     Methods:   From November 2008 to November 2011, 236 patients participated in this study. Peek cages were packed with autologous bone grafts taken from the iliac crest in 112 patients and hydroxyapatite (HA granules in 124 patients.   Patients were followed for 12 months. The patients’ neurological signs, results, and complications were fully recorded   throughout the procedure. Radiological imaging was done to assess the fusion rate and settling ratio.     Results:   Formation of bony bridges at the third month was higher in the autograft group versus the granule group. However, there was no difference between both groups at the 12-month follow-up assessment. No difference (     P > 0.05   was found regarding improvement in neurological deficit as well as radicular pain and recovery rate between the two groups. Conclusions:   Interbody fusion cage containing HA granules proved to be an effective treatment for cervical spondylotic radiculopathy and/or myelopathy. Clinical and neurological outcome, radiographic measurement and fusion rate   in cage containing HA are similar and competitive with autograft packed cages.    

  20. Comparison of outcomes and safety of using hydroxyapatite granules as a substitute for autograft in cervical cages for anterior cervical discectomy and interbody fusion

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    Hosein Mashhadinezhad

    2014-03-01

    Full Text Available Background:   After cervical discectomy, autogenetic bone is packed into the cage to increase the rate of union between adjacent vertebral bodies, but donor site–related complications can still occur. In this study we evaluate the use   of hydroxyapatite granules as a substitute for autograft for interbody fusion.     Methods:   From November 2008 to November 2011, 236 patients participated in this study. Peek cages were packed with autologous bone grafts taken from the iliac crest in 112 patients and hydroxyapatite (HA granules in 124 patients.   Patients were followed for 12 months. The patients’ neurological signs, results, and complications were fully recorded   throughout the procedure. Radiological imaging was done to assess the fusion rate and settling ratio.     Results:   Formation of bony bridges at the third month was higher in the autograft group versus the granule group. However, there was no difference between both groups at the 12-month follow-up assessment. No difference (     P > 0.05   was found regarding improvement in neurological deficit as well as radicular pain and recovery rate between the two groups. Conclusions:   Interbody fusion cage containing HA granules proved to be an effective treatment for cervical spondylotic radiculopathy and/or myelopathy. Clinical and neurological outcome, radiographic measurement and fusion rate   in cage containing HA are similar and competitive with autograft packed cages.

  1. Postoperative cerebrospinal-fluid fistula associated with erosion of the dura. Findings after anterior resection of ossification of the posterior longitudinal ligament in the cervical spine.

    Science.gov (United States)

    Smith, M D; Bolesta, M J; Leventhal, M; Bohlman, H H

    1992-02-01

    Of twenty-two patients who had had anterior decompression of the spinal canal for ossification of the posterior longitudinal ligament and cervical myelopathy, seven had absence of the dura adjacent to the ossified part of the ligament. The spinal cord and nerve-roots were visible through this defect. Although the arachnoid membrane appeared to be intact and watertight in most patients, a cerebrospinal-fluid fistula developed postoperatively in five, and three had a second operation to repair the defect in the dura. On the basis of this experience, we recommend use of autogenous muscle or fascial dural patches, immediate lumbar subarachnoid shunting, and modification of the usual postoperative regimen, such as limitation of mechanical pulmonary ventilation to the shortest time that is safely possible and use of anti-emetic and antitussive medications to protect the remaining coverings of the spinal cord when the dura is found to be absent adjacent to an ossified portion of the posterior longitudinal ligament in the cervical spine. PMID:1541620

  2. Safety and Efficiency of Biomimetic Nanohydroxyapatite/Polyamide 66 Composite in Rabbits and Primary Use in Anterior Cervical Discectomy and Fusion

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    Hui Xu

    2014-01-01

    Full Text Available This study was conducted to validate the safety and efficiency of biomimetic nanohydroxyapatite/polyamide 66 (n-HA/PA66 composite in animal model (rabbit and report its application in anterior cervical discectomy and fusion (ACDF for 4, 12, and 24 weeks. N-HA/PA66 composite was implanted into one-side hind femur defects and the control defects were kept empty as blank controls. A combination of macroscopic and histomorphometric studies was performed up to 24 weeks postoperatively and compared with normal healing. 60 cervical spondylosis myelopathy and radiculopathy patients who were subjected to ACDF using n-HA/PA66 and PEEK cage were involved in this study with six-month minimum follow-up. Their radiographic (cage subsidence, fusion status, and segmental sagittal alignment (SSA and clinical (VAS and JOA scales data before surgery and at each follow-up were recorded and compared. Nanohydroxyapatite/polyamide 66 composite is safe and effective in animal experiment and ACDF.

  3. CT morphometric analysis to determine the anatomical basis for the use of transpedicular screws during reconstruction and fixations of anterior cervical vertebrae.

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    Chun Chen

    Full Text Available BACKGROUND: Accurate placement of pedicle screw during Anterior Transpedicular Screw fixation (ATPS in cervical spine depends on accurate anatomical knowledge of the vertebrae. However, little is known of the morphometric characteristics of cervical vertebrae in Chinese population. METHODS: Three-dimensional reconstructions of CT images were performed for 80 cases. The anatomic data and screw fixation parameters for ATPS fixation were measured using the Mimics software. FINDINGS: The overall mean OPW, OPH and PAL ranged from 5.81 to 7.49 mm, 7.77 to 8.69 mm, and 33.40 to 31.13 mm separately, and SPA was 93.54 to 109.36 degrees from C3 to C6, 104.99 degrees at C7, whereas, 49.00 to 32.26 degrees from C4 to C7, 46.79 degrees at C3 (TPA. Dl/rSIP had an increasing trend away from upper endplate with mean value from 1.87 to 5.83 mm. Dl/rTIP was located at the lateral portion of the anterior cortex of vertebrae for C3 to C5 and ipsilateral for C6 to C7 with mean value from -2.70 to -3.00 mm, and 0.17 to 3.18 mm. The entrance points for pedicular screw insertion for C3 to C5 and C6 to C7 were recommended -2∼-3 mm and 0-4 mm from the median sagittal plane, respectively, 1-4 mm and 5-6 mm from the upper endplate, with TPA being 46.79-49.00 degrees and 40.89-32.26 degrees, respectively, and SPA being 93.54-106.69 degrees and 109.36-104.99 degrees, respectively. The pedicle screw insertion diameter was recommended 3.5 mm (C3 and C4, 4.0 mm (C5 to C7, and the pedicle axial length was 21-24 mm for C3 to C7 for both genders. However, the ATPS insertion in C3 should be individualized given its relatively small anatomical dimensions. CONCLUSIONS: The data provided a morphometric basis for the ATPS fixation technique in lower cervical fixation. It will help in preoperative planning and execution of this surgery.

  4. 颈椎前路内固定术后中远期食管并发症%Delayed esophageal complications after anterior cervical spine surgery

    Institute of Scientific and Technical Information of China (English)

    高瑞; 杨立利; 陈华江; 王新伟; 袁文

    2012-01-01

    Objective To investigate incidence,diagnosis and treatment strategy of delayed esophageal complications after anterior cervical spine surgery.Methods The clinical data of 2316 patients who had undergone anterior cervical spine surgery from January 2001 to December 2011 were analyzed.The delayed esophageal complications were defined as esophageal perforation,esophago-tracheal fistula,esophago-cutaneous fistula,diverticulum of esophagus,esophagopleural fistula and esophageal stenosis that occurred 2 weeks after spine surgery.Results Delayed esophageal complications occurred in 4 patients,and the incidence was 0.17%.Esophageal perforation occurred in 2 patients; the incidence was 0.09%.Case 1 was a 31-year-old man who was found to have esophageal diverticulum and perforation 7 years after anterior cervical spine surgery.Then he underwent removal of implant,excision of diverticulum,and repair of esophagus with sternohyoid muscle flap and omohyoid muscle flap.Case 2 was a 46-year-old man who was found to have esophageal diverticulum 3 years after cervical spine surgery.He also underwent removal of implant,excision of diverticulum,and repair of esophagus with sternohyoid muscle flap and omohyoid muscle flap.Case 3 was a 58-year-old woman who was found to have esophageal diverticulum 5 years after cervical spine surgery.She underwent removal of implant,excision of diverticulum,and repair of esophagus with sternocleidomastoid muscle flap.Case 4 was a 56-year-old woman who was found to have esophageal perforation 3 years after cervical spine surgery.She underwent removal of implant and repair of esophagus with sternocleidomastoid muscle flap.All 4 patients recovered after operation.Conclusion The incidence of delayed esophageal complications after anterior cervical spine surgery is low,and the diagnosis is difficult.X-ray,digestive tract radiography,and gastrointestinal endoscopy are the main diagnostic tools.Surgical treatment is the main and effective management

  5. Evaluation of anterior cervical reconstruction with titanium mesh cages versus nano-hydroxyapatite/polyamide66 cages after 1- or 2-level corpectomy for multilevel cervical spondylotic myelopathy: a retrospective study of 117 patients.

    Directory of Open Access Journals (Sweden)

    Yuan Zhang

    Full Text Available OBJECTIVE: To retrospectively compare the efficacy of the titanium mesh cage (TMC and the nano-hydroxyapatite/polyamide66 cage (n-HA/PA66 cage for 1- or 2-level anterior cervical corpectomy and fusion (ACCF to treat multilevel cervical spondylotic myelopathy (MCSM. METHODS: A total of 117 consecutive patients with MCSM who underwent 1- or 2-level ACCF using a TMC or an n-HA/PA66 cage were studied retrospectively at a mean follow-up of 45.28 ± 12.83 months. The patients were divided into four groups according to the level of corpectomy (1- or 2-level corpectomy and cage type used (TMC or n-HA/PA66 cage. Clinical and radiological parameters were used to evaluate outcomes. RESULTS: At the one-year follow-up, the fusion rate in the n-HA/PA66 group was higher, albeit non-significantly, than that in the TMC group for both 1- and 2-level ACCF, but the fusion rates of the procedures were almost equal at the final follow-up. The incidence of cage subsidence at the final follow-up was significantly higher in the TMC group than in the n-HA/PA66 group for the 1-level ACCF (24% vs. 4%, p = 0.01, and the difference was greater for the 2-level ACCF between the TMC group and the n-HA/PA66 group (38% vs. 5%, p = 0.01. Meanwhile, a much greater loss of fused height was observed in the TMC group compared with the n-HA/PA66 group for both the 1- and 2-level ACCF. All four groups demonstrated increases in C2-C7 Cobb angle and JOA scores and decreases in VAS at the final follow-up compared with preoperative values. CONCLUSION: The lower incidence of cage subsidence, better maintenance of the height of the fused segment and similar excellent bony fusion indicate that the n-HA/PA66 cage may be a superior alternative to the TMC for cervical reconstruction after cervical corpectomy, in particular for 2-level ACCF.

  6. Avaliação do tipo de diamante de benzel em pacientes portadores de mielopatia cervical Evaluación del tipo de diamante de benzel en pacientes con mielopatia cervical Evaluation of the type of benzel's diamond in patients with cervical myelopathy

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    Rodrigo Rezende

    2012-12-01

    Full Text Available OBJETIVO: Difundir o método de Benzel para aferição da angulação cervical e quantificar a prevalência de cada tipo de diamante de Benzel em 30 pacientes portadores de mielopatia cervical com indicação cirúrgica. MÉTODOS: Estudo retrospectivo de pacientes portadores de mielopatia cervical submetidos a tratamento cirúrgico. Foram analisadas radiografias em perfil da coluna cervical onde se aferiram os tipos diamante de Benzel usando técnicas descritas pelo próprio Benzel. Excluímos do estudo aqueles pacientes que desenvolveram a doença após traumas, que foram submetidos reoperações ou aqueles que não forneceram radiografias em perfil adequadas para aferição. RESULTADOS: Foram avaliados 30 pacientes, sendo 25 deles do sexo masculino, com idade entre 30 e 74 anos (média de 52,4 anos. Após a realização das medidas foram encontrados 24 pacientes com diamantes do tipo A (80%, 2 do tipo B (6,7% e 4 tipo C (13,3%. CONCLUSÃO: O diamante de Benzel tipo "A" foi encontrado em 80% dos pacientes portadores de mielopatia cervical no período pré-operatório.OBJETIVO: Difundir el método de Benzel para la medición del ángulo cervical y cuantificar la prevalencia de cada tipo de diamante Benzel en 30 pacientes portadores de mielopatía cervical con indicación quirúrgica. MÉTODOS: Estudio retrospectivo de los pacientes con mielopatía cervical sometidos a tratamiento quirúrgico. Se analizaron las radiografías de perfil de la columna cervical, donde se midieron los tipos de diamante utilizando las técnicas descritas por el mismo Benzel. Se excluyeron del estudio los pacientes que desarrollaron la enfermedad después de trauma, que fueron sometidos a reoperaciones o los que no han presentado adecuadas radiografías de perfil para la medición. RESULTADOS: Se evaluaron 30 pacientes entre los cuales 25 eran del sexo masculino, con edades comprendidas entre 30 y 74 años (promedio de 52,4 años. Después de la realización de las

  7. Avulsión del plexo braquial traumático no controlado con remifentalino: Papel de la analgesia epidural cervical Traumatic brachial plexus root avulsion unresponsive to remifentanyl role cervical epidural analgesia

    OpenAIRE

    M. Cortiñas; G. Moreno-Pardo; S. Uña; M. Arcasa; M. R. Calero; Parra, R.; R. Gálvez

    2007-01-01

    Presentamos el caso de una paciente que sufrió accidente de tráfico con avulsión del plexo braquial izquierdo, y que presentaba dolor muy intenso (escala visual analógica 8) de características neuropáticas en la fase aguda postraumática. Dosis altas de remifentanilo fueron inefectivas para control del cuadro álgico, el cual se trato con éxito con una infusión de ropivacaína a través de catéter epidural cervical (C5-6). El dolor es controlado en fase crónica (escala visual analógica 2) con age...

  8. Reconstrucción artroscópica del ligamento cruzado anterior con injerto autólogo de semitendinoso cuádruple

    OpenAIRE

    Roberto Joaquín Del Gordo D´Amato

    2013-01-01

    ResumenSe presenta un estudio descriptivo de corte transversal, en el cual 26 pacientes fueron intervenidos quirúrgicamente para reconstrucción artroscópica de ligamento cruzado anterior con auto injerto semitendinoso cuádruple en el periodo comprendido entre junio del 2008 y junio del 2009.De los 26.pacientes que hicieron parte del presente estudio 22 fueron de sexo masculino y 4 de sexo femenino, la edad promedio fue de 32 años. En todos los casos se realizo fijación en fémur con tornillo t...

  9. Anterior cervical discectomy with fusion in patients with cervical disc degeneration: a prospective outcome study of 258 patients (181 fused with autologous bone graft and 77 fused with a PEEK cage

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    Roenning Paal

    2010-03-01

    Full Text Available Abstract Background Anterior cervical discectomy with fusion (ACDF is challenging with respect to both patient selection and choice of surgical procedure. The aim of this study was to evaluate the clinical outcome of ACDF, with respect to both patient selection and choice of surgical procedure: fusion with an autologous iliac crest graft (AICG versus fusion with an artificial cage made of polyetheretherketone (PEEK. Methods This was a non-randomized prospective single-center outcome study of 258 patients who underwent ACDF for cervical disc degeneration (CDD. Fusion was attained with either tricortical AICG or PEEK cages without additional anterior plating, with treatment selected at surgeon's discretion. Radicular pain, neck-pain, headache and patient satisfaction with the treatment were scored using the visual analogue scale (VAS. Results The median age was 47.5 (28.3-82.8 years, and 44% of patients were female. 59% had single-level ACDF, 40% had two level ACDF and 1% had three-level ACDF. Of the patients, 181 were fused with AICG and 77 with a PEEK-cage. After surgery, the patients showed a significant reduction in radicular pain (ΔVAS = 3.05, neck pain (ΔVAS = 2.30 and headache (ΔVAS = 0.55. Six months after surgery, 48% of patients had returned to work: however 24% were still receiving workers' compensation. Using univariate and multivariate analyses we found that high preoperative pain intensity was significantly associated with a decrease in pain intensity after surgery, for all three pain categories. There were no significant correlations between pain relief and the following patient characteristics: fusion method (AICG or PEEK-cage, sex, age, number of levels fused, disc level fused, previous neck surgery (except for neck pain, previous neck trauma, or preoperative symptom duration. Two hundred out of the 256 (78% patients evaluated the surgical result as successful. Only 27/256 (11% classified the surgical result as a failure

  10. Comparison of the extraction force of different interbody graft fixation at cervical vertebra after anterior cervical decompression%颈椎间不同植入物拔出载荷的比较

    Institute of Scientific and Technical Information of China (English)

    刘锦波; 唐天驷; 杨惠林

    2001-01-01

    目的:比较颈前路减压后分别植入钛合金螺纹融合支架、异体骨螺纹融合支架和自体髂骨的拔出载荷。方法:以人尸体颈椎为标本,颈前路环锯减压后,分别植入钛合金螺纹融合支架、异体骨螺纹融合支架和自体髂骨,测试以上植入物的最大拔出载荷。结果:减压后植入钛合金螺纹融合支架、异体骨螺纹融合支架、自体骼骨的最大拔出载荷分别为(114.7±23.3)、 (101.5±15.7)、 (58.7±8.3)N。结论:Cloward术减压后,钛合金螺纹融合支架、异体骨螺纹融合支架拔出载荷均大于植入自体髂骨。%Objective:To compare the extraction force of different interbody graft fixation at C4 and C5 after cervical decompression with the method of Cloward.Methods:Cervical vertebra was operated at C4 and C5 using orifice through anterior approach.The extraction force was measured after the allograft threaded fusion cage,titanium threaded fusion cage and autograft iliac bone graft were inserted separately into the interbody space.Results:The extraction force of titanium threaded fusion cage,allograft threaded fusion cage and autograft iliac bone graft were 114.0±23.3N and 101.5±15.7N and 58.7±8.3N respectively.Conclusion:Measured with the method of Cloward,the extraction forces of the allograft threaded fusion cage and titanium threaded fusion cage at C4 and C5 are bigger than that of autograft iliac bone graft after cervical decompression.

  11. Commentary on the effect of steroid use in anterior cervical discectomy and fusion surgery; a randomized controlled trial by Shiveindra B. et al. Journal of Neurosurgery Spine 2015;23:137-43

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    Nancy E Epstein

    2015-01-01

    Background: Steroids are often used in patients undergoing anterior cervical discectomy and fusion (ACDF) surgery to limit postoperative dysphagia. However, a major concern remains steroids′ impact is on fusion. Methods: In this prospective, randomized, double-blinded controlled study, the authors assessed the impact of steroids on swallowing/airway and fusion rates in 112 patients undergoing multilevel ACDF. The patients were randomly assigned to saline or dexamethasone groups prior to s...

  12. Avulsión del plexo braquial traumático no controlado con remifentalino: Papel de la analgesia epidural cervical Traumatic brachial plexus root avulsion unresponsive to remifentanyl role cervical epidural analgesia

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    M. Cortiñas

    2007-04-01

    Full Text Available Presentamos el caso de una paciente que sufrió accidente de tráfico con avulsión del plexo braquial izquierdo, y que presentaba dolor muy intenso (escala visual analógica 8 de características neuropáticas en la fase aguda postraumática. Dosis altas de remifentanilo fueron inefectivas para control del cuadro álgico, el cual se trato con éxito con una infusión de ropivacaína a través de catéter epidural cervical (C5-6. El dolor es controlado en fase crónica (escala visual analógica 2 con agentes específicos contra dolor neuropático (gabapentina, amitriptilina, clonacepam y tramadol.We presented you a patient who suffered a left brachial plexus avulsión with hard neuropatic pain in the posttraumatic acute phase (visual analogue scale 8. High-dose remifentanil infusión was uneffective in controlling pain, which was further ameliorated by ropivacaine infused through a cervical (C5-6 epidural catheter. At discharge pain remained controlled (visual analogue scale 2 with specific treatment against neuropathic pain (gabapentin, amytriptiline, clonacepam, and tramadol.

  13. Comparison of anterior corpectomy and fusion versus laminoplasty for the treatment of cervical ossification of posterior longitudinal ligament: a meta-analysis.

    Science.gov (United States)

    Chen, Zihao; Liu, Bin; Dong, Jianwen; Feng, Feng; Chen, Ruiqiang; Xie, Peigen; Zhang, Liangming; Rong, Limin

    2016-06-01

    OBJECTIVE The purpose of this study was to compare the effectiveness and safety of anterior corpectomy and fusion (ACF) with laminoplasty for the treatment of patients diagnosed with cervical ossification of the posterior longitudinal ligament (OPLL). METHODS The authors searched electronic databases for relevant studies that compared the use of ACF with laminoplasty for the treatment of patients with OPLL. Data extraction and quality assessment were conducted, and statistical software was used for data analysis. The random effects model was used if there was heterogeneity between studies; otherwise, the fixed effects model was used. RESULTS A total of 10 nonrandomized controlled studies involving 819 patients were included. Postoperative Japanese Orthopaedic Association (JOA) score (p = 0.02, 95% CI 0.30-2.81) was better in the ACF group than in the laminoplasty group. The recovery rate was superior in the ACF group for patients with an occupying ratio of OPLL of ≥ 60% (p lordosis. However, it must be emphasized that a surgical strategy should be made based on the individual patient. Further randomized controlled trials comparing the use of ACF with laminoplasty for the treatment of OPLL should be performed to make a more convincing conclusion. PMID:27246491

  14. Influência do suporte e fixação anterior na resistência mecânica do fixador interno vertebral Influencia del soporte y de la fijación anterior sobre la resistencia mecánica del fijador interno vertebralartrodesis cervical anterior por hernia del disco cervica The influence of anterior reconstruction and fixation on the mechanical performance of an internal fixator

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    Gisele Cristina Ale dos Santos

    2009-03-01

    Full Text Available OBJETIVO: avaliar a influência da reconstrução e fixação anterior no desempenho mecânico do fixador interno da coluna vertebral. MÉTODOS: foram formados três grupos experimentais de acordo com a reconstrução e fixação anterior: grupo I -sem suporte anterior; grupo II - com suporte anterior; grupo III - com suporte e fixação anterior. Os corpos de prova foram submetidos a ensaios mecânicos de flexo-compressão, flexão lateral e torção, realizados em máquina de universal de ensaios, tendo sido realizados dez ensaios para cada modalidade (flexo-compressão, flexão lateral e torção em cada grupo experimental, perfazendo um total de 90 ensaios mecânicos. As propriedades mecânicas estudadas foram: o momento-fletor, o torque e a rigidez obtidos a partir da curva carga x deflexão de cada ensaio mecânico. RESULTADOS: observou-se que a colocação do suporte e da fixação anterior aumentou a resistência mecânica nos ensaios de flexo-compressão. Nos ensaios de flexão lateral observou-se aumento da resistência mecânica somente com a fixação anterior. CONCLUSÃO: nos ensaios de torção o suporte anterior e a fixação anterior não aumentaram a resistência mecânica do sistema de fixação vertebral.OBJETIVO: evaluar la influencia de la reconstrucción y fijación anterior en el desempeño mecánico del fijador interno de la columna vertebral. MÉTODOS: fueron formados tres grupos experimentales de acuerdo com la reconstrucción y fijación anterior: grupo I- sin soporte anterior, grupo II- con soporte anterior y grupo III- con soporte y fijación anterior. Los cuerpos de prueba fueron sometidos a ensayos mecánicos de flexocompresión, flexión lateral y torción, realizados en la máquina universal de ensayos, habiéndose realizados 10 ensayos para cada modalidad (flexocompresión, flexión lateral y torción en cada grupo experimental,con untotal de 90 ensayos mecánicos. Las propiedades mecánicas estudiadas fueron el

  15. 颈椎前路蝶形钢板内固定系统的研制及临床应用%Design and preliminary clinical application of anterior cervical butterfly-like locking plate fixation system

    Institute of Scientific and Technical Information of China (English)

    金大地; 瞿东滨; 陈建庭; 江建明; 王吉兴; 朱青安

    2001-01-01

    Objective To evaluate the biomechanical stability and the preliminary clinical efficacy of self-designed anterior cervical butterfly-like locking plate fixation system. Methods The anterior cervical fixation system is composed of one butterfly-like plate and three types of screw made of titanium alloy(TC4,Ti6Al4V) on the basis of unicortical screw fixation and point contact plate fixation principle. Biomechanical stability analyses of the system and Orion locking plate system (Sofamor - Danek Corp) were performed in fresh cervical spine specimens from fourteen young male cadavers. 61 patients with cervical disorders were stabilized with the fixation system. The mean age of the patients during surgery was 48.2 years (range 18 to 68 years). The diagnosis included spondylosis in 26 cases, cervical intervertebral disk protrusion 14, fracture and/or dislocation 18 and tuberculosis 3. Results This anterior butterfly-like cervical plate fixation system holds similar biomechanical stability effects as Orion system. Of 61 cases received the plate fixation system after anterior decompression and autologous interbody fusion, 48 were followed-up for six to ten months, and showed solid interbody fusion in three to four months. No early complications such as implant loosening or failure related to the fixation system were noted. Conclusion The anterior cervical plate fixation system can provide sufficient biomechanical stability to cervical spine after anterior decompression surgery.%目的研制颈椎前路蝶形钢板内固定系统,评价其生物力学稳定性,并进行临床初步应用观察.方法该系统包括蝶形钢板及三种不同用途的螺钉,采用单皮质螺钉固定及点接触原理,由医用钛合金材料(TC4)制成.采用14具青年男性尸体的新鲜颈椎标本,利用脊柱三维运动分析系统,比较蝶形钢板固定与Orion钢板固定对失稳颈椎的稳定作用.临床上应用于颈椎患者的治疗61例,其中颈椎病26例,颈椎间

  16. Anterior surgical treatment of cervical spondylosis of spinal cord and nerve root type%脊髓型及神经根型颈椎病的前路手术治疗

    Institute of Scientific and Technical Information of China (English)

    刘向阳; 杨宝来; 张辉

    2015-01-01

    Objective To analyze the curative effect of anterior operation in treatment of spinal cord and nerve root type cervical spondylosis.Methods Choose our hospital 16 cases of cervical spinal cord and nerve root type of cervical spondylosis patients as the observation object (December 2014 to February 2012), in fact, the implementation of anterior surgery for treatment, observe the effect of surgery.Results The average intraoperative blood loss was (90.12±15.34) ml, the average JOA score was (14.58±1.34), the cure rate was93.75%. Conclusion Spinal cord and nerve root type of cervical spondylosis anterior surgery treatment effect is remarkable, safe and reliable, it is worth promoting.%目的:分析前路手术治疗脊髓型及神经根型颈椎病的疗效。方法选择2012年2月~2014年12月我院收治的脊髓型及神经根型颈椎病患者16例作为研究对象,对其实施前路手术进行治疗,并观察手术效果。结果患者术中平均出血量为(90.12±15.34)mL,JOA平均评分为(14.58±1.34)分,治愈率为93.75%。结论脊髓型及神经根型颈椎病的前路手术疗效显著,安全可靠,值得临床推广应用。

  17. Artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single segmental cervical disc herniation:a 3-year follow-up%颈椎人工间盘置换与前路减压融合修复单节段颈椎间盘突出症:3年随访

    Institute of Scientific and Technical Information of China (English)

    程俊杰; 眭江涛; 马原; 田慧中

    2015-01-01

    stages. Artificial disc replacement can not only play a role in mitigation of cervical disease neurological symptoms and signs, but also maintain stability and semental activity of cervical spine, and reduce secondary adjacent segmental degeneration. These two methods which applied in cervical degenerative intervertebral disc herniation stil remain controversial. OBJECTIVE:To investigate the short-term effect of artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single segmental cervical disc herniation. METHODS:Total y 48 patients with single segment radiculopathy or myelopathy cervical diseases induced by cervical disc herniation that required surgery and received a three-month fol ow-up were included and retrospectively analyzed. These patients were divided into replacement group (n=21) and fusion group (n=27) according to the different repair programs. Patients in the replacement group were subjected to Prestige LP cervical artificial disc replacement, and patients in the fusion group were subjected to disc fusion using interbody fusion cage of Johnson or al ogeneic fibularing. They were fol owed up at 1 week, 3, 6, 12, 24, 36 months after treatment. Complications were recorded during the fol ow-up. The pain of patients was evaluated using neck and upper limb pain visual analogue scale scores. The therapeutic effect was evaluated using Japanese Orthopaedic Association (JOA) score. The clinical symptoms improvement and daily functional status of patients after treatment were evaluated using cervical disability index. RESULTS AND CONCLUSION:During the final fol ow-up, the fusion rate in fusion group was 93%(25/27). Comparisons between groups:at the 1 week and final fol ow-up after treatment, the visual analog scale scores of neck and upper limbs and cervical dysfunction indexes were al lower than those before treatment;the Japanese Orthopaedic Association scores were higher than those before treatment (P0.05). The

  18. Percutaneous endoscopic cervical discectomy using working channel endoscopes.

    Science.gov (United States)

    Ahn, Yong

    2016-06-01

    Percutaneous endoscopic cervical discectomy has evolved as an efficient, minimally invasive spine surgery for cervical disc herniation or radiculopathy. The development of the working channel endoscope makes definitive decompression surgery through a percutaneous approach feasible. There are two methods of approach to target the pathology: anterior and posterior approach. The approach can be determined according to the zone of pathology or the surgeon's preference. The most significant benefits of this endoscopic surgical technique are minimal access tissue trauma and early recovery from the intervention. However, this technique is still evolving and have a steep learning curve. Extensive development of surgical technique and working channel endoscopes will enable us to treat cervical disc herniation more practically. The objective of this review is to describe the cutting-edge techniques of endoscopic surgery in the cervical spine and to discuss the pros and cons of these minimally invasive surgical techniques. PMID:27086505

  19. Resultados do tratamento de fraturas crônicas pela via anterior em pacientes com osteoporose Resultados del tratamiento de fracturas crónicas por la via anterior en pacientes con osteoporosis Results of treatment of chronic fractures by anterior approach in patients with osteoporosis

    Directory of Open Access Journals (Sweden)

    Fabio Leme de Oliveira Pinto

    2011-01-01

    Full Text Available OBJETIVO: Analisar os resultados da cirurgia de corpectomia e artrodese por via anterior nos pacientes com fratura tipo explosão da coluna toracolombar e com osteoporose, que foram submetidos a tratamento conservador prévio por no mínimo sete meses, sem melhora importante do quadro doloroso. MÉTODOS: Foram tratadas seis pacientes idosas com fratura-explosão da coluna toracolombar em um único nível, depois de, no mínimo, sete meses do trauma, pela via anterior, com corpectomia, uso de enxerto autólogo de costela e fixação com parafusos pediculares nos níveis adjacentes. A dor foi avaliada pela EVA no pré-operatório, três semanas, três meses, seis meses e um anos após a cirurgia. RESULTADO: As pacientes apresentaram melhora significativa da dor pós-operatória, com diminuição substancial do uso de medicação analgésica. CONCLUSÕES: Os autores recomendam a via anterior isolada como método de tratamento para fraturas tipo explosão crônicas em pacientes com osteoporose pela baixa taxa de complicações e pelos resultados satisfatórios encontrados.OBJECTIVO: Analizar los resultados de la cirugía de corpectomía y artrodesis por la vía anterior, en pacientes con fracturas tipo explosión de la columna toracolumbar y, con osteoporosis, que habían sido sometidos a tratamiento conservador previo por lo menos durante siete meses, sin mejora importante del cuadro de dolor. MÉTODOS: fueron tratadas seis pacientes ancianas del sexo femenino con la fractura-explosión de la columna toracolumbar en solamente un nivel, después de, como mínimo, siete meses del traumatismo, a través de la vía anterior, con corpectomía, utilización del injerto autólogo de costilla y fijaci��n con tornillos pediculares en los niveles adyacentes. El dolor fue evaluado con EVA en pre-operatorio, tres semanas, tres meses, seis meses y un año después de la cirugía. RESULTADO: Las pacientes presentaron mejoría significativa del dolor

  20. 颈椎前路手术早期并发症防治探讨%The study on prevention and treatment of postoperative complications in early stage of anterior cervical spine surgery

    Institute of Scientific and Technical Information of China (English)

    李强; 陈向阳; 冯虎; 邓斌; 蒋允昌; 乔建恭

    2013-01-01

    目的 回顾分析颈椎前路手术早期常见并发症的发生原因,提出防治策略.方法 对2006-06-2011-08我科开展的416例颈椎前路手术进行回顾性分析.结果 本组共发生早期并发症共29例,总发生率为6.97%.常见并发症为:咽喉部不适吞咽疼痛6例,颈脊髓损伤4例,喉上、喉返神经损伤5例;食管瘘2例;脑脊液漏2例;涎漏2例;气道阻塞3例;髂骨供骨区并发症4例.除喉头水肿、脑脊液漏患者死亡各1例外,其余发生并发症患者均逐渐康复.结论 颈椎前路手术术后早期可能会发生多种并发症,充分的术前准备,熟悉颈前路相关解剖,熟练的手术操作,规范的术后管理,能够减少并发症.%Objective To analyze the causes for early postoperative complications in early stage of cervical surgery by anterior approach and to explore corresponding prevention and treatment measures. Methods A retrospective analysis was performed on 416 cases treated with anterior cervical surgery from June 2006 to August 2011. Results In these cases 29 postoperative complications associated with surgery were found, with an incidence of 6.97%,of which 6 cases were throat pain, 4 cases were aggravated spinal cord injuries,5 cases were laryngeal, recurrent laryngeal nerve injuries,2 cases were esophageal fistula,2 cases were cerebrospinal fluid leakage,2 cases were saliva leakage,3 cases were respiratory tract block,4 cases were complications in the vessels area that supply the iliac bone. One patient with respiratory tract block and one patient cerebrospinal fluid leakage died,but then the rest were recovered gradually. Conclusion Various early postoperative complications may occur in the anterior cervical spine surgery. Adequate preoperative preparation, thorough understanding of anatomy related to the anterior approach,skilled surgical technique and perfect postoperative management may prevent the complications in anterior cervical spine surgery.

  1. Five-year clinical results of cervical total disc replacement compared with anterior discectomy and fusion for treatment of 2-level symptomatic degenerative disc disease: a prospective, randomized, controlled, multicenter investigational device exemption clinical trial.

    Science.gov (United States)

    Radcliff, Kris; Coric, Domagoj; Albert, Todd

    2016-08-01

    OBJECTIVE The purpose of this study was to report the outcome of a study of 2-level cervical total disc replacement (Mobi-C) versus anterior cervical discectomy and fusion (ACDF). Although the long-term outcome of single-level disc replacement has been extensively described, there have not been previous reports of the 5-year outcome of 2-level cervical disc replacement. METHODS This study reports the 5-year results of a prospective, randomized US FDA investigational device exemption (IDE) study conducted at 24 centers in patients with 2-level, contiguous, cervical spondylosis. Clinical outcomes at up to 60 months were evaluated, including validated outcome measures, incidence of reoperation, and adverse events. The complete study data and methodology were critically reviewed by 3 independent surgeon authors without affiliation with the IDE study or financial or institutional bias toward the study sponsor. RESULTS A total of 225 patients received the Mobi-C cervical total disc replacement device and 105 patients received ACDF. The Mobi-C and ACDF follow-up rates were 90.7% and 86.7%, respectively (p = 0.39), at 60 months. There was significant improvement in all outcome scores relative to baseline at all time points. The Mobi-C patients had significantly more improvement than ACDF patients in terms of Neck Disability Index score, SF-12 Physical Component Summary, and overall satisfaction with treatment at 60 months. The reoperation rate was significantly lower with Mobi-C (4%) versus ACDF (16%). There were no significant differences in the adverse event rate between groups. CONCLUSIONS Both cervical total disc replacement and ACDF significantly improved general and disease-specific measures compared with baseline. However, there was significantly greater improvement in general and disease-specific outcome measures and a lower rate of reoperation in the 2-level disc replacement patients versus ACDF control patients. Clinical trial registration no. NCT00389597

  2. Posterior Cervical Foraminotomy: Indications, Technique, and Outcomes.

    Science.gov (United States)

    Dodwad, Shah-Jahan M; Dodwad, Shah-Nawaz M; Prasarn, Mark L; Savage, Jason W; Patel, Alpesh A; Hsu, Wellington K

    2016-06-01

    Cervical radiculopathy presents with upper extremity pain, decreased sensation, and decreased strength caused by irritation of specific nerve root(s). After failure of conservative management, surgical options include anterior cervical decompression and fusion, disk arthroplasty, and posterior cervical foraminotomy. In this review, we discuss indications, techniques, and outcomes of posterior cervical laminoforaminotomy. PMID:27187617

  3. A meta-analysis of clinical effects of Bryan cervical disc replacement versus anterior cervical discectomy and fusion%Bryan颈椎间盘置换与颈前路间盘切除植骨融合疗效的系统分析

    Institute of Scientific and Technical Information of China (English)

    李德毅; 张旭; 刘川; 吴继生

    2013-01-01

    BACKGROUND:Bryan cervical disc replacement and anterior cervical discectomy and fusion have a dispute in the treatment of cervical spondylosis. OBJECTIVE:To evaluate the clinical effects of Bryan cervical disc replacement and anterior cervical discectomy and fusion by meta-analysis, thereby providing clinical evidence for treatment strategy of cervical spondylosis. METHODS:The authors searched Medline, PubMed, EMBASE, OVID, CBM, CNKI and also searched manual y seven relevant Chinese orthopedic journals for articles pertinent to clinical research of Bryan cervical disc replacement and anterior cervical discectomy and fusion. Extracted data included the range of motion of the cervical spine, visual analog scale score, neck disability index, the Japanese Orthopaedic Association score. Meta-analysis and forest plots were conducted with RevMan4.2.2 Software. RESULTS AND CONCLUSION:There are eight articles in the meta-analysis, including 883 patients (430 patients receiving Bryan cervical disc replacement, and 453 patients receiving anterior cervical discectomy and fusion). Meta-analysis did detect statistical y significant differences in the range of motion of the cervical spine at 3 months and 24 months postoperatively between the two groups, but did not detect statistical y significant differences in visual analog scale score, neck disability index, the Japanese Orthopaedic Association score between the two groups. These findings indicate that Bryan cervical disc replacement is superior to anterior cervical discectomy and fusion in the range of motion of the cervical spine. However, the current literature offers no evidence to support superiority of the Bryan cervical disc replacement over the anterior cervical discectomy and fusion.%背景:Bryan颈椎间盘置换与颈前路间盘切除植骨融合治疗颈椎病的临床疗效存在争议。  目的:应用 Meta 分析方法,评价 Bryan 颈椎间盘置换与颈前路间盘切除植骨融合治疗颈椎病

  4. 人工颈椎椎间盘置换与颈前路减压融合术治疗脊髓型颈椎病的疗效分析%Comparison of artifical cervical disc replacement versus anterior discectomy and fusion for the treatment of cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    杨兴; 薛峰; 盛晓文; 彭育沁; 陈兵乾

    2012-01-01

    目的 比较人工颈椎椎间盘置换术与颈前路椎间盘切除减压植骨融合术(anterior cervical discectomy and fusion,ACDF)治疗脊髓型颈椎病的临床疗效.方法 回顾性分析本院收治的人工颈椎椎间盘置换术及ACDF治疗的脊髓型颈椎病病例.测量所有患者颈椎活动度(range of motion,ROM),置换节段及相邻节段的ROM,并行日本骨科学会(Japanese Orthopaedic Association,JOA)评分及Odom分级.结果 所有患者术后JOA评分和Odom功能评定均得到显著改善.置换组术后颈椎ROM、置换节段及其邻近间隙平均ROM无明显改变,差异无统计学意义(P>0.05).ACDF组患者中,术后颈椎ROM显著减小,邻近间隙ROM明显增大,差异有统计学意义(P<0.05).置换组术后邻近节段的ROM明显小于ACDF组,差异有统计学意义(P<0.01).结论人工颈椎椎间盘置换术能保持颈椎ROM,避免邻近节段退变,早、中期疗效满意,远期效果尚有待临床进一步研究.%Objective To compare the clinical outcome of artifical cervical disc replacement versus anterior cervical discectomy and fusion ( ACDF ) in the treatment of cervical spondylotic myelopathy. Methods A total of 50 cases of cervical spondylotic myelopathy treated by artifical cervical disc replacement ( n = 20 ) or ACDF ( n = 30 ) were involved. Among these cases , the range of motion ( ROM ) of the cervical vertebra, the implanted level and the adjacent segment were measured. The Japanese Orthopaedic Association ( JOA ) score and Odom' s grade were record and analyzed. Results All of these patients were followed-up, and JOA score and Odom' s grade of all patients were significantly improved. The ROM of the cervical vertebrae, the implanted levels and the adjacent segments were preserved in artifical cervical disc replacement group ( P >0. 05 ). In the ACDF group, the ROM of the cervical vertebrae decreased, but the adjacent segments of the fusion segment compensatory increased remarkably( P 0

  5. Aspergilosis cervical con diseminación al sistema nervioso central. Presentación de un caso y revisión de bibliografía

    Science.gov (United States)

    Vergara, Guillermo Enrique; Roura, Natalia; del Castillo, Marcelo; Mora, Andrea; Alcorta, Santiago Condomi; Mormandi, Rubén; Cervio, Andrés; Salvat, Jorge

    2015-01-01

    Introducción: la Aspergilosis Invasiva (AI) del Sistema Nervioso Central (SNC) es infrecuente y ocurre generalmente en pacientes inmunocomprometidos. Puede presentarse con cuadros de meningitis, aneurismas micóticos, infartos o abscesos. Es una infección con pronóstico reservado y puede afectar el SNC de forma primaria o secundaria a partir de un foco que se disemina por vía hematógena. Presentamos el caso de un paciente con AI con invasión primaria a nivel óseo y diseminación posterior al cerebro. Caso clínico: Paciente masculino de 25 años con diagnóstico de leucemia linfática aguda en tratamiento quimioterápico que presentó neumonitis por metotrexate por lo que inicia tratamiento con corticoides. Posteriormente agregó cervicalgia y con el diagnóstico de osteomielitis cervical se realiza punción bajo tomografía computada (TC) sin aislarse gérmenes. Se colocó Halo Vest e inició tratamiento antibiótico empírico. Posteriormente presentó afasia de expresión secundaria a lesión frontal izquierda. Se realizó evacuación de absceso cerebral aislando A. fumigatus. El tratamiento antibiótico específico posterior permitió una buena respuesta clínica y radiológica. Conclusión: La presencia de lesiones en el SNC de pacientes inmunocomprometidos debe incluir a las micosis como diagnóstico diferencial. La evacuación quirúrgica permite llegar rápidamente al diagnóstico mejorando la respuesta posterior al tratamiento antibiótico. Para evaluar la respuesta terapéutica y posibles recaídas se debe realizar un seguimiento periódico clínico radiológico. Palabras clave: Aspergilosis cerebral; Aspergilosis cervical; Aspergilosis invasiva; Voriconazol. PMID:26600985

  6. The anterior operation for cervical ossification of posterior longitudinal ligament combined with adjacent disc herniation%前路手术治疗合并邻近椎间盘突出的颈椎后纵韧带骨化症

    Institute of Scientific and Technical Information of China (English)

    任斌; 蔡林; 陈志龙; 王建平; 胡超; 张桃根

    2012-01-01

    Objective To investigate the efficacy and the selection of surgery time of anterior operation for cervical ossification of posterior longitudinal ligament combined with cervical disc herniation. Methods Totally 24 cases of cervical ossification of posterior longitudinal ligament combined with cervical disc herniation underwent anterior operation in our department from January 2005 to January 2011. There were 21 males and 3 females. The mean age was 52 years old (range; 40-68 years). Preoperatively, 2-3 ossified segments of the posterior longitudinal ligament combined with contiguous cervical herniated disc compressing the spinal cord were revealed through cervical X-ray film, CT and MRI examinations. All patients were treated with the anterior cervical subtotal corpectomy combined with the discectomy of contiguous cervical herniated disc by the cage fusion surgery of internal fixation for reconstruction. The preoperative and postoperative Japanese Orthopaedic Association (JOA) scores were analyzed and compared, and the improvement rate was also calculated. Results All patients were followed up for an average period of 22 months (range; 8-36 months). The mean JOA score of neurological function was preoperatively 7.5 points (range; 4-13 points). The mean JOA score was postoperatively 13.6 points (range; 10-16 points). The mean improvement rate of neurological function was 65.6% (range; 32%-81%). The efficacy of 7 cases was excellent, 12 cases good, 5 cases fair and none bad. The excellence rate was 79.1%. Conclusions Cervical ossification of posterior longitudinal ligament often combines with contiguous cervical herniated disc resulting in spinal cord injury. To avoid the sharp deterioration of spinal cord function, early surgical intervention should be taken. The anterior cervical subtotal corpectomy combined with the discectomy of contiguous cervical herniated disc by the cage fusion surgery of internal fixation for reconstruction in the treatment of cervical

  7. Effects of anterior fusion cage fixation on cervical curvature, stability and axial symptoms%增加前路cage融合对颈椎曲度、稳定性及轴性症状的影响

    Institute of Scientific and Technical Information of China (English)

    李宽宽; 夏磊; 桑亮

    2014-01-01

    背景:对于严重的颈椎间盘突出、后纵韧带钙化、黄韧带增生,实施前后联合入路不仅可以达到彻底减压的目的,同时植入cage及前路钢板矫形固定可部分恢复椎体间隙及颈椎生理曲度。  目的:比较颈椎病颈后路单开门椎管扩大成形及增加前路cage融合内固定对治疗后患者颈椎曲度、稳定性及轴性症状发生的影响。  方法:回顾性分析颈椎病外科治疗50例患者的临床资料。其中行一期前后联合入路脊髓减压(前路 cage+钢板融合固定)22例(前后路联合治疗组);单纯行颈后路单开门椎管扩大成形(后路开窗铆钉固定)28例(单纯后路治疗组)。治疗后随访6-24个月,分别对两组治疗后神经功能恢复情况、轴性症状的发生率及颈椎曲度指数、病变节段椎间滑移度进行统计分析。  结果与结论:两组患者的神经功能恢复均获得较好的日本骨科学会(JOA)改善率,前后路联合治疗组患者轴性症状的发生率相对低,颈椎曲度指数较单纯后路治疗组患者有较为明显的改善,而单纯后路治疗组椎间滑移度相对较大。结果表明一期前后联合入路使用 cage、前路钢板、后路铆钉行脊髓减压可以有效维持颈椎的生理曲度从而维持矢状面的平衡,减少患者轴性症状的发生率,对维持治疗后颈椎长期的稳定性起到重要作用。%BACKGROUND:The combination of anterior and posterior approaches for severe cervical intervertebral disk herniation, posterior longitudinal ligament calcification and ligament flava hyperplasia can completely reduce compression. Simultaneously, cage implantation and anterior plate fixation partial y recover vertebral interspace and physiological curvature of cervical vertebra. OBJECTIVE:To compare the effects of cervical posterior single-door laminoplasty for cervical spondylosis and anterior cage-assisted fusion on curvature

  8. Observation on the Curative Effect of Anterior Approach Surgery for the Treatment of Cervical Fracture-Dislocation%前路手术治疗下颈椎骨折脱位的疗效观察

    Institute of Scientific and Technical Information of China (English)

    谢旭垣; 孔志强; 龙朝仪; 成本强

    2016-01-01

    目的:探讨颈椎前路减压复位植骨融合内固定手术治疗下颈椎骨折脱位的疗效。方法对本院自2010年6月至2014年6月收治的24例下颈椎骨折脱位患者采用前路减压复位、自体骨植骨、锁定钛板或加钛网内固定手术,评估术后颈椎生理曲度、植骨融合程度、神经功能恢复情况。结果术后随访4~24个月,定期X线检查,发现术后颈椎Cobb角测量结果比术前明显改善。按照Lenke标准分级,椎间植骨在术后6个月内均得到有效融合。根据Franke1分级显示,绝大部分患者术后神经功能得到不同程度的改善。所有患者的JOA得分均有明显提高。结论下颈椎骨折脱位应用前路减压复位植骨融合内固定手术操作简单,可早期稳定脊柱,恢复颈椎正常弯度及高度,能有效解除脊髓压迫,促进脊髓神经功能的恢复。%Objective To explore the curative effect of anterior cervical decompression and reduction, bone graft fusion and internal fixation for the treatment of subaxial cervical fracture-dislocation. Methods A total of 24 patients with cervical fracture-dislocation admitted to our hospital from June 2010 to June 2014 were selected. All patients received anterior decompression and reduction, autograft, and internal fixation. The postoperative cervical curvature, bone graft fusion degree and recovery of nerve function were evaluated. Results All patients were followed-up for 4~24 months. The X-ray examination showed that the cervical Cobb angle after operation was significantly better than that before operation. According to Lenke classification standard, all the lumbar intervertebrae fusion achieved to effective integration within 6 months. According to the Frankel classification, most patients had varying degrees of improvement in the postoperative nerve function, and the JOA score of all patients had significant improvement. Conclusions Anterior cervical decompression and reduction

  9. Rastreamento anterior para câncer de colo uterino em mulheres com alterações citológicas ou histológicas Previous screening for cervical cancer among women with cytological and histological abnormalities

    Directory of Open Access Journals (Sweden)

    C Rama

    2008-06-01

    Full Text Available OBJETIVO: Analisar a história de rastreamento citológico anterior em mulheres que apresentaram alterações citológicas e confirmação histológica para câncer cervical. MÉTODOS: Estudo transversal com 5.485 mulheres (15-65 anos que se submeteram a rastreamento para o câncer cervical entre fevereiro de 2002 a março de 2003, em São Paulo e Campinas, SP. Aplicou-se questionário comportamental e foi feita a coleta da citologia oncológica convencional ou em base líquida. Para as participantes com alterações citológicas indicou-se colposcopia e, nos casos anormais, procedeu-se à biópsia cervical. Para investigar a associação entre as variáveis qualitativas e o resultado da citologia, utilizou-se o teste de qui-quadrado de Pearson com nível de significância de 5%. RESULTADOS: Dentre os resultados citológicos, 354 (6,4% foram anormais, detectando-se 41 lesões intra-epitelial escamosa de alto grau e três carcinomas; em 92,6% revelaram-se normais. De 289 colposcopias realizadas, 145 (50,2% apresentaram alterações. Dentre as biópsias cervicais foram encontrados 14 casos de neoplasia intra-epitelial cervical grau 3 e quatro carcinomas. Referiram ter realizado exame citológico prévio: 100% das mulheres com citologia compatível com carcinoma, 97,6% das que apresentaram lesões intra-epiteliais de alto grau, 100% daquelas com confirmação histológica de carcinoma cervical, e 92,9% das mulheres com neoplasia intra-epitelial cervical grau 3. A realização de citologia anterior em período inferior a três anos foi referida, respectivamente, por 86,5% e 92,8% dessas participantes com alterações citológicas e histológicas. CONCLUSÕES: Entre as mulheres que apresentaram confirmação histológica de neoplasia intra-epitelial cervical grau 3 ou carcinoma e aquelas que não apresentaram alterações histológicas não houve diferença estatisticamente significante do número de exames citológicos realizados, bem como o tempo

  10. 前路减压植骨融合内固定术治疗颈椎间盘突出症的疗效分析%Analysis of anterior cervical decompression and autograft fusion combined with internal fixation in the treatment of cervical disc protrusion

    Institute of Scientific and Technical Information of China (English)

    杨朝晖; 吴险峰; 邹磊

    2013-01-01

    Objective To explore the clinical outcome of treatment of the anterior cervical discertomy and fusion with rigid plate fixation for cervical disc herniation. Methods Twenty five patients with cervical disc herniation had been treated by multilevel anterior cervical discectomy and fusion with rigid plate fixation from Oct 2008 to Oct 2011. Results All patients had been followed - up for 8 to 24 months ( I I months in average ). Bone union was achieved in all patients. All cases were scored after operation to assess the curative effect. There were 15 cases that belonged to the excellent, 8 to the good, 2 to the fair and 0 to the poor based on the Jndet criteria. The good and excellence rate was 92% in patients. Conclusion The treatment of traumatic cervical disc protrusion with anterior cervical decompression and bone autograft fusion combined with internal fixation has satisfactory clinical effect with fewer complications.%目的 探讨前路减压植骨融合钢板内固定治疗颈椎间盘突出症的疗效.方法 对收治的25例颈椎椎间盘突出症患者行颈椎前路减压,取自体髂骨植骨融合内固定治疗.结果 本组患者均获得随访,随访时间8~24个月,平均11个月.植骨均达到骨性愈合,无骨不连发生.25例患者神经功能获得改善,根据JOA神经功能评定标准,优15例,良8例,可2例,差0例,优良率92%.结论 颈椎前路减压、椎间盘切除、植骨融合钢板内固定是治疗颈椎间盘突出症的一种有效方法.

  11. Cervical Spondylotic Myelopathy: Factors in Choosing the Surgical Approach

    OpenAIRE

    Yalamanchili, Praveen K.; Vives, Michael J.; Chaudhary, Saad B.

    2012-01-01

    Cervical spondylotic myelopathy is a progressive disease and a common cause of acquired disability in the elderly. A variety of surgical interventions are available to halt or improve progression of the disease. Surgical options include anterior or posterior approaches with and without fusion. These include anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion, cervical disc replacement, laminoplasty, laminectomy with and without fusion, and combined approaches. Rec...

  12. Three-level cervical disc herniation

    Directory of Open Access Journals (Sweden)

    St. Iencean Andrei

    2015-09-01

    Full Text Available Multilevel cervical degenerative disc disease is well known in the cervical spine pathology, with radicular syndromes or cervical myelopathy. One or two level cervical herniated disc is common in adult and multilevel cervical degenerative disc herniation is common in the elderly, with spinal stenosis, and have the same cause: the gradual degeneration of the disc. We report the case of a patient with two level cervical disc herniation (C4 – C5 and C5 – C6 treated by anterior cervical microdiscectomy both levels and fusion at C5 – C6; after five years the patient returned with left C7 radiculopathy and MRI provided the image of a left C6 – C7 disc herniation, he underwent an anterior microsurgical discectomy with rapid relief of symptoms. Three-level cervical herniated disc are rare in adults, and the anterior microdiscectomy with or without fusion solve this pathology.

  13. 零切迹颈前路椎间融合固定系统在颈前路融合术中的初步应用%The primary clinical application of Zero-p anterior cervical intervertebral fusion system for cervical intervertebral fusion

    Institute of Scientific and Technical Information of China (English)

    贺瑞; 尚希福; 张文志; 胡业丰; 许翔; 姚刚; 李旭; 段丽群; 葛畅

    2012-01-01

    Objective To revaluate the clinical effect of zero-p anterior cervical intervertebral fusion system (zero-p ACIDfor cervical anterior intervertebral fusion. Method From 2009.12 to 2010.10,24cases of patients were treated surgically by zero-p ACIF. 22 cases of single-level, 2cas- es of two-level,incloud 7 cases cervical injury and 17 cases cervical spondylotic myelopathy. Result All cases obtained follow up with average of 14months (range 12 to 20 months),all cases have no postoperative dysphagia and tardive esophageal fistula. The disc height were achieved in final follow-up respectively. Place of intervertebral fusion system has no change or loose. Conclusion Zero-p ACIF has more excellent material and mechanical properties,can effectively maintain the fusion cage height and no effect on the prevertebral tissue. It is a new means of anterior cervical fusion.%目的 探讨零切迹颈前路椎问融合固定系统(Zero-p ACIF)在颈椎前路融合术中的应用效果.方法 2009-12-2010-10,对24例(26节段)颈椎疾病患者行前路椎问零切迹椎问融合固定系统内固定,其中颈椎外伤性椎间盘突出、不稳7例,颈椎问盘疾患17例,其中双节段2例.结果 24例患者随访12~20个月,平均随访14个月,JOA评分由术前平均8.6分上升到末次随访时15.2分,术后X线片与末次X线片提示椎间高度无丢失,内固定无松动.结论 Zero-p ACIF有较优异的材料和力学性能,能有效维持融合椎间高度,对椎前组织无影响,是一种新的颈前路融合手段.

  14. Hospital charges associated with "never events": comparison of anterior cervical discectomy and fusion, posterior lumbar interbody fusion, and lumbar laminectomy to total joint arthroplasty.

    Science.gov (United States)

    Daniels, Alan H; Kawaguchi, Satoshi; Contag, Alec G; Rastegar, Farbod; Waagmeester, Garrett; Anderson, Paul A; Arthur, Melanie; Hart, Robert A

    2016-08-01

    OBJECTIVE Beginning in 2008, the Centers for Medicare and Medicaid Service (CMS) determined that certain hospital-acquired adverse events such as surgical site infection (SSI) following spine surgery should never occur. The following year, they expanded the ruling to include deep vein thrombosis (DVT) and pulmonary embolism (PE) following total joint arthroplasty. Due to their ruling that "never events" are not the payers' responsibility, CMS insists that the costs of managing these complications be borne by hospitals and health care providers, rather than billings to health care payers for additional care required in their management. Data comparing the expected costs of such adverse events in patients undergoing spine and orthopedic surgery have not previously been reported. METHODS The California State Inpatient Database (CA-SID) from 2008 to 2009 was used for the analysis. All patients with primary procedure codes indicating anterior cervical discectomy and fusion (ACDF), posterior lumbar interbody fusion (PLIF), lumbar laminectomy (LL), total knee replacement (TKR), and total hip replacement (THR) were analyzed. Patients with diagnostic and/or treatment codes for DVT, PE, and SSI were separated from patients without these complication codes. Patients with more than 1 primary procedure code or more than 1 complication code were excluded. Median charges for treatment from primary surgery through 3 months postoperatively were calculated. RESULTS The incidence of the examined adverse events was lowest for ACDF (0.6% DVT, 0.1% PE, and 0.03% SSI) and highest for TKA (1.3% DVT, 0.3% PE, 0.6% SSI). Median inpatient charges for uncomplicated LL was $51,817, compared with $73,432 for ACDF, $143,601 for PLIF, $74,459 for THR, and $70,116 for TKR. Charges for patients with DVT ranged from $108,387 for TKR (1.5 times greater than index) to $313,536 for ACDF (4.3 times greater than index). Charges for patients with PE ranged from $127,958 for TKR (1.8 times greater than

  15. Comparison of anterior decompression and fusion versus laminoplasty in the treatment of multilevel cervical ossification of the posterior longitudinal ligament: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Liu W

    2016-04-01

    Full Text Available Weijun Liu,1,* Ling Hu,2,* Po-Hsin Chou,3 Ming Liu,1 Wusheng Kan,1 Junwen Wang1 1Department of Orthopedics, Pu Ai Hospital, Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Department of Anesthesiology, Tianyou Hospital, Affiliated to Wuhan University of Science and Technology, Wuhan, People’s Republic of China; 3Department of Orthopedics & Traumatology, Taipei Veterans General Hospital, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC *These authors contributed equally to this work Purpose: A meta-analysis was conducted to evaluate the clinical outcomes, complications, reoperation rates, and late neurological deterioration between anterior decompression and fusion (ADF and laminoplasty (LAMP in the treatment of multilevel cervical ossification of the posterior longitudinal ligament (OPLL. Methods: All related studies published up to August 2015 were acquired by searching PubMed and EMBASE. Exclusion criteria were case reports, revision surgeries, combined anterior and posterior surgeries, the other posterior approaches including laminectomy or laminectomy and instrumented fusion, non-English studies, and studies with quality assessment scores of <7. The main end points including Japanese Orthopedic Association (JOA score, recovery rate of JOA, cervical lordosis, complication rate, reoperation rate, and late neurological deterioration were analyzed. All available data was analyzed using RevMan 5.2.0 and Stata 12.0. Results: A total of seven studies were included in the meta-analysis. The mean surgical level of ADF was 3.1, and the mean preoperative occupation ratios of ADF and LAMP group were 55.9% and 51.9%, respectively. No statistical difference was observed with regard to preoperative occupation ratio and preoperative JOA score. Although LAMP group had a higher preoperative cervical lordosis than ADF group (P<0.05, weighted mean difference [WMD

  16. Advantages of slow anesthesia induced by amnesia and analgesia for anterior cervical surgery%健忘镇痛慢诱导用于颈椎前路手术的优势

    Institute of Scientific and Technical Information of China (English)

    任国玲; 高丽霞; 单学栋; 韩凤梅

    2011-01-01

    Objective To investigate the feasibility and advantages of slow anesthesia induced by amnesia and analgesia for anterior cervical surgery. Methods A total of 52 patients receiving surgery of anterior cervical spine were averagely divided into groups A and B before operation. Patients of Group A developed slow anesthesia induced by amnesia and analgesi-a through endotracheal intubation, and those of group B underwent quick induction of anesthesia through tracheal intubation. The cough response during tracheal intubation and the tolerance of incubating conditions were recorded respectively. At the same time, the postoperative impression of tracheal intubation was followed up. Results Both group A and B had successful operation procedures. The patients in group A were intubated without changing the head positions; their own muscle tension effectively protected the cervical spine; and the patients were well tolerant to intubation after surgery. Whereas, the patients of group B had to have their cervical spine well-protected by others, and were not tolerant to intubation removal. In this group, 19 cases had restlessness during intubation taking-off and drug had to be applied for intubation tolerance. Conclusion Slow anesthesia induced by amnesia and analgesia is a simple, convenient and practical approach for anterior cervical surgery, which can effectively protect the cervical spine and patients well tolerate intubation.%目的 探讨健忘镇痛慢诱导用于颈椎前路手术的可行性和优势.方法 将52例颈椎前路手术患者平均分为2组:A组行健忘镇痛慢诱导气管插管全麻,B组行快诱导气管插管全麻.分别记录患者气管插管过程中的呛咳反应、带气管插管患者耐管情况,随访患者术后对气管插管的印象.结果 A组和B组都顺利完成手术,A组患者插管不改变头位,在自身肌张力保护下插管,有效保护颈椎病变部位,且术后能很好耐受带管.B组插管时令专人保护颈椎,

  17. Anterior cervical fusion and fixed system (Zero-P) for treating cervical spondylosis%新型颈椎前路椎间融合固定系统(Zero-P)治疗颈椎病的疗效分析

    Institute of Scientific and Technical Information of China (English)

    包肇华; 邹俊; 朱若夫; 吴春屾; 曹成

    2013-01-01

      背景:颈椎前路减压融合内固定术是治疗颈椎病的有效手段。但接骨板内固定在增加融合率的同时常导致一些并发症。  目的:探讨一种新型零切迹颈椎前路椎间融合固定系统(Zero-P)治疗颈椎病的疗效,以降低术后并发症的发生率。  方法:2010年6月至2011年6月对51例颈椎病患者行颈椎前路减压融合术。A组33例使用椎间融合器联合钛板固定;B组18例使用Zero-P。比较两组手术时间,术中出血量,JOA评分及改善率,NDI评分,术后融合率,术后并发症发生率。  结果:A组随访9~18个月,平均12个月;B组随访6~19个月,平均10个月。两组手术时间,术中出血量,JOA评分及改善率,NDI评分,融合率均无显著差异(P>0.05)。但B组术后并发症发生率明显低于A组(P  结论:Zero-P能降低术后并发症的发生率,尤其是吞咽不适的发生,是一种值得进一步临床应用的颈椎前路椎间融合固定系统。%Background: Anterior cervical discectomy and fusion (ACDF) is an effective treatment for cervical spondylosis. But inter-nal fixation with plate often results in some postoperative complications. Objective: To evaluate the clinical outcomes of a new anterior cervical fusion and fixed system (Zero-Profile) in the treat-ment of cervical spondylosis so as to decrease the postoperative complications. Methods: A total of 51 patients with cervical spondylosis were treated with ACDF between June 2010 and June 2011. Cage and titanium plate implantation were used in 33 patients of group A. Zero-Profile anterior cervical fusion and fixed system was applied in 18 patients of group B. Operation time, intraoperative blood loss, JOA and NDI scores, fusion rate and com-plications were compared between groups. Results: The mean follow-up period of group A was 12 months (range, 9 to 18 months). And the mean follow-up period of group B was10 months

  18. Anterior surgery for the treatment of acute single segment 30 cases of cervical disc%前路手术治疗急性单节段颈椎间盘突出30例

    Institute of Scientific and Technical Information of China (English)

    吴成如; 张诗虎

    2013-01-01

    目的 研究探讨前路颈椎间盘切除+椎间融合器+钛板内固定治疗急性颈椎间盘突出症的效果.方法 采用前路手术对我科2008-03-2011-03收治的30例急性颈椎间盘突出症患者进行治疗,所有患者均获得平均15个月的随访,根据术后摄片及JOA评分判断疗效.结果 在随访过程中,所有患者均未出现临床并发症,术后摄片显示均获得骨性融合,依据JOA评分标准:优(改善率大于75%)20例,良(改善率50~75%)8例,好转(改善率25~50%)2例.结论 该方法治疗急性颈椎间盘突出症可达到充分减压、重建颈椎生理曲度、恢复椎间隙高度、椎体间高融合率、颈椎牢固固定的作用.而且该术式操作简单,手术时间短、出血少、并发症少,是治疗急性颈椎间盘突出一种可靠方法.%Objective research and discuss the effect of the treatment of acute cervical disc herniation by using anterior cervical discectomy, Intervertebral fusion and Internal fixation with titanium plate. Methods 30 cases of patients with acute cervical disc herniation in our department in March 2008-March 2011 were treated by using anterior surgery,all patients received an average of 15 months of follow-up visit,then judge the curative effect according to postoperative radiography and JOA scores. Results In the process of follow-up, all patients did not show clinical complications, postoperative radiography showed bony fusion,according to JOA scoring criteria, optimal (improvement rate more than 75%) 20 cases, fine (improvement rate 50%~75%) 8 cases,improved (improvement rate 25%-50%) 2 cases. Conclusion the treatment of acute cervical disc herniation can achieve full decompression, reconstruction of cervical physiological curvature, restore interverte-bral disc height,high fusion rate between the vertebral bodies, cervical vertebra firmly fixed. And the operation is simple,short operation time,less bleeding,fewer complications,so the treatment of acute

  19. Heterotopic ossification following single-level anterior cervical discectomy and fusion: results from the prospective, multicenter, historically controlled trial comparing allograft to an optimized dose of rhBMP-2.

    Science.gov (United States)

    Arnold, Paul M; Anderson, Karen K; Selim, Abdulhafez; Dryer, Randall F; Kenneth Burkus, J

    2016-09-01

    OBJECTIVE Heterotopic ossification (HO) has been reported following total hip, knee, cervical, and lumbar arthroplasty, as well as following posterolateral lumbar fusion using recombinant human bone morphogenetic protein-2 (rhBMP-2). Data regarding HO following anterior cervical discectomy and fusion (ACDF) with rhBMP-2 are sparse. A subanalysis was done of the prospective, multicenter, investigational device exemption trial that compared rhBMP-2 on an absorbable collagen sponge (ACS) versus allograft in ACDF for patients with symptomatic single-level cervical degenerative disc disease. METHODS To assess differences in types of HO observed in the treatment groups and effects of HO on functional and efficacy outcomes, clinical outcomes from previous disc replacement studies were compared between patients who received rhBMP-2/ACS versus allograft. Rate, location, grade, and size of ossifications were assessed preoperatively and at 24 months, and correlated with clinical outcomes. RESULTS Heterotopic ossification was primarily anterior in both groups. Preoperatively in both groups, and including osteophytes in the target regions, HO rates were high at 40.9% and 36.9% for the rhBMP-2/ACS and allograft groups, respectively (p = 0.350). At 24 months, the rate of HO in the rhBMP-2/ACS group was higher than in the allograft group (78.6% vs 59.2%, respectively; p pain scores), neurological status, and overall success in patients in the rhBMP-2/ACS group, but not in patients in the allograft group. CONCLUSIONS Implantation of rhBMP-2/ACS at 1.5 mg/ml with polyetheretherketone spacer and titanium plate is effective in inducing fusion and improving pain and function in patients undergoing ACDF for symptomatic single-level cervical degenerative disc disease. At 24 months, the rate and dimensions (length and anteroposterior diameter) of HO were higher in the rhBMP-2/ACS group. At 24 months, range of motion was reduced, with Park Grade 3 HO in both treatment groups. The impact of

  20. Hybrid Surgery术式治疗颈前路多节段脊髓型颈椎病的临床分析%Clinic analysis of Hybrid Surgery to treat multi segmental anterior cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    福嘉欣; 江汉; 江毅; 肖联平; 田永刚

    2015-01-01

    Objective To investigate the effect of corpectomy decompression by subtotal vertebrectomy and fusion of adjacent segmental artificial disc replacement through anterior intervertenral spance (Hybrid Surgery) in the anteriorcervical spondylotic myelopathy treatment . Methods Hybrid Surgery were operated on 18 patients who suffered from anterior cervi⁃cal spondylotic myelopathy . Follow up of 1-50 months. Patient’s conditions were assessed according to the Japanese Associ⁃ation for Department of orthopedics assessment score (JOA score) before and after operation. Effects of Hybrid operation were assessed by the improvement of JOA score, Odom’s follow-up grade and cervical mobility . Results The JOA scores of all 18 operated patients were improved from 10.6 ± 1.7 before operation to 13.5 ± 2.4 after operation. And the difference is statistically significant (t=1.314, P 0.05). Conclusion Hybrid Surgery of anterior cervical decompression and fusion can both improve the nerve function and preserve cervical mobility.%目的:探讨颈椎前路经椎间隙或椎体次全切除减压植骨融合联合邻近节段人工间盘置换(Hybrid Surgery)在颈前路多节段脊髓型颈椎病治疗中的效果。方法应用Hybrid Surgery术式治疗颈前路多节段脊髓型颈椎病患者18例。随访1~50个月,手术前后根据日本骨科协会评估分数(JOA)进行评分。通过JOA评分的改善情况, Odom’s分级随访结果及颈椎活动度的变化评价Hybrid Surgery的效果。结果18例术后JOA评分(13.5±2.4)分高于术前(10.6±1.7)分,差异有统计学意义(t=1.314,P0.05)。结论 Hybrid Surgery术式颈前路充分减压融合,既可改善患者神经功能,又可保留一定程度上的颈椎活动度。

  1. 23例颈椎病颈椎前路髂骨植骨融合手术治疗分析%Analysis of 23 Cases of Cervical Spondylosis Treated by Anterior Iliac Bone Graft Fusion

    Institute of Scientific and Technical Information of China (English)

    冯恺

    2016-01-01

    目的:探究颈椎病颈椎前路髂骨植骨融合手术临床效果。方法选取我院2014年1月~2015年9月接收的23例颈椎病患者行颈椎前路髂骨植骨融合手术,分析临床情况。结果23例均成功手术,21例复查结果显示恢复良好。4例出现轻微饮水呛咳,发生率为17.39%。患者均未出现严重并发症。结论颈椎病颈椎前路髂骨植骨融合手术,整体的治疗效果满意,故在临床中可以采用该方法进行治疗,但需注意操作的严密性和谨慎性,以保证临床治疗的效果。%Objective To explore the clinical effect of anterior iliac bone graft fusion in the treatment of cervical spondylosis.Methods23 patients with cervical spondylosis received from January 2014 to September 2015 in our hospital were selected and underwent anterior iliac bone graft fusion. Results 23 cases were successfuly operated,and 21 cases showed good recovery. 4 cases of mild drinking cough occurred,the incidence rate was 17.39%. There were no serious complications in the patients.Conclusion In the patients with cervical spondylosis anterior iliac graft bone fusion surgery,the overal treatment effect was significantly,so in clinical can use this method of treatment,but should pay attention to the operation of the strict and cautious,in order to guarantee the effect of clinical treatment.

  2. Study on the Effect of Anterior Operation for Treatment of Cervical Fracture and Dislocation%前路手术治疗颈椎骨折脱位的效果研究

    Institute of Scientific and Technical Information of China (English)

    孙忠林

    2015-01-01

    Objective Anterior surgery treatment effect to cervical spine fracture and dislocation is to be studied.MethodsChoose 44 patients with cervical spine fracture and dislocation who were received and treated in hospital from November 2013 to December 2014 and separate them into two groups according to their hospitalization sequence with 22 patients in study group and 22 patients in control group, patients in study group are given anterior surgery treatment, while patients in control group are given posterior surgery treatment, and then compare treatment effects between two groups.Results Patients’ treatment efficacy, ASIA rating and complication incidence in study group are much more favorable than counterparts in control group, there is a treatment differential between two groups, and such a differential has statistic value (P<0.05).Conclusion Anterior surgery treatment is of efficacy in treatment of patients with cervical spine fracture and dislocation, it is conducive to patients’ recovery and reducing complication incidence, thus, such a surgery treatment is quite worthwhile to be promoted and applied clinically..%目的:探讨前路手术治疗颈椎骨折脱位的效果。方法选取2013~2014年12月我院收治的44例颈椎骨折脱位患者,按照入院的先后顺序分为22例研究组和22例参照组,研究组采用前路手术,参照组采用后路手术,观察两组患者的治疗效果。结果研究组患者的治疗总有效率、ASIA评级、并发症的发生率明显优于参照组,差异显著,有统计学意义(P<0.05)。结论前路手术治疗颈椎骨折脱位的效果显著,患者的恢复情况好,有效降低并发症的发生率。

  3. 前后路联合手术治疗颈椎后纵韧带骨化症%The Safety of Combined Posterior-Anterior Approaches for Cervical Ossification of the Posterior Longitudinal Ligament

    Institute of Scientific and Technical Information of China (English)

    李永军; 唐小穗; 申勇; 于俊叶

    2011-01-01

    目的 回顾性分析研究采用后路单开门椎管成形术联合前路减压植骨融合内固定术治疗68例颈椎后纵韧带骨化症患者的临床及影像学资料,通过分析手术疗效、并发症、适应证评价手术安全性.方法 回顾性分析研究本院1999年3月至2010年4月采用前后路联合手术治疗的68例颈椎后纵韧带骨化症患者的临床及影像学资料,所有患者术后随访至少1年,平均18个月;对患者进行术前、术后JOA评分及Nurick分级,采用配对t检验及秩和检验分别对JOA评分及Nurick分级进行统计学分析,评价临床疗效及手术安全性.结果 患者JOA评分由术前(6.7±1.1)分提高到术后(15.1±0.6)分,差异有统计学意义(P<0.001,α=0.05),神经功能改善率为(81.5±5.6)%.Nurick分级从术前的(2.8±1.2)级提高到术后的(0.7±0.5)级,差异有统计学意义(P<0.001,α=0.05).术后神经根麻痹者4例,内固定物松动者1例,临近节段退变加重者3例,无脊髓或神经根永久性损伤、内固定物失败、颈椎后凸畸形等严重并发症发生.结论 前后路联合手术治疗颈椎后纵韧带骨化症,可以使脊髓彻底减压,纠正颈椎后凸畸形,维持颈椎稳定性,降低术中损伤脊髓的风险,减少内固定失败及假关节形成等并发症的发生,可获得理想手术疗效,提高了手术安全性.%Objective To evaluate the applicability and safety of posterior single open-door vertebral canaloplasty combined with anterior decompression , fusion and internal fixation for the management of cervical ossification of the posterior longitudinal ligament,the authors retrospectively reviewed 68 consecutive procedures of this type performed at their respective institutions and studied the surgical effects and surgical complications,surgical indications. Methods Retrospectively analyzed 68 patients with the disease of cervical ossification of the posterior longitudinal ligament operated by combining

  4. Acceso a la información de mujeres con VPH, displasia y cáncer cervical in situ Access to information by women with HPV, cervical dysplasia and cancer in situ

    Directory of Open Access Journals (Sweden)

    Ma del Carmen Castro-Vásquez

    2010-06-01

    Full Text Available OBJETIVO: Presentar un análisis relacional de cómo mujeres diagnosticadas con el virus del papiloma humano (VPH, displasia del cuello del útero o neoplasias del cuello uterino, reciben y/o acceden a la información y cómo la viven en sus relaciones cercanas. MATERIAL Y MÉTODOS: En 2008 se realizaron 34 entrevistas cualitativas a mujeres en dos clínicas de colposcopía de la Secretaría de Salud, en Hermosillo, Sonora. El análisis se basó en la teoría fundamentada. RESULTADOS: Existe una franca analogía entre cáncer cervicouterino (CaCu y muerte, una amplia desinformación sobre VPH y displasias y una práctica persistente entre los médicos de no ofrecer información oportuna y clara a las pacientes. Existe una apreciación estigmatizante hacia la infección por VPH que afecta las relaciones cercanas de las mujeres. CONCLUSIÓN: A pesar de la necesidad de las pacientes de obtener información, no la exigen al médico, lo que contribuye a su desconfianza y angustia.OBJECTIVE: To present a relational analysis of how women who are diagnosed with the human papilloma virus (HPV, cervical dysplasia or cervical neoplasia receive or seek information, and how they experience this process within their immediate relationships. MATERIALS AND METHODS: In 2008, 34 qualitative interviews were carried out with women at two Secretary of Health colposcopy clinics in Hermosillo, Sonora. Analysis was based on grounded theory. RESULTS: There is a patent analogy between cervical cancer and death, much disinformation about HPV and dysplasias, and a persistent lack of timely and clear information given to patients by doctors. There is a stigma attached to HPV infection which affects women's immediate relationships. CONCLUSION: Despite patients' need to obtain information, they do not demand it from their doctor, which contributes to their anguish and distrust.

  5. Comparison of anterior cervical discectomy and fusion and anterior cervical corpectomy and fusion for the treatment of multi-segmental cervical spondylotic myelopathy%前路椎间盘切除减压融合与椎体次全切除减压融合治疗多节段颈椎病疗效比较

    Institute of Scientific and Technical Information of China (English)

    吴畏; 朱天亮

    2014-01-01

    目的:比较前路椎间盘减压融合( ACDF)与前路椎体次全切除减压融合( ACCF)治疗多节段颈椎病的效果。方法将138例多节段脊髓型颈椎病患者按照治疗方式的不同分为观察组(行ACDF治疗)和对照组(行ACCF治疗),比较两组手术时间、术中出血量、术后住院时间、术前与术后6个月颈椎总活动度、颈椎曲度、颈椎节段性高度及JOA评分。结果手术时间:观察组(128.3±32.4)min,对照组(163.2±43.6)min;术中出血量:观察组(161.4±122.5)ml,对照组(319.2±308.7)ml;以上指标观察组均少于对照组(P0.05)。术后颈椎曲度:观察组23.5°±7.4°,对照组16.1°±7.2°;椎间节段性高度:观察组5.6°±0.4°,对照组4.7°±0.8°;以上指标两组比较差异有统计学意义(P0. 05 ) . Postoperative cervical curvature: the observation group was 23. 5° ± 7. 4°, the control group was 16. 1° ± 7. 2°;intervertebral segmental height:observation group was 5. 6° ± 0. 4°, the control group was 4. 7° ± 0. 8°; between these indicators there were statistically significant differences between groups ( P <0. 05 ) . Conclusions Compared with ACCF, ACDF has shorter operative time, less blood loss, cervical physiological curvature and height of intervertebral segment recovered well, but there is no statistically significant differences on postoperative hospital stay time, postoperative JOA score and cervical total activity.

  6. 显微镜辅助下颈前路精细化减压治疗多节段脊髓型颈椎病的研究%Elaborative decompression under microscope through anterior cervical approach for treatment of multilevel cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    邵进; 杨铁毅; 刘树义; 张岩; 吴亮; 黄国华; 宋超; 范鑫斌

    2015-01-01

    目的:探讨显微镜辅助下颈前路精细化椎间隙减压内固定治疗多节段脊髓型颈椎病的临床效果。方法2011年1月~2014年1月,第二军医大学附属上海市浦东新区公利医院骨科52例多节段脊髓型颈椎病患者给予了显微镜辅助下精细化减压治疗。摄颈椎正侧位X线片,测量颈椎曲度,运用日本矫形外科学会(JOA)评分标准进行神经功能评价。结果所有52例患者均获得随访,术前、术后3 d、术后6个月和术后12个月颈椎生理曲分别为(14.92±2.81)º、(19.85±3.37)º、(19.57±2.69)º、(19.49±3.05)º,日本矫形外科学会(JOA)评分分别为(9.82±3.32)、(13.72±3.23)、(13.63±3.17)、(13.56±3.24)分,术后3 d、6个月和术后12个月颈椎生理曲度较术前均明显恢复、JOA评分较术前均明显提高(P<0.01);末次随访示植骨融合。除1例患者术后10 d发生血肿致呼吸困难,即刻清除血肿后恢复正常外,未发生切口感染、钛板断裂、螺钉松动以及融合器下沉或移位等并发症。结论显微镜辅助下颈前路手术,具备视野清晰、配合默契、彻底精细减压、术后即刻功能恢复等优势,显著提高颈椎前路手术优良率。%Objective To investigate the clinical efficacy of elaborative decompression under microscope through anterior cervical approach for treatment of multilevel cervical spondylotic myelopathy. Methods From January 2011 to January 2014, a total of 52 patients of multilevel cervical spondylotic myelopathy was carried out elaborative decompression under microscope through anterior cervical approach. The cervical curvature was measured by anterior-posterior and lateral X-ray of the cervical vertebrae, and the neurological function was evaluated using JOA score. Results All the 52 patients were followed up. The cervical curvature of preoperation, 3 days, 6 months and 12 months was (14.92±2.81)o, (19.85±3.37)o, (19.57±2.69)o, (19.49±3.05)orespectively. The JOA

  7. Fusion around cervical disc prosthesis: case report.

    NARCIS (Netherlands)

    Bartels, R.H.M.A.; Donk, R.

    2005-01-01

    OBJECTIVE AND IMPORTANCE: Cervical arthroplasty is a relatively new method to maintain motion after cervical anterior discectomy. Two cases are presented in which bony fusion occurred around a cervical disc prosthesis. CLINICAL PRESENTATION: A 30-year-old man and a 49-year-old woman underwent a righ

  8. Cervical disc hernia operations through posterior laminoforaminotomy

    OpenAIRE

    Coskun Yolas; Nuriye Guzin Ozdemir; Hilmi Onder Okay; Ayhan Kanat; Mehmet Senol; Ibrahim Burak Atci; Hakan Yilmaz; Mustafa Kemal Coban; Mehmet Onur Yuksel; Umit Kahraman

    2016-01-01

    Objective: The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. Materials and Methods: We retrospectively evaluated 35 patients ...

  9. 8例前路颈椎间盘摘除后颈椎动态稳定器植入术的围手术期护理%Perioperative nursing of 8 patients with dynamic cervical implant after anterior cervical discectomy

    Institute of Scientific and Technical Information of China (English)

    蔡张滢; 吕畅; 周松梅

    2012-01-01

    总结了8例经颈前路椎间盘摘除颈椎动态稳定器(dynamic cervical implant,DCI)植入术的围手术期护理措施.术前完善各项影像学检查,做好仰卧位训练、呼吸功能锻炼和气管推移训练;术后做好呼吸道管理及并发症的观察,早期进行功能康复指导,注意保障患者安全.本组术后神经功能均有明显改善,随访时日本骨科学会脊髓功能评分平均分由术前12.1分上升至15.8分.%This paper summarizes the perioperative nursing of 8 patients with dynamic cervical implant(DCI) after anterior cervical discectomy. The key points in nursing were preoperative imaging examinations, supine position training, breathing exercise and tracheal shift training,as well as postoperative airway management,observation of complications,early functional exercise guidance and patient safety management. All patients showed improvement in neural functions after operation without complications. The JOA score of spinal function increased from 12.1 to 15.8.

  10. 颈椎椎前筋膜的解剖特点及其与周围结构的关系%Anatomic features office prevertebral fascia and its significance in the anterior cervical approach

    Institute of Scientific and Technical Information of China (English)

    单建林; 姜恒; 李放

    2011-01-01

    目的 观察颈椎椎前筋膜的解剖特点及其与周围结构的关系,优化颈前手术入路.方法 成人厂J体标本22具.在环状软骨下缘水平横形切断气管、食管.观察椎前筋膜在椎体前方的移行,观察右侧喉返神经、甲状腺F动脉穿出椎前筋膜处与颈椎椎体水平的对应关系和与颈动脉鞘的位置关系.在同水平横行切开椎前筋膜、颈动脉鞘及其内容.横断面观察椎前筋膜的层次、质地、各层次向两侧的移行及与颈动脉鞘的关系,观察颈动脉鞘的形态及体验游离椎前筋膜的难易.结果 颈椎椎前筋膜分为深、浅两层,浅层致密,深层薄弱,二层容易相互分离,颈动脉鞘内侧直接与椎前筋膜浅层相移行.右侧喉返神经均在胸1椎体水平自颈动脉鞘内缘穿出椎前筋膜,甲状腺F动脉约在颈6椎体水平自颈动脉鞘内缘穿出椎前筋膜.结论 颈椎椎前筋膜的解剖特点及其与周围结构的关系可被利用使颈前手术入路更合理和安全.%Objective To make the anterior cervical approach more reasonable and safer by means of investigating the anatomic features of the prevertebral fascia and its anatomic relationships to surrounding organs. Methods Twenty-two embalmed cadavers were dissected. At the level of cricoid cartilage the trachea and esophagus were divided and pulled aside to observe the lateral transition and continuation of the prevertebral fascia and observe the location and corresponding level to the cervical vertebra where the inferior thyroid artery and the fight recurrent laryngeal nerve exit from the prevertebral fascia and its location relationship to the carotid sheath. At the same level the carotid sheath and its content and the prevertebral fascia were cut transversely to observe the layers and texture of the prevertebral fascia and transition of each layer, the morphology of the carotid sheath and its relationship to each layer of the prevertebral fascia were observed

  11. Reporte de caso: restauración del sector anterior con prótesis parcial fija en cerámica de fluorapatita

    Directory of Open Access Journals (Sweden)

    Janeth Mercedes Rojas Murillo

    2012-09-01

    Full Text Available La necesidad de restauración del sector anterior, no solo por estética sino para mejorar la función y autoestima del paciente, lleva a pensar en satisfacer estos requerimientos teniendo en cuenta los inconvenientes que dependen del estado inicial, involucrando los tejidos duros y blandos, que pueden llevar a un éxito o fracaso del tratamiento; por lo cual se debe tener una planeación adecuada del tratamiento, dependiendo las características individuales del paciente. La utilización de prótesis realizadas en metal cerámica, que ha venido siendo reemplazada por el uso de sistemas totalmente cerámicos ha llevado a desarrollar materiales con una resistencia y propiedades equivalentes a las prótesis convencionales con el fin de dar un resultado final más estético. Al encontrar pacientes cuya preocupación es el cambio de prótesis removibles por prótesis fijas en los que se encuentra una  mayor pérdida dental, se debe evaluar la posibilidad y  viabilidad de realizar prótesis fijas , que pueden ofrecer resultados más estéticos, sin comprometer la resistencia y duración del tratamiento a largo plazo, además de encontrar condiciones desfavorables como puede ser la perdida de dimensión vertical, o desgastes dentales extensos que requieran de una rehabilitación integral para el éxito del  tratamiento, aspectos importantes para la elección del material ideal para el caso individual del paciente.

  12. 颈椎前路融合与置换体外生物力学实验的新观点%Advances in research on anterior cervical fusion and replacement in vitro biomechanical experiment

    Institute of Scientific and Technical Information of China (English)

    吕聪伟; 蒲婷; 廖振华; 刘伟强

    2013-01-01

    背景:传统“金标准”颈前路减压植骨融合及近年来迅速发展的人工颈椎间盘置换是临床上常见的治疗颈椎病的方式。大量科研工作者和临床医生希望通过颈椎体外标本实验研究脊柱生物力学,为临床治疗提供指导数据。  目的:对现有颈椎体外标本生物力学实验研究进展进行综述,并对未来的研究方向进行展望。  方法:以“Cervical Spine, Fusion, Replacement, Hybrid, Biomechanics, In vitro, Adjacent-level Degeneration, Review”为英文检索词检索Pubmed数据库,以“颈椎,融合,置换,混合术,生物力学,体外,相邻节段退变,综述”为检索词检索CNKI数据库和万方数据库,检索2007年1月至2013年3月有关颈椎前路融合与置换体外生物力学实验研究进展的文献,主要整理近3年来相关研究,排除陈旧文章和重复性工作,最后对40篇文献进行归纳与讨论。  结果与结论:文章对现有的颈椎体外标本融合、置换实验进行总结,集中体现在手术多节段、运动控制条件差异化、颈椎耦合运动测试和新型植入器械4个方面,对比总结融合与置换治疗对邻近节段运动范围、关节内压力、髓核内压力和椎间孔形态的影响,探讨融合、置换后存在的问题。最后结合临床的需求,展望颈椎体外标本实验的发展趋势及应用前景。%BACKGROUND:Traditional“gold standard”of anterior cervical decompression with fusion and artificial cervical disc replacement rapidly developed in recent years are common clinical methods for the treatment of cervical spondylosis. A large number of researchers and clinicians hope to research the biomechanics of spine through cervical specimen in vitro experiments, which provide guidance for clinical surgery. OBJECTIVE:To review the cervical specimen in vitro experiments and to prospect the future research. METHODS:The PubMed database

  13. Measurement and clinical significance on anatomic landmark of anterior cervical decompression%颈椎前路减压手术解剖标志定位测量及其临床意义

    Institute of Scientific and Technical Information of China (English)

    林永绥; 王万明; 张发惠; 郑和平; 王春

    2014-01-01

    Objective The primary purpose of the current study is to provide more scientific landmarks for safe and efficient decompression within limited operating field in cervical anterior decompression. Methods Relative data were observed and measured at C3~7 of 15 adult cadaveric specimens and some data were calculated basing on above data:the ratio of anterior crus of uncinate process-medial border of longus colli muscle distance and medial border of longus colli muscle-median sagittal plane distance(AULD/MLPD), the ratio of anterior crus of uncinate process- medial border of foramen transversarium distance and anterior crus of uncinate process-medial border of longus colli muscle distance (AUTD/AULD), the ratio of anterior crus of uncinate process-lateral border of dural sac perpendicular distance and posterior crus of uncinate process-lateral border of dural sac distance(AUDD/PUDD), and the ratio of the nearest point of uncinate process and nerve root-anterior crus of uncinate process perpendicular distance and anteroposterior crus of uncinate process perpendicular distance(UNAD/APUD). Results AULD/MLPD averaged 0.83 at C3, 0.55 at C4, 0.20 at C5, 0.34 at C6, and 0.27 at C7. AUTD/AULD averaged 2.71, AUDD/PUDD averaged 0.28, and UNAD/APUD averaged 0.34. Conclusion Anterior crus of uncinate process is a consistent anatomic landmark at anterior border of cervical vertebrae, which could serve as a stationary and reliable landmark in cervical anterior decompression, and facilitate the location of dural sac, cervical nerve root and vertebral artery during operation according to the ratios of AUDD/PUDD, UNAD/APUD and AUTD/AULD.%目的:为颈椎前路减压手术在有限显露术野中达到安全、有效减压提供更科学的减压标志。方法在15具成人尸体标本上,解剖观测C3~7节段相关解剖数据,以所测量的数据为基础,计算:(1)椎体钩前脚至颈长肌内侧缘的距离/颈长肌内侧缘至正中矢状面的距离(AULD/MLPD);(2

  14. Cervical dysplasia

    Science.gov (United States)

    ... by your provider. Make sure to get the HPV vaccine when it is offered to you. This vaccine prevents many cervical cancers. ... Early diagnosis and prompt treatment cures most cases of cervical ... severe cervical dysplasia may change into cervical cancer.

  15. Reconstrucción artroscópica del ligamento cruzado anterior con injerto autólogo de semitendinoso cuádruple

    Directory of Open Access Journals (Sweden)

    Roberto Joaquín Del Gordo D´Amato

    2013-10-01

    Full Text Available ResumenSe presenta un estudio descriptivo de corte transversal, en el cual 26 pacientes fueron intervenidos quirúrgicamente para reconstrucción artroscópica de ligamento cruzado anterior con auto injerto semitendinoso cuádruple en el periodo comprendido entre junio del 2008 y junio del 2009.De los 26.pacientes que hicieron parte del presente estudio 22 fueron de sexo masculino y 4 de sexo femenino, la edad promedio fue de 32 años. En todos los casos se realizo fijación en fémur con tornillo transfixiante en titanio y tornillo de interferencia reabsorbible en tibia.El rango de movilidad fue completo en el 92.3%, el reintegro a la actividad deportiva realizada previa a la lesión fue del 84.6% y a actividad de menor exigencia en 11.54%. Las lesiones asociadas en cartílago y meniscos estuvieron presentes en el 65.38% de los pacientes.Al aplicar la escala de Lisholm encontramos un bajo porcentaje de dolor residual y limitaciones en la realización de actividades físicas, sin embargo, en 26.92 % de los pacientes presentaron algún grado de limitación al realizar cunclillas.El nivel de satisfacción expresado por los pacientes con el procedimiento quirúrgico empleado, fue entre excelentes y buenos en el 92.3 % de los casos regular en el 3.8% y malo en el 3.8%. (DUAZARY 2011, 34 - 41 Nivel de evidencia IVAbstractThis is a descriptive study of 26 patients were seen for an arthroscopic surgical reconstruction of the anterior cruciate ligament using a quadruple-stranded semitendinosus auto graft. This study was conducted between June 2008 and June 2009. Of the 26 patients that took part of the study, 22 were male and 4 were female. The average age was 32 years. In cases, the femur was transfixated with a titanium screw and the tibia with a resorbable interference screw. The range of motion was full in 92.3% of patients. 84.6% of patients were able to resume their sport activities and 11.54% were able to return to less demanding activities

  16. 颈椎椎体间融合器的临床应用(附135例报告)%Anterior Decompression and Fusion with Cages in the Cervical Spine

    Institute of Scientific and Technical Information of China (English)

    陈德玉; 赵定麟; 贾连顺; 倪斌; 肖建如; 沈强; 叶晓健; 朱海波

    2001-01-01

    To observe and compare the stability and fusion rate of three kinds of the interbody fusion cages after anterior decompression in the cervical spine.Methods:135 patients with cervical spondylosis and disc herniation were stabilized by using interbody fusion cages after anterior decompression,among them,65 cases with BAK,42 cases with CHTF and 28 cases with InterFix technique.X-ray films and CT were taken after operation to observe the stability and fusion of the segments.Results:The patients were followed up from 8 months to 31 months.The operated segments were stable.There was no difference in the fusion rate among three interbody fusion techniques.Conclusion:The immediate stability of the operated segments can be obtained by using interbody fusion cages.These techniques eliminate the complications of autograft and may be an alternative for replacing the traditional cervical interbody fusion with bone graft.%目的:观察比较3种颈椎椎体间融合器前路减压后椎体间融合的固定及融合效果。方法:采用BAK、CHTF和InterFix?3种颈椎椎体间融合器行颈椎病及颈椎间盘突出症前路减压后椎体间融合135例,其中BAK 65例,CHTF 42例,InterFix 技术28例。术后颈椎X线片及CT检查,观察手术椎节的稳定性和融合情况。结果:随访8~31月,施术节段稳定,3种颈椎椎体间融合器固定融合率无显著差异。结论:颈椎椎体间固定融合技术使施术椎节立即稳定,避免了自体植骨引起的并发症,可作为替代传统颈前路椎体间植骨融合术的方法之一。

  17. Delayed Esophageal Perforation after Cervical Spine Plating

    OpenAIRE

    Kim, Seong Jung; Ju, Chang Il; Kim, Dong Min; Kim, Seok Won

    2013-01-01

    Although anterior approaches to the cervical spine are popular and safe, they cause some of complications. Esophageal perforation after anterior spinal fusion is a rare but potentially life-threatening complication. We present a rare case of delayed esophageal perforation caused by a cervical screw placed via the anterior approach. A 43-year-old man, who had undergone surgery for complete cord injury at another orthopedic department 8 years previously, was admitted to our institute due to pai...

  18. Terapia génica con citocinas contra cáncer cervicouterino Gene therapy with cytokines against cervical cancer

    Directory of Open Access Journals (Sweden)

    Víctor Hugo Bermúdez-Morales

    2005-12-01

    Full Text Available La terapia génica es una excelente alternativa para el tratamiento de muchas enfermedades. La capacidad para manipular el DNA ha permitido dirigir la terapia génica para corregir la función de un gen alterado, aumentar la expresión de un gen o activar la respuesta inmune. Así, se puede proponer el uso del DNA como un medicamento capaz de controlar, corregir o curar una enfermedad. La terapia génica contra cáncer tiene un potencial enorme, y en la última década se han obtenido resultados muy alentadores del uso del DNA para controlar diversas neoplasias en modelos animales, lo cual ha permitido su aplicación en protocolos experimentales en humanos. Esta revisión concentra una reseña de los fundamentos de la terapia génica y su aplicación en cáncer cervical, desde el punto de vista de las alteraciones de la respuesta inmune enfocadas al microambiente tumoral y el uso de las citocinas como moduladores de la respuesta inmune.Gene therapy is an excellent alternative for treatment of many diseases. Capacity to manipulate the DNA has allowed direct the gene therapy to correct the function of an altered gene, to increase the expression of a gene and to favour the activation of the immune response. This way, it can intend the use of the DNA like medication able to control, to correct or to cure many diseases. Gene therapy against cancer has an enormous potential, and actually the use of the DNA has increased to control diverse cancer in animal models, with very encouraging results that have allowed its applications in experimental protocols in human. This work concentrates a review of the foundations of the gene therapy and its application on cervical cancer, from the point of view of the alterations of the immune system focused on the tumour micro-environment, and the use of the cytokines as immunomodulators.

  19. Clinical Observation on Anterior Cervical Decompression and Bone Graft Fusion with Locking Plate Internal Fixation in Treatment of Cervical Spinal Cord Injury without Fracture and Dislocation%颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤的临床探讨

    Institute of Scientific and Technical Information of China (English)

    孙海中

    2016-01-01

    Objective To discuss the effect of anterior cervical decompression and bone graft fusion with locking plate inter-nal fixation in treatment of cervical spinal cord injury without fracture and dislocation (SCIWORA). Methods 60 cases of patients with SCIWORA treated in our hospital from March 2011 to March 2014 were selected as the research object and randomly divided into two groups, the control group were given anterior cervical decompression and bone graft treatment, and the observation group were given anterior cervical decompression and bone graft fusion with locking plate internal fixa-tion treatment, both groups were scored by Japan department of orthopedics association (JOA)before and after operation, and the improvement rates of clinical symptoms after operation and the intervertebral fusion rates after half a year of the two groups were evaluated. Results Six months later after operation, the intervertebral fusion rate in the observation group was obviously higher than that in the control group (96.67%vs 80.0%), the difference was statistically significant (P<0.05), the JOA scores after three months of operation and six months of operation in the observation group were respectively (12.38± 1.69)points and (15.96±2.33)points, which were obviously higher than those in the control group, and the differences were statistically significant (P<0.05). Conclusion The curative effect of anterior cervical decompression and bone graft fusion with locking plate internal fixation in treatment of SCIWORA is definite.%目的 探讨颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤(SCIWORA)的效果. 方法 整群选取该院2011年3月—2014年3月收治的无骨折脱位型颈脊髓损伤(SCIWORA)患者60例作为研究对象,采用数字随机对照表将患者分为对照组和观察组,对照组行颈前路减压植骨融合术治疗,观察组在对照组基础上加锁钛板内固定治疗,手术前后均行日本骨科协

  20. Clinical Observation on Anterior Cervical Decompression and Bone Graft Fusion with Locking Plate Internal Fixation in Treatment of Cervical Spinal Cord Injury without Fracture and Dislocation%颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤的临床探讨

    Institute of Scientific and Technical Information of China (English)

    孙海中

    2016-01-01

    目的 探讨颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤(SCIWORA)的效果. 方法 整群选取该院2011年3月—2014年3月收治的无骨折脱位型颈脊髓损伤(SCIWORA)患者60例作为研究对象,采用数字随机对照表将患者分为对照组和观察组,对照组行颈前路减压植骨融合术治疗,观察组在对照组基础上加锁钛板内固定治疗,手术前后均行日本骨科协会(JOA)评分,评估两组术后临床症状好转率及半年后植骨融合率.结果 观察组术后半年后植骨融合率为96.67%显著高于对照组80.0%,差异具有统计学意义(P<0.05);观察组术后3、6个月JOA评分分别为(12.38±1.69)分、(15.96±2.33)分均显著高于对照组,差异具有统计学意义(P<0.05). 结论 颈前路减压植骨融合带锁钛板内固定治疗SCIWORA疗效确切.%Objective To discuss the effect of anterior cervical decompression and bone graft fusion with locking plate inter-nal fixation in treatment of cervical spinal cord injury without fracture and dislocation (SCIWORA). Methods 60 cases of patients with SCIWORA treated in our hospital from March 2011 to March 2014 were selected as the research object and randomly divided into two groups, the control group were given anterior cervical decompression and bone graft treatment, and the observation group were given anterior cervical decompression and bone graft fusion with locking plate internal fixa-tion treatment, both groups were scored by Japan department of orthopedics association (JOA)before and after operation, and the improvement rates of clinical symptoms after operation and the intervertebral fusion rates after half a year of the two groups were evaluated. Results Six months later after operation, the intervertebral fusion rate in the observation group was obviously higher than that in the control group (96.67%vs 80.0%), the difference was statistically significant (P<0.05), the JOA scores after three

  1. Effect of anterior cervical spine surgery on inflammatory cytokines for cervical spondylotic myelopathy%颈椎前路手术对脊髓型颈椎病患者椎间盘组织中炎性细胞因子的影响

    Institute of Scientific and Technical Information of China (English)

    李翔; 戴志唐; 常新; 戴璐

    2011-01-01

    目的 探讨颈椎前路手术对脊髓型颈椎病(CSM)患者椎间盘组织中炎性细胞因子的影响.方法 35例脊髓型颈椎病患者(CSM组)和30例颈椎外伤患者(对照组)均行颈椎前路手术治疗,观察治疗效果.采用固相分离放射免疫分析法(SPRIA)测定两组颈椎间盘组织中白细胞介素(IL)-6、IL-8、肿瘤坏死因子(TNF)-α水平.结果病程≤6个月组优良率为81.8%,病程>6个月组优良率为38.5%,两组优良率比较差异有统计学意义(P<0.05);CSM患者术前JOA评分为(9.73±2.12)分,术后JOA评分为(14.21±2.52)分,术后JOA评分显著高于术前(P<0.05);CSM组颈椎间盘中IL-6、IL-8、TNF-α水平均显著高于对照组(P<0.05).结论 颈椎前路手术是治疗CSM的一种较有效手术方法;IL-6、IL-8、TNF-α在颈椎间盘退变和CSM发病中起重要作用.%Objective To explore the effect of anterior cervical spine surgery on inflammatory cytokines for cervical spondylotic myelopathy (CSM).Methods Thirty cases of CSM ( CSM group) and 30 cases of cervical trauma (control group) were given the anterior cervical spine surgery.The CID IL-6,IL8 and tumor necrosis factor (TNF)-α levels were detected by solid phase radioimmunoassay.The patients of CSM were followed up for the clinical efficacy and courses of disease were analyzed.Results The excellent rate in course of disease ≤ 6 months group and the course of disease > 6 months group was 81.8% and 38.5% respectively (P < 0.05 ).The preoperative and postoperative JOA scores in patients with CSM were (9.73 ±2.12) and (14.21 ±2.52) respectively (P<0.05).The CID IL-6,IL-8 and TNF-α levels in CSM group were significantly higher than in control group (P < O.05 ).Conclusion The anterior cervical spine surgery is an effective surgical treatment for CSM.The IL-6,IL-8 and TNF-α may play important roles in cervical disc degeneration and CSM.

  2. Clinical outcomes of selective anterior cervical corpectomy combined with segmental disectomy and fusion for treating three-level cervical myelopathy%前路选择性椎体切除结合单间隙减压植骨融合术治疗三节段脊髓型颈椎病的临床疗效

    Institute of Scientific and Technical Information of China (English)

    曹涌; 张烽; 陈向东; 姜星杰

    2011-01-01

    Objective To evaluate the clinical outcomes of selective anterior cervical corpectomy combined with segmental disectomy and fusion for treating three-level cervical myelopathy. Methods Thirtee patients of multilevel cervical myelopathy with 3 consecutive segments were treated with anterior cervical corpectomy combined with segmental disectomy and fusion. Study parameters included JOA score and grading the Odom criteria. The sagittal segmental alignment of fusion levels was measured using the Cobb method before and after surgery. Graft fusion rate was observed during final follow up. Results The patients were followed up for 12 to 39 months. The JOA score of 13 patients was higher three months after surgery than that before[(14. 6± 1.0) points vs. (11.1 ± 1.0) points] (P<0. 01). Surgical results of Odom criteria were excellent in 8 cases, good in 3 cases, fair in 2 cases. Graft fusion rate was 100%. Radiograph analysis indicated that the Cobb angle of mean segmental lordosis was 3.7 degrees before, 10.7 degrees one week later and 10.4 degrees during the final follow up. Conclusion Selective anterior cervical corpectomy combined with segmental disectomy and fusion results in high fusion rates with sufficient decompression in the treatment of three-level cervical myelopathy.%目的 分析颈前路选择性椎体次全切除十单间隙减压植骨融合术治疗三节段脊髓型颈椎病的临床疗效.方法 13例脊髓型颈椎病患者行颈前路选择性椎体次全切除十单间隙减压、自体髂骨植骨、钢板内固定术.分析术前及随访时的日本骨科协会(JOA)评分,记录术后Odom分级.测量术前、术后1周及末次随访时颈椎侧位X线片,观察术后颈椎植骨融合率、颈椎曲度(Cobb角)维持、症状及功能改善率.结果 13例患者随访12~39个月,术后3个月JOA评分为(14.6±1.0)分,明显高于术前的(11.1±1.0)分(P<0.01).术后Odom分级:优8例,良3例,一般2例,植骨融合率100%.

  3. Clinical application of anterior cervical subtotal corpectomy and fusion with n-HA/PA66 composite artificial vertebral body for cervical spondylosis%纳米羟基磷灰石/聚酰胺66复合人工椎体在颈椎病前路椎体次全切除术中的临床应用

    Institute of Scientific and Technical Information of China (English)

    张文志; 王潇; 段丽群; 尚希福; 许翔; 胡业丰; 姚刚

    2012-01-01

    目的 探讨纳米羟基磷灰石/聚酰胺66(n-HA/PA66)复合人工椎体在颈椎前路次全切除术中应用的短中期临床疗效.方法 自2008年5月~2009年6月对44例脊髓型颈椎病行前路椎体次全切除、椎管减压、n-HA/PA66复合人工椎体植骨融合+钢板内固定术治疗,以JOA评分改善率评价神经功能恢复情况,并依据X线片判断椎间稳定性和融合情况.结果 本组无术中并发症,伤口均一期愈合.患者获随访12~26个月,平均18个月,症状均明显改善,JOA评分由术前(6.4±1.8)分提高到术后(15.2±1.5)分,JOA改善率83.0%,优良率86.4%,问卷调查满意度97.6%.X线检查证实无人工椎体移位、下沉,融合率100%.结论 n-HA/PA66复合人工椎体具有良好的生物相容性及安全性,是一种较理想的骨移植材料,适用于颈椎病前路次全切除术中.%Objective To evaluate the short and mid-term clinical effect of anterior cervical subtotal corpectomy and fusion with n-HA/PA66 composite artificial vertebral body for cervical spondylosis. Methods From may 2008 to June 2009, 44 patients with cervical spondylosis received anterior cervical subtotal corpectomy,spinal canal decompression and reconstruction by n-HA/PA66 composite artificial vertebral body combined with plate instrumentation. Neurological function was assessed by improvement rate of JOA score, and roentgenograms was analyzed to identify the stability of the fused level. Results In all patients, no complications occurred during operation. Wounds were normally healed without acute or chronic infection. All patients were followed up for 12 to 26 months, with an average of 18 months. Preoperative symptoms were all improved in patients, the mean JOA scores was (6.4±1.8) preoperatively and improved to (15.2±1.5) at final follow-up, JOA improvement rate was 83.0%, the excellent and good rate was 85.7%, patients of 97.6% were satisfied with this procedure. The X-ray films demonstrated that no

  4. 颈前路非融合与融合技术联合应用治疗颈椎病%Anterior combination of non-fusion and fusion approach for cervical spondylosis

    Institute of Scientific and Technical Information of China (English)

    毛宁方; 赵颖川; 倪海健; 李明; 王传锋; 吴云刚; 白玉树; 朱晓东; 石志才

    2012-01-01

    目的:评价颈前路融合与非融合技术联合应用治疗颈椎病的临床疗效.方法:2008年3月~2010年6月期间,采用前路减压融合(anterior cervical discectomy and fusion,ACDF)术联合颈人工椎间盘置换术(cervical artificial disc replacement,C-ADR)治疗28例颈椎病患者,手术涉及二个椎间隙19例,涉及三个椎间隙9例,置换和融合为相邻间隙24例,非相邻间隙4例.术前、术后进行JOA评分和颈椎残障功能量表(neck disability index,NDI)评定,按Odom标准评定治疗效果.根据术前、术后、随访时的颈椎标准侧位X线片,观察植骨融合、内固定及人工椎间盘的情况.结果:手术均顺利完成,手术时间70~150min,平均85min;出血量50~300ml,平均180ml.1例患者术后出现轻度呼吸困难,对症处理后症状逐步好转.术后切口均Ⅰ期愈合,无椎动脉损伤及喉返神经损伤发生.经过14~39个月(平均22个月)随访,所有患者内置人物无松动、移位,植骨融合时间在3~8个月,平均4.5个月;所有人工椎间盘置换节段运动功能良好.术前JOA评分为10.3分,末次随访时为13.8分,平均改善率为52.2%;术前NDI评分为38.5分,末次随访时为22.3分,较术前显明改善(P<0.01).末次随访时接Odom标准评定手术疗效:优14例,良8例,尚可5例,差1例.结论:颈前路融合与非融合技术联合应用可综合两种技术的优点,在彻底减压的同时,减可少固定融合节段.%Objectives: To observe ihe clinical outcome of anterior combination of non-fusion and fusion approach for cervical spondylosis. Methods: Twenty-eight cases with cervical spondylosis (CS) undergoing combination of anterior cervical discectomy and fusion(ACDF) and cervical artificial disc replacement(C-ADR) between March 2008 and June 2010 were reviewed. Two levels of intervertebral discs were involved in 19 cases, while three levels were involved in 9 cases. The levels of fusion and non-fusion were adjacent in 24

  5. Vertebral artery injuries in cervical spine surgery

    OpenAIRE

    Schroeder, Gregory D.; Hsu, Wellington K.

    2013-01-01

    Background: Vertebral artery injuries during cervical spine surgery are rare, but potentially fatal. When performing cervical spine surgery, it is imperative that the surgeon has a systematic approach for avoiding, and if necessary, dealing with a vertebral artery injury. Methods: This is a review paper. Results: Upper posterior cervical spine surgeries put the vertebral artery at the highest risk, as opposed to anterior subaxial cervical spine procedures, which put the artery at the least ri...

  6. 颈椎前路手术的早期并发症及其预防和处理%Prevention and management of early complications in anterior cervical spine surgery

    Institute of Scientific and Technical Information of China (English)

    余鹏; 汤逊; 徐永清; 周田华; 石健; 李阳; 李伟嘉

    2012-01-01

    [ Objective]To analyze the prevention and management of early complications associated with anterior cervical spine surgery. [Method] From Jan 1997 to Mar 2003,559 cases were treated with anterior cervical surgery, and received analysis on complications during the occurrence, the patient's disease,sex,age,systemic complications,surgical,anesthesia,nursing and paralysis of the multi-factor analysis. By analyzing causes of complications, the countermeasures developed. [ Result 1 Total 141 complications occurred in 118 patients and the incidence was 25.22%,including dysphagia in 53 cases,superior laryngeal nerve or recurrent laryngeal nerve injury in 11 cases,hematoma in 4 cases,increased spinal cord injury in 3 cases,esophageal fistula in 1 case,cerebrospinal fluid leakage in 4 cases,bone hematoma and infections in 5 cases, hyponatremia in 39 cases,pulmonary infection in 12 cases,deep vein thrombosis in 5 cases,death in 4cases. [Conclusion] Adequate preoperative preparation and assessment,thorough understanding of anatomy related to the anterior approach and the operation carefully, postoperative careful observation and care are essential for preventing the early postoperative complications of anterior cervical spine surgery.%[目的]分析颈椎前路手术早期的各种并发症,探讨相关的影响因素及应对策略.[方法]回顾分析本院1997年1月~2011年3月559例经颈椎前路手术的各种早期并发症发生情况,对患者的病种、性别、年龄、全身并发症情况、手术、麻醉、护理及瘫痪情况多因素进行分析,分析相关并发症的可能发生原因,介绍处理方法.[结果]118例患者141例次出现术后早期并发症,发生率25.22%,其中,术后吞咽困难53例,喉上神经或喉返神经损伤11例,颈部切口血肿4例,脊髓损害加重3例,食道瘘1例,脑脊液漏4例,取骨区血肿或脂肪液化感染5例,低钠血症39例,肺部感染12例,下肢深静脉血栓形成5例,死亡4

  7. Evaluation of arthrodesis and cervical alignment in the surgical results of cervical discectomy using polymethylmetacrylate Avaliação da artrodese e do alinhamento cervical após discectomia cervical com interposição de polimetilmetacrilato

    OpenAIRE

    Marcelo Luis Mudo; Andrea Vieira Amantea; Andrei Fernandes Joaquim; Mirto Nelso Prandini; Sérgio Cavalheiro

    2009-01-01

    BACKGROUND AND OBJECTIVES: Surgical treatment of cervical radiculopathy with or without myelopathy is a controversy issue, although anterior discectomy is the most common form of treatment. METHOD: We present the evaluation of the arthrodesis' rate and cervical alignment in 48 patients with cervical degenerative disease (CDD) submitted to anterior cervical discectomy with interposition of polymethylmetacrylate (PMMA). Odom and Nürick scales were used to evaluation of functional status before ...

  8. 人工椎间盘置换加颈前路椎体次全切减压植骨融合术治疗多节段颈椎病%Artificial Disc Replacement Combined with Anterior Cervical Decompression and Autograft Bone Fusion for the Treatment of Multi-segment Cervical Spondylosis

    Institute of Scientific and Technical Information of China (English)

    廖维峰; 肖晟; 黄象望; 刘向阳; 张毅; 向铁城

    2014-01-01

    [目的]探讨人工椎间盘置换加颈前路椎体次全切减压植骨融合术治疗多节段颈椎病的临床疗效。[方法]湖南省人民医院2008年2月至2012年6月收治的12例多节段颈椎病手术病例,均行人工椎间盘置换加颈前路椎体次全切减压植骨融合术,随访时间为12~18个月,平均随访15.5个月,均摄术前、术后及末次随访时的颈椎正侧位及颈椎过伸过屈位X线片及磁共振检查,观察植骨融合、内固定及人工椎间盘的情况,以JO A评分评价神经功能改善情况。[结果]所有病例内置物无松动、移位,植骨融合时间在3~6个月,平均4.9个月。置换间隙活动度术后1年时为12.5°±5.0°,与术前(12.3°±4.9°)比较无统计学差异(P>0.05)。术前JOA 评分平均为9.3分,术后6个月时平均为16.1分,平均改善率为91.2%。[结论]人工椎间盘置换加颈前路椎体次全切减压植骨融合术治疗多节段颈椎病近期疗效满意,是治疗多节段颈椎病的一种可行方法。%[Objective]To explore the clinical efficacy of cervical artificial disc replacement combined with anterior cervical decompression and autograft bone fusion for the treatment of multi -segment cervical spon-dylosis .[Methods]Twelve patients with multi- segment cervical spondylosis operated in Hunan provincial people's hospital from Feb .2008 to June 2012 underwent cervical artificial disc replacement combined with an-terior cervical decompression and autograft bone fusion .The follow up time was 12~18 months(average 15 .5 months) .Cervical MRI and X-ray films of cervical normal lateral position ,hyperextension and hyperflexion position were performed before and after operation and at the last time of follow up .Bone fusion ,internal fixa-tion and artificial disc were observed .JOA score was used to evaluate the improvement of neurological func-tion .[Results]No loosening and displacement of

  9. Application of n-HA/PA66 in anterior cervical subtotal corpectomy and fusion for treatment of cervical spondylotic myelopathy%纳米羟基磷灰石/聚酰胺在脊髓型颈椎病椎体次全切减压融合术中的应用

    Institute of Scientific and Technical Information of China (English)

    杨朝垒; 王利民; 谭洪宇; 王卫东; 廖文胜; 鲍恒; 刘屹林

    2011-01-01

    Objective To discuss the application effect of nano-hydroxyapatite and polyamide composite (n-HA/PA66) in anterior cervical subtotal corpectomy and fusion with plate for the treatment of cervical spondylotic myelopathy. Methods Thirty patients with cervical spondylotic myelopathy were treated with anterior cervical subtotal corpectomy, in which n-HA/PA66 was grafted and platted for the decompression and fusion. The clinical results and graft fusion were evaluated after the operation. Results All patients were operated successfully and followed up for 9 to 17 months with an average of 12.6 months. The neurological symptoms and signs of patients were greatly improved. There was no allergic and toxic reactions induced by n-HA/PA66 implantation. Imaging studies showed that cervical alignments and intervertebral height were well maintained, and graft fusions were achieved in all cases 6 to 8 months after operation. However, there were heterotopic ossifications of different degrees in the posterior edge of n-HA/PA66 artificial vertebral body. Conclusions n-HA/PA66 artificial vertebral body has good fusion rate, and could effectively maintain the biological alignment and cervical intervertebrai height. The long-term effects depend on further follow-up.%目的 探讨纳米羟基磷灰石/聚酰胺(n-HA/PA66)在脊髓型颈椎病椎体次全切减压融合术中的应用效果.方法 对30例脊髓型颈椎病患者均行颈椎前路椎体次全切n-HA/PA66植入钛板内固定术,对其疗效及融合情况进行评价.结果 30例患者均成功完成手术并获得随访,随访时间9~17个月,平均12.6个月.所有患者神经症状均明显改善,植入物未引起过敏及毒性反应,颈椎生理曲度、椎间高度有良好的恢复和维持,术后6~8个月时获得植骨融合,n-HA/PA66人工椎体后缘存在不同程度的异位骨化.结论 n-HA/PA66人工椎体作为颈椎前路手术植骨材料融合率高,可以有效保持颈椎生理曲度及椎

  10. Anterior and Posterior Approaches in One Stage Operation for Treatment of Cervical Spondylotic Myelopathy with Cervical Spine Threaded Fusion Cage%应用颈椎螺旋融合器前后路一次性手术 治疗脊髓型颈椎病

    Institute of Scientific and Technical Information of China (English)

    袁峰; 龚维成; 郭开今; 周冰; 葛保健

    2001-01-01

    Objective: To discuss the procedure and the clinical significance of one stage operation accomplished through posterior and anterior routes with threaded fusion cage (TFC) for the treatment of cervical spondylotic myelopathy (CSM) of severe multi-segmental cervical disc herniation, intervertebral instability and spinal canal stenosis. Methods: The posterior approach was carried out with laminoplasty or laminectomy firstly on 7 patients, then the anterior intervertebral decompression was executed and the TFC was planted. Assessment after surgery was based on the recovery rate using the scoring system of the Japanese Orthopaedic Association. Results: The average follow-up were 12 months. After operation 7 patients′ skin sensation showed improvement and limb muscle strength elevated. The overall mean improvement was 76.2%. Conclusion: The procedure is decompressed completely and carried safely. The instability of the cervical spine is resolved.%目的:对合并发育性颈椎管狭窄的严重的多节段颈椎间盘突出及不稳的脊髓型颈椎病患者应用颈椎螺旋融合器前后路一次性手术治疗,并进行分析。方法:对7例合并发育性颈椎管狭窄的多节段颈椎间盘突出及不稳的脊髓型颈椎病患者先行后路颈椎单开门椎板成形术或颈椎板切除减压术,然后前路行颈椎间盘、骨赘切除减压颈椎螺旋融合器植入术,术后采用日本整形外科学会标准17分法进行测评。结果:平均随访时间12个月,7例患者术后均有不同程度皮肤感觉改善和四肢肌力提高,其中2例大小便障碍者括约肌功能恢复,脊髓功能的平均改善率为76.2%。结论:本手术方法减压彻底,具有安全性,颈椎螺旋融合器的应用解决了颈椎间稳定性问题。

  11. Applie danatomy on the landmark of anterior decompression surgery in cervical vertebrae%颈椎病前路手术减压范围标志的解剖学研究

    Institute of Scientific and Technical Information of China (English)

    韩伟峰; 林欣; 李小光; 崔维; 熊英

    2009-01-01

    Objective: To explore the suitable anatomic marks as safe border of transverse decompression in anterior border of cervical vertebral surgery. Methods: Anatomic data of vertebral artery were measured on 12 adult embalmed cadavers (44 sides), for locating vertebral artery during three-dimensional CT reconstructing. Under the microscope, the distance between bilateral medial borders of longus colli muscles was measured, while the features of vertebral artery, nerve root, uncinate joint were observed and analyzed. Results:The distances between horizontal tangent of anterior vertebral body and anterior transversal foramen, bilateral root of anterior wall of transversal foramens, and bilateral medial borders of iongus colli muscles gradually decreased from downside to upside. The distance between anterior angle oftmcinate process was (17.3±2.92) mm averagely, and dural sac width (16.5±0.42)mm. The distance between the medial border of iongus colli muscles and medial margin of the vertebral artery, medial border of longns colli muscles and median sagittal plane had no significant difference at C4~6 level, however, which had significant difference at C3 and C7 level (P<0,05). Hyperplasia of uncinate joint can be found in senile cadavers, with the most serious case of which covering the vertebral artery completely and pushing it posterolaterally. Conclusions: For anterior approach, it is necessary to analyze image data carefully before the surgery, make sure operation process individually, and consider about the hyperplasy of uncovertebral joint.%目的:探讨颈前路手术减压范围及安全界限的解剖标志.方法:对12具成人尸体标本进行三维CT重建,并测量定位椎动脉所需解剖数据,在显微镜下测量颈长肌内侧缘间距等数据,并观察椎动脉、神经根、钩椎关节及其对应关系.结果:椎体前缘与横突孔前缘水平切线间距离、双侧横突孔内侧壁距离及颈长肌内侧缘间距由下端至上端逐渐

  12. Detección de mutaciones en los genes K-ras, H-ras y EGFR en muestras de plasma sanguíneo y cepillado cervical de pacientes con neoplasia intraepitelial cervical (NIC III y cáncer de cuello uterino

    Directory of Open Access Journals (Sweden)

    Dabeiba Adriana García

    2009-03-01

    Full Text Available Introducción: El cáncer cervical es el segundo cáncer más importante en mujeres a nivel mundial y la segunda causa de muerte en mujeres por cáncer. Se ha demostrado que el proceso de carcinogénesis cervical presenta componentes tanto genéticos, epigenéticos y medio ambientales. En la actualidad, muchos estudios se encaminan en la búsqueda de marcadores moleculares como mutaciones en oncogenes y/o genes tumor supresor que se asocien con la progresión de esta entidad. Los genes candidatos más estudiados en cáncer cervical en distintas poblaciones han sido H-ras, K-ras, EGFR entre otros.Objetivos: Se identificó el virus de papiloma humano (VPH genérico y específico en el ADN libre de plasma y de cepillado cervical de pacientes con cáncer cervical invasivo y con neoplasia intraepitelial cervical (NIC III además de evaluar alteraciones genéticas, como mutaciones en los genes H-ras, K-ras y EGFR.Metodología: Para ello se detectó el VPH genérico mediante PCR con los iniciadores GP5+/GP6+, y específico para VPH 16 y 18 en la región E6/E7. Para detectar las mutaciones en el codón 12 de H-ras, codones 12 y 13 de K-Ras y el exón 21 de EGFR se realizó mediante secuenciación directa de los productos de PCR de estos fragmentos génicos.Resultados: Obteniendo una buena correlación entre las muestras de plasma sanguíneo y los cepillados cervicales, tanto para los hallazgos de VPH p=0.0374 como para las mutaciones evaluadas p=0. En general, para EGFR en el exón 21 no se encontraron mutaciones, al igual que para los codones 12 y 13 en K-ras y codón 12 en H-ras.Conclusión: El uso del ADN presente en el plasma puede ser relevante para el análisis de mutaciones y de la presencia de marcadores tumorales cuando no se dispone de otras muestras.

  13. Desarrollo de un nuevo método para el análisis del estado de metilación del gen hTERT y su asociación con la infección por el virus de papiloma humano en tejidos de pacientes con cáncer cervical invasivo

    OpenAIRE

    Morales Cárdenas, Mauro Nicolás

    2013-01-01

    El cáncer de cuello uterino es un problema de salud pública en Colombia, con una incidencia de 21.5 X 100000 mujeres al año. Se ha demostrado una fuerte relación entre la infección con el virus del papiloma humano (VPH) de alto riesgo y el desarrollo de cáncer cervical y de sus lesiones precursoras. La presencia de VPH es así, una causa necesaria pero no suficiente para el desarrollo de cáncer cervical y otros factores del virus, del huésped y del ambiente pueden estar involucrados en la onco...

  14. Experiencia con el colgajo de Kirschbaum en secuelas de quemaduras cérvico-faciales

    Directory of Open Access Journals (Sweden)

    P. Rossell-Perry

    2014-06-01

    Full Text Available Presentamos nuestra experiencia con el colgajo de Kirschbaum (colgajo en charretera en la corrección de retracciones cicatriciales de la región cervical anterior y del tercio inferior de la cara. Llevamos a cabo un estudio retrospectivo sobre una serie de 63 pacientes con retracciones cicatriciales de la región cervical anterior y del tercio inferior facial, operados por el primer autor entre los años 1996 y 2012 dentro del marco de las campañas quirúrgicas desarrolladas a lo largo del país (Perú en las áreas geográficas con mayor necesidad de atención especializada. En todos los casos empleamos el colgajo en charretera tomado de la región lateral del cuello y de la región deltoidea. Evaluamos a los pacientes mediante el examen físico y la documentación fotográfica obtenida en los periodos pre y postoperatorio. Obtuvimos mejoría en diferentes grados de la limitación funcional de la región cervical y facial en todos los casos operados, con viabilidad total del colgajo en 59 casos (93,65 % y parcial en 4 casos (6,34 % . No hubo ningún caso de pérdida total. Las complicaciones recogidas fueron pocas, principalmente hematomas, 6 casos (9,52 % e infección, 2 casos (3,17 % . Las zonas donantes evolucionaron con cicatriz hipertrófica en 22 de los casos (34,92 % . En conclusión, nuestra experiencia con el uso de esta técnica quirúrgica ha demostrado ser de utilidad en el tratamiento de las secuelas de quemadura con retracción cicatricial cervical y facial, por lo que consideramos que el colgajo de Kirschbaum es seguro y tiene pocas complicaciones.

  15. Anterior or posterior approach for the treatment of severe ossification of posterior longitudinal ligament in the cervical spine%严重颈椎后纵韧带骨化症前路和后路手术比较

    Institute of Scientific and Technical Information of China (English)

    陈宇; 陈德玉; 王新伟; 杨立利; 宋滇文; 严望军; 叶晓健; 袁文

    2008-01-01

    目的 探讨前路和后路手术治疗严重颈椎后纵韧带骨化症的适应证选择、疗效及并发症.方法 2004年1月至2006年12月,手术治疗椎管狭窄率大于50%的严重颈椎后纵韧带骨化症患者34例(男29例,女5例,平均57.2岁),前路采用椎体次全切除减压钛网植骨内固定术14例(男12例,女2例),后路采用椎板切除减压侧块螺钉固定术20例(男17例,女3例).比较两种手术方式患者的颈椎管矢状径、颈椎曲度、椎管狭窄率、骨化物分型、骨化物范围、脊髓压迫率等的差异.采用JOA评分评价患者术前、术后神经功能,并计算改善率.结果 影像学结果显示前路手术主要为范围在3个节段以内的局限型和分节型骨化患者,而后路手术主要为范围超过3节段的连续型和混合型骨化患者,骨化物的分型及范围是选择的主要依据.所有患者随访6个月~3年,平均1.5年.前路手术组JOA评分从术前平均(9.3+1.8)分提高至术后平均(14.2±1.3)分,平均改善率62.3%±15.2%;后路手术组JOA评分从术前平均(8.7+1.6)分提高至术后平均(11.4±1.2)分,平均改善率33.5%±12.7%.两组患者疗效差异有统计学意义(P<0.01).结论 对于骨化范围在3个节段以内的患者,前路手术是安全、有效的治疗方式,而后路手术则适用于范围超过3个节段的严重颈椎后纵韧带骨化症患者.%Objective To discuss the surgical indications,results and complications of anterior or posterior approach for the treatment of severe ossification of posterior longitudinal ligament(OPLL)in the cervical spine.Methods Between 2002 and 2006,34 patients(29 males and 5 females,mean age 57.2 years)with severe cervical ossification of posterior longitudinal ligament(the canal stenosis rate exceeding 50%)were surgically treated in our hospital.Among them,14 patients(12 males and 2 females)underwent anterior corpectomy and fusion,and the other 20 patients (17 males and 3 females

  16. Fatores prognósticos associados ao tratamento cirúrgico da mielorradiculopatia espondilótica cervical Factores pronósticos asociados con el tratamiento quirúrgico de la mielorradiculopatía cervical espondilótica Prognostic factors associated with surgical treatment of cervical spondylotic myeloradiculopathy

    Directory of Open Access Journals (Sweden)

    Alexandre Meluzzi

    2012-01-01

    Full Text Available OBJETIVO: Identificar os fatores clínicos dos indivíduos, fatores sociais, ambientais e dos exames de imagem que se correlacionam ao resultado final de melhora neurológica em pacientes submetidos ao tratamento cirúrgico da mielopatia espondilótica cervical. MÉTODOS: A avaliação clínica foi quantificada pela escala deficitária da JOA. Analisamos 200 casos de mielorradiculopatia cervical, operados no HC-FMUSP, no período de janeiro de 1993 a janeiro de 2007. A média de segmento foi de 06 anos e 08 meses. A análise radiológica foi baseada nos critérios de instabilidade de White e scala de Kellgren. RESULTADOS: Em 80% houve melhora, 14% estabilização e em 6% piora do quadro neurológico. A piora neurológica não foi associada com nenhum fator clínico, ambiental ou de imagem. A melhora neurológica foi diretamente proporcional a menor idade na cirurgia, ausência de co-morbidade, sinal de Hoffman, atrofia muscular, hipersinal medular na RNM, menor período de evolução pré-operatório, melhor status neurológico pré-operatório e inversamente proporcional ao diâmetro AP do canal medular e multiplicidade de compressões. Identificou-se associação com o tabagismo. Mais de 70 anos, evolução superior a 24 meses, atrofia muscular, pontuação JOA igual ou inferior a sete pontos e diâmetro AP do canal inferior ou igual a seis mm não foram associado à melhora.OBJETIVO: Identificar los factores clínicos de los pacientes, factores sociales, ambientales y de exámenes de imagen que se correlacionan con el resultado final de mejoría neurológica en pacientes sometidos a tratamiento quirúrgico de la mielopatía cervical espondilótica. MÉTODOS: La evaluación clínica fue cuantificada por la escala de JOA. Se analizaron 200 casos de mielorradiculopatía cervical, operados en el HC-FMUSP, desde enero de 1993 a enero de 2007. El promedio del segmento fue de 06 años y 08 meses. El análisis radiológico se basó en los criterios

  17. Cervical spinal cord compression after thyroidectomy under general anesthesia.

    Science.gov (United States)

    Yao, Wenlong; Qiu, Jin; Zhou, Zhiqiang; Zhang, Lin; Zhang, Chuanhan

    2014-02-01

    Cervical spinal cord injury is a rare but serious complication after general anesthesia. The risk factors include traumatic cervical injury, cervical spine instability, and difficult airway management. It has also occurred in the absence of cervical instability. Here we report a patient who had a history of intermittent neck pain without numbness. Preoperative radiologic examinations showed degenerative changes in the cervical spine. She developed progressive tingling and numbness in her limbs after thyroidectomy under general anesthesia. Magnetic resonance imaging showed a cervical disc protruding into the canal at C5-C6, which was considered to be induced by surgical positioning. She recovered after anterior cervical decompression and internal fixation surgery. PMID:23828450

  18. Absence of scalenus anterior muscle.

    Directory of Open Access Journals (Sweden)

    Murakami S

    2003-06-01

    Full Text Available A rare anomaly of the scalenus muscles is described. In this case, the right scalenus anterior muscle was absent. As a substitute for this muscle, some aberrant muscle slips arose from the lower vertebrae and descended in front of the ventral rami of the lower cervical nerves. These aberrant slips then ran between the ventral rami of the the eighth cervical and first thoracic nerves, and were fused with the right scalenus medius muscle. Thus, the subclavian artery and vein ran in front of the aberrant slips, together with the ventral ramus of the first thoracic nerve. The aberrant muscle slips issued 2 accessory bundles. One bundle ran between the ventral rami of the fourth and fifth cervical nerves and was fused with the scalenus medius muscle; the other bundle ran between the ventral rami of the fifth and sixth cervical nerves and was fused with the scalenus medius muscle.

  19. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... been utilized to perform anterior cervical discectomies and fusions. The fusion procedure has been the most common way to ... significant benefits over the previous procedure of the fusion, and that is, able to maintain motion of ...

  20. Cervical Spondylotic Myelopathy: Factors in Choosing the Surgical Approach

    Directory of Open Access Journals (Sweden)

    Praveen K. Yalamanchili

    2012-01-01

    Full Text Available Cervical spondylotic myelopathy is a progressive disease and a common cause of acquired disability in the elderly. A variety of surgical interventions are available to halt or improve progression of the disease. Surgical options include anterior or posterior approaches with and without fusion. These include anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion, cervical disc replacement, laminoplasty, laminectomy with and without fusion, and combined approaches. Recent investigation into the ideal approach has not found a clearly superior choice, but individual patient characteristics can guide treatment.

  1. Insertion of lower cervical spine anterior pedicle screw in 18 cadavers%下颈椎前路椎弓根螺钉置入的实验研究

    Institute of Scientific and Technical Information of China (English)

    王远政; 刘洋; 邓忠良

    2012-01-01

    目的 探讨下颈椎前路椎弓根螺钉置入技术的可行性.方法 取18具成人尸体正常颈椎标本,剔除其周围软组织至清楚显露椎体前壁.CT扫描后,用Mimics软件重建三维模型,并测量C3~C7个体化置钉参数,包括进钉点(即椎弓根中轴线在椎体前壁投影点)、置钉方向(螺钉在横断面和矢状面上的倾斜角度)以及螺钉长度.严格按照测量结果,直视下置入椎弓根螺钉.术后作CT扫描,评价置钉效果.结果 进针点:C3、C4位于置钉椎弓根对侧,正中矢状面旁2~3 mm,距上终板6~7 mm;C5~ C7与置钉椎弓根同侧,其中C5位于正中矢状面旁1~2 mm,距上终板7.0~7.5 mm,C6、C7则为4~5 mm和7.5 ~8.5 mm.置钉方向:理想角度在C3、C4为外倾角46°~47°,头倾角-11°~-7°;在C5外倾角约48°,头倾角接近0°;C6、C7为36°~40°和8~13°.螺钉长度:可选择28、30、32 mm,其直径为3.5 mm.本组共置钉144枚.术后CT示,全部螺钉均经椎体前方置入椎弓根内抵达侧块.其中,有16枚胀破椎弓根外侧皮质,3枚穿破外侧皮质(均发生在C3、C4节段).结论 下颈椎前路椎弓根螺钉置入技术是可行的.%Objective To study the feasibility of lower cervical spine anterior pedicle screw ( APS) insertion and provide basis for its clinical application according to the preoperative APS related technological parameters. Methods Normal cervical spine specimens of 18 cadavers were carefully dissected to resect the surrounding tissue and to clearly expose the centrum antetheca. Following the CT scans, three dimensional model was reconstructed by Mimics software. The imaging data to measured key parameters of anterior transpedicular screw fixation were also produced by Mimics software. The individual screw insertion parameters including intersection point (projective point of pedicle central axis on the centrum antetheca) , insertion angle (the inclined angle of screws in cross-sectional and sagittal

  2. Degenerative cervical myelopathy.

    Science.gov (United States)

    Kato, So; Fehlings, Michael

    2016-09-01

    Cervical myelopathy is the most common cause of acquired spinal cord compromise. The concept of degenerative cervical myelopathy (DCM), defined as symptomatic myelopathy associated with degenerative arthropathic changes in the spine axis, is being introduced. Given its progressive nature, treatment options have to be chosen in a timely manner. Surgical options include anterior discectomy and fusion (ACDF), anterior corpectomy and fusion (ACCF), arthroplasty (in highly select cases), posterior laminectomy with/without fusion, and laminoplasty. Indications for each should be carefully considered in individual patients. Riluzole, a sodium-glutamate antagonist, is a promising option to optimize neurologic outcomes post-surgery and is being examined in the CSM-Protect Randomized Controlled Trial. Preoperative risk assessment is mandatory for prognostication. Sagittal alignment is known to play an important role to optimize surgical outcome. Guidelines for optimal management of DCM are in process. In principle, all but the mildest cases of DCM should be offered surgery for optimal outcome. PMID:27250040

  3. Management of cervical polyradiculopathy through multisegmental laminoforaminotomies

    Directory of Open Access Journals (Sweden)

    Hosam Eldin Abdel Azim Mostafa Habib

    2014-12-01

    Conclusion: Cervical laminoforaminotomy is an effective technique in addressing multisegmental cervical radicular compression. Moreover, this technique eliminates the need of fusion and possible internal fixation, which are essential if the alternative anterior procedure was performed; thus, reducing the overall cost and morbidity.

  4. Early detection of cervical cancer with visual inspection methods: a summary of completed and on-going studies in India Detección oportuna de cáncer cervical con métodos de inspección visual: un resumen de estudios en India

    Directory of Open Access Journals (Sweden)

    R Sankaranarayanan

    2003-01-01

    in two cluster randomized controlled intervention trials in India. One of these studies is a 4-arm trial addressing the comparative efficacy of VIA, cytology and primary screening with HPV DNA testing. This trial will provide valuable information on comparative detection rates of CIN 2-3 lesions by the middle of 2003. The expected outcomes from the Indian studies will contribute valuable information for guiding the development of public health policies on cervical cancer prevention in countries with different levels of socio-economic and health services development and open up new avenues of research.La India es un país de alto riesgo de cáncer cervical, donde se presentan cerca de la cuarta parte de los casos del total mundial (126 000 casos incidentes y 71 000 muertes durante 2000. La tasa de incidencia estandarizada por edad se encuentra en el rango de 16 a 55 por 100 000 mujeres en diferentes regiones con tasas particularmente altas en áreas rurales. El control del cáncer cervical por detección temprana y tratamiento es una prioridad del Programa Nacional de Control de Cáncer y, desafortunadamente, no hay programas organizados de tamizaje citológico en este país. La infraestructura técnica y financiera para organizar tamizaje en este tipo de cáncer, ha promovido la inspección visual como una potencial alternativa de la citología cervical en la India. Se investigan cuatro tipos de opciones de detección visual de neoplasia cervical: a inspección a ojo desnudo sin la aplicación de ácido acético, opción ampliamente conocida como downstaging; b inspección de ojo desnudo después de la aplicación de ácido acético de 3 a 5% (VIA; c VIA usando un dispositivo de aumento (VIAM; d inspección visual después de la aplicación de yodo-lugol (VILI. Se ha mostrado que el Downstaging ha sido pobremente sensible y específico para detectar neoplasia cervical y no es considerado ampliamente como una prueba de tamizaje conveniente para cáncer cervical. VIA

  5. Application of Zero-P interbody fusion in degenerative disease at the adjacent segments after anterior cervical fusion%Zero-P椎间融合术在治疗颈前路融合术后相邻节段退变性疾病中的应用

    Institute of Scientific and Technical Information of China (English)

    程彩霞; 卢旭华; 谢宁; 郭翔; 郭群峰; 倪斌

    2012-01-01

    Objective To investigate the clinical outcomes of Zero-P interbody fusion in the treatment of degenerative disease at the adjacent segments after anterior cervical decompression and fusion with internal fixation. Methods Sixteen patients with degenerative diseases at adjacent segments after anterior cervical decompression and fusion with internal fixation received Zero-P anterior cervical interbody fusion. Japanese Orthopaedic Association ( JOA) scores were compared before and after the operation. Postoperative dysphagia and intervertebral fusion were observed. Results Postoperative JOA score was significantly increased as compared with preoperative score (P<0.05). No dysphagia occurred and all the patients obtained solid fusion. Conclusion The mid- and short-term curative effect is satisfactory for the Zero-P intervertebral fusion in the treatment of cervical degenerative disease in the adjacent segments after anterior cervical fusion.%目的 探讨采用Zero-P椎间融合术治疗颈前路减压融合内固定术后相邻节段退变性疾病的疗效.方法 对16例颈前路减压融合内固定术后发生相邻节段退变性疾病的患者采用Zero-P行颈前路椎间融合术,比较患者手术前后日本骨科学会(Japanese Orthopaedic Association,JOA)评分,观察患者术后吞咽困难发生情况及椎间融合情况.结果 患者术后JOA评分较术前提高,差异有统计学意义(P<0.05),未发生吞咽困难,所有患者均获得牢固融合.结论 采用Zero-P椎间融合术治疗颈前路融合术后相邻节段退变性疾病中短期疗效较好.

  6. Treatment of cervical dislocation with locked facets

    Institute of Scientific and Technical Information of China (English)

    YU Ze-sheng; James J.Yue; WEI Feng; LIU Zhong-jun; CHEN Zhong-qiang; DANG Geng-ting

    2007-01-01

    Background Lower cervical dislocation with locked facets is common in cervical injury. The locked facets include unilateral and bilateral types. Different successful closed reduction rates has been achieved between unilateral and bilateral types by using rapid skull traction, which was commonly used to reduce the cervical dislocation. It is important to investigate a suitable management specific to patients with different types of cervical locked facets.Methods A total of 38 patients with cervical dislocation with locked facet due to cervical injury treated by rapid skull traction and operation from 1988 to 2005 were reviewed. Rapid skull traction was used in all the patients. Successful closed reduction rate was 88.0% in patients with bilateral cervical locked facets and that was 15.4% in those with unilateral cervical locked facets. These data were then statistically compared by Chi-square test. Patients who were reduced successfully underwent anterior cervical discectomy and fusion at the injured level, and those who failed in closed reduction received posterior open reduction and fixation.Results In this series, there was statistically significant difference (P<0.05) in the rate of successful closed skull traction reduction between unilateral and bilateral locked facets dislocation. Unilateral cervical locked facets dislocation was not easily reduced by skull traction which was suitable for reduction of bilateral cervical locked facets dislocation. However,unilateral cervical locked facets dislocation can be reduced by posterior open reduction.Conclusions Unilateral cervical locked facets dislocation should be treated immediately with posterior open reduction and instrumentation. Bilateral cervical locked facets dislocation can be reduced by rapid skull traction firstly and anterior cervical discectomy and interbody fusion later.

  7. Absence of scalenus anterior muscle.

    OpenAIRE

    Murakami S; Horiuchi K; Yamamoto C; Ohtsuka A; Murakami T.

    2003-01-01

    A rare anomaly of the scalenus muscles is described. In this case, the right scalenus anterior muscle was absent. As a substitute for this muscle, some aberrant muscle slips arose from the lower vertebrae and descended in front of the ventral rami of the lower cervical nerves. These aberrant slips then ran between the ventral rami of the the eighth cervical and first thoracic nerves, and were fused with the right scalenus medius muscle. Thus, the subclavian artery and vein ran in front of the...

  8. Influência do suporte e fixação anterior na resistência mecânica do fixador interno vertebral Influencia del soporte y de la fijación anterior sobre la resistencia mecánica del fijador interno vertebralartrodesis cervical anterior por hernia del disco cervica The influence of anterior reconstruction and fixation on the mechanical performance of an internal fixator

    OpenAIRE

    Gisele Cristina Ale dos Santos; Antonio Carlos Shimano; Helton LA Defino

    2009-01-01

    OBJETIVO: avaliar a influência da reconstrução e fixação anterior no desempenho mecânico do fixador interno da coluna vertebral. MÉTODOS: foram formados três grupos experimentais de acordo com a reconstrução e fixação anterior: grupo I -sem suporte anterior; grupo II - com suporte anterior; grupo III - com suporte e fixação anterior. Os corpos de prova foram submetidos a ensaios mecânicos de flexo-compressão, flexão lateral e torção, realizados em máquina de universal de ensaios, tendo sido r...

  9. Anterior pedicle screw insertion for low cervical spine:anatomical observation%下颈椎前路椎弓根螺钉置入相关的解剖学观察

    Institute of Scientific and Technical Information of China (English)

    王远政; 刘洋; 陈富; 陈亮; 晏铮剑; 柯珍勇; 邓忠良

    2012-01-01

    目的:观察成人下颈椎前路椎弓根螺钉(Anterior pedicle screw,APS)置入相关的径线和角度,为该术的临床应用提供相关解剖学参数.方法:成人干燥尸体下颈椎(C3~C7)标本22具,分别用手工和CT测量椎弓根最窄处的高度、宽度及内外侧皮质厚度,椎弓根中轴线全长,轴线夹角,并进行统计学分析.随机在CT室资料库中抽取100例成人活体颈椎CT图像,用Mimics 软件行三维重建,除以上参数外,还测量进钉点位置的相关数据,计算置钉参数的95%CI.结果:22具标本的相关径线及角度,其手工测量值与CT测量值间无统计学差异.成人活体下颈椎CT图像测量结果通过95%CI的计算,可以得出:C3、C4进钉点位于椎体正中矢状面受术椎弓根对侧2~3 mm,距椎体上终板平面6~7 mm,进钉角度为外倾角46°~48°,头倾角C3:-11°~-12°,C4-6°~7°.C5进钉点位于椎体正中矢状面受术椎弓根同侧旁1~2 mm,距椎体上终板平面7~8 mm,进钉角度为外倾角47°~49°,头倾角1°~2°.C6、C7进钉点位于受术椎弓根同侧,正中矢状面旁4~5 mm,距椎体上终板平面7.5~8.5 mm,进钉角度为外倾角C6:40°~42°,C7:36°~38°,头倾角C6:6°~7°,C7:11°~13°.置钉长度选择30、32、34 mm较为适宜,螺钉直径可选择3.5 mm或4.0mm.结论:本实验证实了CT测量下颈椎APS置入技术相关参数的准确性,同时在国内首次利用大样本研究对该技术置钉参数进行了探索.%Objective:To observe the pathlines and angles related to lower cervical spine anterior pedicle screw(APS)fixation in adults so as to provide anatomical parameters in clinics. Methods:A total of 22 cervical spine(C3-C7)specimens of human adult cadavers were individually measured by hand and CT scan to determine the height and width of the narrowest part in pedicle, thickness of inner and outer cortexes, pedicle axis length and included angle of axes followed by statistical methods. One

  10. Satisfacción de los pacientes con cervicalgia y lumbalgia en un servicio de rehabilitación Satisfaction of patients with cervical pain and low back pain in a rehabilitation service

    Directory of Open Access Journals (Sweden)

    M. A. González Viejo

    2005-12-01

    Full Text Available Fundamento. Son objetivos del presente trabajo: reducir el tiempo de espera para iniciar tratamiento de pacientes con lumbalgia/cervicalgia; conocer el grado de satisfacción de los pacientes al ser tratados mediante terapia en grupo; y determinar si existe correlación entre la satisfacción global, mejora del dolor e impacto sobre las actividades de la vida diaria. Material y métodos. Estudio prospectivo observacional. Población a estudio: usuarios de las consultas de un hospital terciario y del centro de especialidades adscrito al mismo, que acudieron por dolor cervical/lumbar y que modificaron una serie de ejercicios en grupo. Período de estudio: del 1 de octubre de 2001 al 1 de abril de 2002. El instrumento de medida para valorar el dolor y discapacidad fue el cuestionario Von Korff del dolor lumbar, realizándose una adaptación del mismo para el dolor cervical. Análisis estadístico: test no paramétrico de Wilcoxon. Resultados. Total de pacientes 273 (176 cervicalgias y 97 lumbalgias: 198 mujeres y 75 hombres. Edad media: 48,5 (20-81. La valoración subjetiva de los pacientes tratados en grupo mejoró en 72 sujetos (pBackground. The aims of the present paper are: to reduce waiting time for treatment of patients with low back pain/cervical pain; to determine the degree of satisfaction of patients being treated by groups; and to determine whether there is correlation amongst satisfaction, improvement of pain and impact on the activities of everyday life. Methods. Prospective observational study. Study population: users of the surgeries of a tertiary hospital and the specialties center attached to it, who attended surgery because of cervical/low back pain, and practiced a serie of exercises. Period of study: 1 october 2001 to 1 April 2002. The instrument of measurement used for evaluating pain and disability was the Von Korff questionnaire for low back pain, with an adaptation of this questionnaire for cervical pain. Statistical

  11. 单纯前路或后路手术治疗多节段颈椎病的疗效观察%Observation of the Efficacy of Simple Anterior or Posterior Operation for the Treatment of Multi-level Cervical Spondylosis

    Institute of Scientific and Technical Information of China (English)

    盛斌; 黄象望; 肖晟; 向铁城; 刘向阳; 张毅

    2014-01-01

    [Objective] To evaluate the clinical efficacy of cervical anterior or posterior operation for the treat-ment of multilevel cervical spondylosis and its influence on cervical curvature .[Methods] A total of 32 patients (aged 36~67 years of average 55 years ,19 males and 13 females) with multilevel cervical spondylosis underwent the operation via anterior or posterior approach from Jan .2005 to Jan .2013 .In anterior group(n=16) ,8 patients underwent selective anterior cervical hybrid decompression and fusion (ACHDF) ,and 4 patients underwent anteri-or cervical corpectomy and fusion(ACCF) on two segments ,and 4 patients underwent artificial cervical disc arthro-plasty combined with adjacent segment fusion(Hybrid) .In posterior group( n=16) ,8 patients underwent lamin-oplasty and 8 patients underwent laminectomy with internal fixation and fusion (LIFF) .Surgical complications were recorded .Visual analogue scale(VAS) and Japanese orthopedic association(JOA) score during preoperative and postoperative follow-up were compared between anterior and posterior approach patients .Cervical curvature was observed by lateral X-ray .[Results]Compared with before operation ,neck and upper limb VAS and JOA score in anterior group and posterior group after operation were obviously improved (all P 0 .05 ) .During the follow-up ,the image examination showed that the location of implants were right and bone fusion was obtained within 3 ~ 6 months .Compared with before operation ,cervical curvature had different levels of recovery in two groups after operation ( P 0 .05) .[Conclusion]Individualized appropriate surgical methods should be planned .Both anterior and posterior operation can effectively relieve nerve compression and recover cervical curvature so as to get a good clinical efficacy .Compared with poste-rior operation ,the anterior operation has certain advantages in reducing the operative time and intraoperative bleed-ing .%[目的]评价采用单纯颈椎前路或后路治

  12. Anterior surgical treatment of 4-level cervical spondylotic myelopathy%前路手术治疗4节段脊髓型颈椎病的疗效分析

    Institute of Scientific and Technical Information of China (English)

    侯铁胜; 严宁; 虞舜志; 蔡晓冰; 张海龙; 顾广飞; 赵杉; 贺石生

    2015-01-01

    Objective To investigate the clinical results, neurological scores, radiographic changes and complications for patients with 4-level cervical spondylotic myelopathy (4-level CSM) who underwent anterior decompression and fusion surgery.Methods All the medical records of anterior cervical surgery in our hospital between September 2006 and March 2014 were collected.Among them, thirty-two consecutive patients with 4-level CSM underwent the anterior decompression and fusion procedures were retrospectively investigated.Neurological function was measured at different times using Japanese Orthopedic Association (JOA) scores.The visual analogue score (VAS) was recorded for neck-shoulder pain evaluation.X-rays were conducted before and after surgery for cervical lordosis and fusion rate.Complications such as iliac pain, dysphonia, C5 palsy, cerebral fluid leakage, axial neck pain and temporary dysphagia were recorded and analyzed as well.Results All the operations were performed uneventfully.The mean operative time was 136± 18min and mean blood loss was 67±16ml.The overall follow-up period of the patients ranged from 1-8 years (average 3.6± 1.7years).The VAS score significantly decreased from 7.3± 1.2 preoperatively to 3.6±0.8 at 12 months postoperatively.The JOA score was 9.2± 1.6 preoperatively, and 9.6±2.2, 12.5±3.3, 13.2±3.2, 13.7±3.4 at 1 week, 3 months, 6 months and 12 months postoperatively.Autologous iliac bone grafts were used in 4 patients, whose fusion rate was 100% at 6 months postoperatively.Titanium meshes were used in 28 patients, whose fusion rate was 85.7% at 6 months postoperatively and 100% at 12 months postoperatively.No hardware-related complications such as screw pull-out or plate bending occurred during the short-or long-term follow-up.Complications included iliac pain (3 cases), dysphonia (1 case), C5 palsy (1 case), cerebral fluid leakage (2 cases), axial neck pain (5 cases) and temporary dysphagia (1 case).Conclusion Anterior

  13. Cervical Cancer

    Science.gov (United States)

    ... the place where a baby grows during pregnancy. Cervical cancer is caused by a virus called HPV. The ... for a long time, or have HIV infection. Cervical cancer may not cause any symptoms at first. Later, ...

  14. Liquid-based cervical cytology using ThinPrep technology: weighing the pros and cons in a cost-effectiveness analysis.

    NARCIS (Netherlands)

    Bekker-Grob, E.W. de; Kok, I.M. de; Bulten, J.; Rosmalen, J. van; Vedder, J.E.M.; Arbyn, M.; Klinkhamer, P.J.; Siebers, A.G.; Ballegooijen, M. van

    2012-01-01

    PURPOSE: Cervical cancer screening with liquid-based cytology (LBC) has been developed as an alternative to the conventional Papanicolaou (CP) smear. Cost-effectiveness is one of the issues when evaluating LBC. Based on the results of a Dutch randomised controlled trial, we conducted cost-effectiven

  15. Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2007-03-06

    Did you know that cervical cancer rates differ by race/ethnicity and region? Or that cervical cancer can usually be prevented if precancerous cervical lesions are found by a Pap test and treated? Find out how getting regular Pap tests can save a woman's life.  Created: 3/6/2007 by National Breast and Cervical Cancer Early Detection Program.   Date Released: 4/25/2007.

  16. 颈椎骨折经前路减压融合内固定术患者的围手术期的护理%Nursing Experience in Perioperative Period of Patients with Cervical Spine Fracture by Anterior Decompression and Internal Fixation

    Institute of Scientific and Technical Information of China (English)

    包秀梅

    2015-01-01

    Objective To investigate the cervical spine fracture by anterior decompression and fusion with internal fixation in patients with perioperative nursing.Methods A retrospective analysis of patients with general information from patients with anterior cervical surgery,preoperative and postoperative analysis of 2 nursing intervention patients,and observation of patients with complications. Results For 10 patients with anterior cervical spine surgery, the patients were given comprehensive, comprehensive and careful nursing, and no complications were found.Conclusion Careful nursing measures can promote the rehabilitation of patients, improve the quality of life of patients.%目的探讨颈椎骨折经前路减压融合内固定术患者的围手术期的护理。方法回顾性分析10例颈椎前路手术患者的一般资料,从术前、术后2方面分析给予患者的护理措施,并观察患者并发症的情况。结果对于10例颈椎前路手术患者的术前术后均给予全面、综合、精心的护理,未发现任何的并发症。结论精心的护理措施能促进患者的康复,提高患者的生活质量。

  17. The Research of Artificial Cervical Disc Replacement

    Institute of Scientific and Technical Information of China (English)

    Zhao Zhua; Qiang Shenb

    2008-01-01

    Cervical arthroplasty after anterior decompression with insertion of a prosthetic total disc replacement has been suggested as an alternate to anterior cervical fusion. It develops quickly during recent years. Currently there are several cervical arthroplasty devices. Each device varies in terms of materials, range of motion and constraint. Early studies suggest that in the short term, the complication rate and efficacy is no worse than fusion surgery. Long-term results have not yet been reported. This review examines the current prostheses as well as discussing issues regarding indications and technique. It is hoped that an improvement of cervical arthroplasty occurs in terms of materials and design as spinal surgeons enter a new dines of the management of cervical spine disease.

  18. Observation of the effect of multilevel anterior discectomy and fusion for aged patients with cervical spondylotic myelopathy%前路经椎间隙减压植骨融合术治疗老年人多节段脊髓型颈椎病的疗效观察

    Institute of Scientific and Technical Information of China (English)

    王军; 刘玉芹; 朱洪新; 师大雷; 仇立萍; 李翠萍; 杨磊

    2011-01-01

    目的 探讨颈前路经椎间隙减压植骨融合术治疗老年人多节段脊髓型颈椎病的疗效.方法 对25例老年脊髓型颈椎病患者行颈前路椎间隙减压、椎间植骨融合器(cage)植骨、钛板螺钉内固定术治疗,术后随访3~10个月,观察JOA评分改善率、Odoms临床疗效、植骨融合情况以及并发症发生情况.结果 末次随访时Odoms临床疗效评定,优8例,良14例,中3例,优良率为88%.JOA评分由术前的7.8分提高到末次随访时的12.8分,JOA评分平均改善率为54%.末次随访时cage及内固定位置良好,植骨融合率为100%.结论 颈前路经椎间隙减压植骨融合内固定术治疗老年人多节段脊髓型颈椎病临床疗效良好,值得推广.%Objective To explore the efficacy of multilevel anterior cervical discectomy and fusion for aged patients with cervical spondylotic myelopathy. Methods 25 aged patients with cervical spondylotic myelopathy were treated by multilevel anterior cervical discectomy and fusion. Japanese Orthopedic Association (JOA) scores were evaluated,clinical results were graded from excellent to poor using Odoms criteria,and the sagittal alignment of fusion segements were measured using Cobb method. Bone fusion and complications was evaluated. Results The final follow up score according to Odoms criteria was excellent in 8 patients ,good in 14 patients,and fair in 3 patients ,with excellent and good rate of 88%. The JOA score at final follow up(7.8) was significantly higher than preoperative(12. 8),with average improvement rate of 54%. At final follow up,bone fusion rate was 100%. Conclusion Multilevel anterior discectomy and fusion for aged patients with cervical spondylotic myelopathy was effective.

  19. 护理干预在下颈椎骨折脱位前路复位减压植骨手术中的应用%Application of Nursing Intervention in Anterior Reduction and Decompression and Bone Graft Surgery in Lower Cervical Spine Fracture and Dislocation

    Institute of Scientific and Technical Information of China (English)

    李永岩

    2015-01-01

    目的:研究分析护理干预应用于下颈椎骨折脱位前路复位减压植骨手术的使用情况。方法根据我院2007年1月~2010年12月的35例下颈椎骨折脱位前路复位减压植骨手术治疗患者来进行研究分析。结果不完全性脊髓损伤的患者术后神经功能恢复Ⅰ级以上;完全性脊髓损伤的患者术后神经功能恢复无明显改善,患者疼痛缓解,肌力改善,没有肺部感染和泌尿系统症状存在。结论下颈椎骨折脱位前路复位减压植骨治疗手术需要提前做好准备,让患者的颈椎稳定,做好患者的生命体征以及并发症观察和预防,提升手术治疗效果,让患者的生活质量得到改善。%Objective To study and analyze the application of anterior reduction and decompression of the lower cervical spine fracture and dislocation of the lower cervical spine fracture and dislocation.MethodsAccording to our hospital from January 2007 to December 2010, 35 cases of lower cervical spine fracture and dislocation anterior reduction and bone graft surgery for patients to study and analysis.ResultsPatients with incomplete spinal cord injury recovered more than one grade. After surgery, patients with complete spinal cord injury had no obvious improvement in neurological function recovery. ConclusionAnterior reduction and decompression and bone grafting in the treatment of lower cervical spine fracture and dislocation need to be prepared in advance, so that patients with cervical stability, good life signs and complications observation and prevention, improve the surgical treatment effect, so that the quality of life of patients has been improved.

  20. Reporte de caso: restauración del sector anterior con prótesis parcial fija en cerámica de fluorapatita

    OpenAIRE

    Janeth Mercedes Rojas Murillo

    2012-01-01

    La necesidad de restauración del sector anterior, no solo por estética sino para mejorar la función y autoestima del paciente, lleva a pensar en satisfacer estos requerimientos teniendo en cuenta los inconvenientes que dependen del estado inicial, involucrando los tejidos duros y blandos, que pueden llevar a un éxito o fracaso del tratamiento; por lo cual se debe tener una planeación adecuada del tratamiento, dependiendo las características individuales del paciente. La utilización de ...

  1. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... anterior pelvic exenteration performed with the robotic surgical system on a woman with recurrent cervical cancer developing ... proceed with a pelvic exenteration using the robotic system both to minimize the risk of complications due ...

  2. A minimum 2-year comparative study of autologous cancellous bone grafting versus beta-tricalcium phosphate in anterior cervical discectomy and fusion using a rectangular titanium stand-alone cage.

    Science.gov (United States)

    Yamagata, Toru; Naito, Kentaro; Arima, Hironori; Yoshimura, Masaki; Ohata, Kenji; Takami, Toshihiro

    2016-07-01

    Although titanium stand-alone cages are commonly used in anterior cervical discectomy and fusion (ACDF), there are several concerns such as cage subsidence after surgery. The efficacy of β-tricalcium phosphate (β-TCP) granules as a packing material in 1- or 2-level ACDF using a rectangular titanium stand-alone cage is not fully understood. The purpose of this study is to investigate the validity of rectangular titanium stand-alone cages in 1- and 2-level ACDF with β-TCP. This retrospective study included 55 consecutive patients who underwent ACDF with autologous iliac cancellous bone grafting and 45 consecutive patients with β-TCP grafting. All patients completed at least 2-year postoperative follow-up. Univariate and multivariate analyses were performed to examine the associations between study variables and nonunion after surgery. Significant neurological recovery after surgery was obtained in both groups. Cage subsidence was noted in 14 of 72 cages (19.4 %) in the autograft group and 12 of 64 cages (18.8 %) in the β-TCP group. A total of 66 cages (91.7 %) in the autograft group showed osseous or partial union, and 58 cages (90.6 %) in the β-TCP group showed osseous or partial union by 2 years after surgery. There were no significant differences in cage subsidence and the bony fusion rate between the two groups. Multivariate analysis using a logistic regression model showed that fusion level at C6/7, 2-level fusion, and cage subsidence of grades 2-3 were significantly associated with nonunion at 2 years after surgery. Although an acceptable surgical outcome with negligible complication appears to justify the use of rectangular titanium stand-alone cages in 1- and 2-level ACDF with β-TCP, cage subsidence after surgery needs to be avoided to achieve acceptable bony fusion at the fused segments. Fusion level at C6/7 or 2-level fusion may be another risk factor of nonunion. PMID:27098659

  3. Aspergilosis cervical con diseminación al sistema nervioso central. Presentación de un caso y revisión de bibliografía

    OpenAIRE

    Guillermo Enrique Vergara; Natalia Roura; Marcelo del Castillo; Andrea Mora; Santiago Condomi Alcorta; Rubén Mormandi; Andrés Cervio; Jorge Salvat

    2015-01-01

    Introducción: la Aspergilosis Invasiva (AI) del Sistema Nervioso Central (SNC) es infrecuente y ocurre generalmente en pacientes inmunocomprometidos. Puede presentarse con cuadros de meningitis, aneurismas micóticos, infartos o abscesos. Es una infección con pronóstico reservado y puede afectar el SNC de forma primaria o secundaria a partir de un foco que se disemina por vía hematógena. Presentamos el caso de un paciente con AI con invasión primaria a nivel óseo y diseminación posterior al ce...

  4. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

    Full Text Available ... across here and to remove the distracting pins. Let's see how it looks with the X-ray. ... and there's a cage intervening between each now. Let's take out the retractors and we'll close ...

  5. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

    Full Text Available ... her arms. The herniated discs are between the level of number three and four, and four and ... side, which is her left side. The upper level is now decompressed, so we'll move down ...

  6. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

    Full Text Available ... see better here. This is number three vertebrae, number four can incise the disc. We're still well in front of the spinal cord, which is deep and behind the vertebrae here. So this is the first part of the procedure, the discectomy, which means ...

  7. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

    Full Text Available ... is going to be a hormone bone morphogenic protein that will -- it's actually good to have some ... of the cage. This is the bone morphogenic protein, which has been mixed up on a sponge ...

  8. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

    Full Text Available ... here, this is the patient's left side. A nerve will come out from the spinal cord and go down the left arm, which ... Here is the dura in front of the spinal cord. The nerve that's pinched is going out here where this ...

  9. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

    Full Text Available ... going to make this small incision on the right side of her neck. So the skin is ... coagulate little blood vessels. We're on the right side of her neck, and going between muscles ...

  10. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

    Full Text Available ... bit, procuring the end plate of C3 and C4 of an end plate basically parallel for the ... there you see the screws in the C3, C4, and C5; and there's a cage intervening between ...

  11. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

    Full Text Available ... this point, we've cleaned out the disc space and we're going to put in distracting ... visualize better towards the back of the disc space. And this will open the space as you ...

  12. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

    Full Text Available ... also on this side, which is her left side. The upper level is now decompressed, so we'll move down to the lower level and do the same thing again, spreading the disc space open, thinning the ...

  13. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

    Full Text Available ... to the front of the spine here. The structure will feel or the carotid artery – her right ... ligament and removing disc against the spinal cord, but now it's the level below. For scale purposes, ...

  14. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

    Full Text Available ... family that we're finishing up. I'll be out in about ten minutes to talk to them. This is a skin stitch and it's a dissolvable stitch because it's a particular --. Everything seemed to go very well. Her spinal cord is now decompressed. The nerves ...

  15. Anterior Cervical Discectomy and Fusion with Plating

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    Full Text Available ... on the operating room table where we have a marker to show us position where we're ... control bleeding with these small forceps that send a current through them that coagulate little blood vessels. ...

  16. Anterior Cervical Discectomy and Fusion with Plating

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    Full Text Available ... We control bleeding with these small forceps that send a current through them that coagulate little blood ... here called the platysma. I'm going to send word out to the family that we're ...

  17. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

    Full Text Available ... to decompress it by removing the disc material against it here and also on this side, which ... space open, thinning the ligament and removing disc against the spinal cord, but now it's the level ...

  18. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

    Full Text Available ... four can incise the disc. We're still well in front of the spinal cord, which is ... it's a particular --. Everything seemed to go very well. Her spinal cord is now decompressed. The nerves ...

  19. Magnetic resonance imaging of anterior cruciate ligament of the knee: a comparison of four sequences; Valoracion del ligamento cruzado anterior de la rodilla con RM: comparacion de cuatro secuencias

    Energy Technology Data Exchange (ETDEWEB)

    Casillas, C.; Marti-Bonmati, L.; Molla, E.; Ferrer, P.; Dosda, R. [Clinical Quiron-ATQ. Valencia (Spain)

    1999-07-01

    To compare the diagnostic efficacy of the four magnetic resonance imaging (MRI) sequences that compose the standard protocol for the study of the knee in our center when employed in the examination of anterior cruciate ligament (ACL). A prospective study was carried out based on MRI findings in the knees of 326 consecutive patients. Sagittal [proton density (PD{sub w}eighted turbo-spin-echo and T2*-weighted gradient echo], coronal (PD-weighted turbo-spin-echo with fat suppression) and transverse (T2*-weighted gradient echo with magnetization transfer) images were evaluated. Each sequence was analyzed independently by two radiologists, while another two assessed all the sequences together with the clinical findings. Four categories were established: normal ACL, partially torn, completely torn and synovialized. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) with respect to the definitive diagnosis were calculated for each sequence. The statistical analysis of the findings for each category was done using the chi-squared test and the Kappa test was employed to assess the degree of agreement. According to the final diagnosis, 263 ACL were normal, 29 were partially torn, 33 were completely torn and there was 1 case of synovialization associated with a completely torn ACL. The relationship between the analysis of the ACL according to each sequence and the definitive diagnosis was very significant (p<0.001) and the agreement was excellent. All the sequences presented similar levels of diagnostic precision. The coronal sequence had least number of diagnostic errors (2.1%). The combinations of imaging techniques that resulted in the lowest error rate with respect to the definitive diagnosis were coronal PD-weighted turbo-spin-echo with fat suppression and sagittal PD-weighted turbo-spin-echo. Coronal images are highly precise in the evaluation of ACL. Sagittal sequences are the most valid for diagnosis of torn ACL

  20. [Cervical Spondylotic Amyotrophy].

    Science.gov (United States)

    Sonoo, Masahiro

    2016-05-01

    Keegan (1965) reported a patient who presented with "dissociated motor loss," an acute paralysis of the upper extremity with minimal sensory signs and no long tract signs, and documented an anterior root lesion following autopsy. Sobue et al. (1975) reported similar cases using the term "cervical spondylotic amyotrophy (CSA)," but postulated pathology of the anterior horn. Although Keegan's "dissociated motor loss" surely referred to isolated motor paresis with no or minimal sensory signs, contrary to existing criticism, a more general term, CSA, should be preferred. CSA is divided into proximal and distal types. Distal CSA often presents with a drop finger, and thus may be misdiagnosed as posterior interosseous nerve palsy. Documentation of the involvement of ulnar muscles by clinical signs and EMG would lead to the diagnosis of distal CSA. Proximal CSA may be confused with neuralgic amyotrophy (NA), although the sparing of the serratus anterior and the stereotypic involvement of deltoid, infraspinatus, biceps brachii, and brachioradialis suggest CSA. Cervical MRI is not diagnostic in around half of CSA cases, and denervation in paraspinal EMG is a more sensitive test that can exclude NA. Amyotrophic lateral sclerosis is another important differential diagnosis for CSA. PMID:27156504

  1. Estudio de los defectos congénitos del arco anterior, arco posterior y foramen transversarium de C1

    OpenAIRE

    Blanco Pérez, Esther

    2015-01-01

    La primera vértebra cervical (atlas) se caracteriza por presentar rasgos anatómicos diferentes al resto de las vértebras cervicales, no tiene cuerpo ni apófisis espinosa, sino que muestra una morfología anular, con dos arcos (anterior y posterior) y dos masas laterales. Las alteraciones congénitas del arco posterior del atlas son poco frecuentes, habiéndose publicado frecuencias entre 0,73% y 4%, casi siempre asintomáticas, por lo que se diagnostican incidentalmente. Sin embargo, también...

  2. 牵引复位联合前路减压内固定治疗低位颈椎骨折脱位的疗效分析%The efficacy analysis of lower cervical spine fracture-dislocation treated by traction reduction combined with anterior decompression and internal fixation

    Institute of Scientific and Technical Information of China (English)

    邱小波; 潘显明; 公丕安; 黎娇

    2012-01-01

    Objective To investigate the efficacy of lower cervical spine fracture-dislocation treated by traction reduction combined with anterior decompression and internal fixation. Methods A total of 22 patients with lower cervical spine fracture-dislocation were treated by operation from October 2007 to October 2010. The skull traction under local anesthesia was performed in the first step, and then under traction reduction anterior decompression and internal fixation were carried out in the second step. Results After surgery, all patients were followed up for more than 12 months. According to the X-ray films, the fracture-dislocation was made in a complete reset, the natural array of the cervical spine and physiological circular measure regained and the implanted bone was completely fused, without internal fixation breaking or loosening. According to the Frangkel grading, the grade of 6 cases were remarkably reduced (2 levels), 3 cases effectively reduced (1 level), and 3 cases were invalid. Conclusions The treatment of lower cervical spine fracture-dislocation with traction reduction combined with anterior decompression and internal fixation is effective.%目的 探讨牵引复位联合前路减压内固定治疗低位颈椎骨折脱位的疗效.方法 对2007年10月至2010年10月22例低位颈椎骨折脱位患者,第一步在局部麻醉下行颅骨牵引术,第二步在牵引复位情况下,行前路减压内固定术.结果 该组病例术后随访12个月以上,X线片显示骨折脱位均复位,颈椎的正常序列及生理弧度恢复,植骨全部融合,无内固定断裂及松动.按Frangkel分级,显效(降低2级)6例,有效(降低1级) 13例,无效3例.结论 在颈椎牵引复位的基础上行前路减压植骨融合内固定是治疗低位颈椎骨折脱位的有效方法.

  3. The analysis of therapeutic effect of Halo-vest reduction combined with anterior decompression and internal fixation on lower cervical spine fracture-dislocation%Halo-vest复位单纯前路减压内固定治疗下颈椎骨折脱位的疗效分析

    Institute of Scientific and Technical Information of China (English)

    姚关锋; 王新家; 罗滨; 王伟东; 曾机灿

    2013-01-01

    Objective:To investigate the efficacy of lower cervical spine fracture-dislocation treated by Halo-vest reduction combined with anterior decompression and internal fixation. Methods:A total of 17 patients with lower cervical spine fracture-dislocation were treated by operation from January 2009 to December 2011.The Halo-vest external fixation was performed under 1oca1 anesthesia in the first step, and then under reduction anterior decompression and internal fixation were carried out in the second step.Results: After surgery, al patients were fol owed up for more than 12 months.According to the X-ray films and CT scan,the fracture-dislocation was made in a complete reset,the natural arrangement of the cervical spine and physiological circular measure regained and the implanted bone was completely fused,without internal fixation breaking or loosening.According to the Frankel grading,the grade of 5 cases were remarkably reduced(2 levels),10 cases effectively reduced(1 leve1),and 2 cases were invalid.Conclusions: The treatment of lower cervical spine fracture-dislocation with Halo-vest reduction combined with anterior decompression and internal fixation is effective.%  目的探讨Halo-vest复位单纯前路减压内固定治疗下颈椎骨折脱位的疗效。方法对2009年l月至2011年12月17例下颈椎骨折脱位患者,首先在局麻下行Halo-vest固定术,然后逐步撑开,在复位情况下,行前路减压内固定术。结果术后随访12~24个月,平均15.4个月。常规X光正侧位片显示骨折脱位均复位,恢复颈椎的正常序列及生理弧度,CT显示植骨融合,未发现内固定断裂及松动。按Frankel分级,显效(降低2级)5例,有效(降低1级)10例,无效2例。结论在Halo-vest复位的基础上行前路减压植骨融合内固定是治疗下颈椎骨折脱位的安全有效方法。

  4. One Stage Surgical Treatment of Combined Posterior and Anterior Approach for Myelogenous Cervical Spondylosis of Spinal Stenosis combining Huge Herniated Disk%一期后前路联合手术治疗椎管狭窄合并巨大间盘突出脊髓型颈椎病

    Institute of Scientific and Technical Information of China (English)

    修海军

    2012-01-01

    Objective: To investigate the clinical effects and application of one stage surgical treatment of combined posterior and anterior approach for myelogenous cervical spondylosis of spinal stenosis combining huge herniated disk. Method: Analyze the clinical date of 25 patients who had the surgery from January 2007 to June 2010 respectively. There were 17 males and 8 females with the average age of 60. 4 years and the age ranging from 56 to 74. Result: 25 patients were followed up for 3 , 6 and 24 months, and the average improvement rate of JOA score were 63. 5% , 74. 4% and 76. 5% respectively. X-ray and MRI after the surgery had shown that no looseness of the internal fixation was found, cervical spinal cord compression was relieved and the cylinder could be seen again. Conclusion: It was an effective surgery of one stage surgical treatment of combined posterior and anterior approach for myelogenous cervical spondylosis of spinal stenosis combining huge herniated disk and it could relieve cervical spinal cord compression and rebuild the stability of cervical vertebrae. The advantages were as follows: shortening the treatment period; easing the pain for secondary surgery and saving medical cost.%目的:探讨一期后、前路联合手术治疗椎管狭窄合并巨大间盘突出脊髓型颈椎病的临床疗效和应用价值.方法:回顾分析2007年1月至2010年6月接受该术式的25例患者的临床资料,男17例,女8例,年龄56-74岁,平均60,4岁.结果:本组25例患者经3、6、24月的随访,JOA评分平均改善率分别为63.5%,74.4%,76.5%,术后行X线,MRI复查,内固定无松动,颈髓压迫解除,恢复了圆柱形状.结论:一期后、前路联合手术治疗椎管狭窄合并巨大间盘突出脊髓型颈椎病是一种有效可行的手术方法,能充分解除脊髓压迫,重建颈椎稳定性.优点:缩短治疗周期,消除了二次手术的痛苦,节省了医疗费用.

  5. Disminución del rendimiento académico con el Plan Bolonia respecto al plan anterior en España

    Directory of Open Access Journals (Sweden)

    María Isabel LÓPEZ RODRÍGUEZ

    2016-05-01

    Full Text Available La incorporación del Sistema Europeo de Transferencia de Créditos (ECTS verá sus frutos en breve con la salida al mercado laboral de los primeros egresados. En este estudio se realiza una primera valoración de los resultados obtenidos, analizando si el plan de estudios (grado o licenciatura y el uso de las nuevas metodologías docentes han marcado diferencias significativas en el rendimiento académico. Los resultados indican que éste es mayor en los licenciados y para los alumnos que se han beneficiado de una nueva herramienta pedagógica. Se han considerado los datos de dos promociones de doble licenciatura y doble grado. Descartadas, como causas, inputs potencialmente importantes como nivel preuniversitario y opción de bachillerato se plantea, como causa de la disminución del rendimiento, la implantación de los grados con una inversión prácticamente nula, lo que habría supuesto que el alumnado carezca de la disminución de presencialidad requerida para la correcta autogestión académica

  6. Radiculopatía cervical

    OpenAIRE

    Adriana Murillo Calderón

    2012-01-01

    La patología cervical traumática y su relación con el quehacer de la medicina legal tiene gran importancia y vigencia, principalmente cuando se hace necesario realizar valoraciones a pacientes con alteraciones cervicales y se debe definir si estas están en relación a un trauma determinado o repetitivo en el tiempo como puede ocurrir en algunos casos de riesgos de trabajo. El médico forense debe estar muy bien preparado, conocer la anatomía cervical y de los miembros superiores, realizar un in...

  7. Tratamiento multidisciplinar del traumatismo cervical con fractura de apófisis odontoides en militar: a propósito de un caso

    OpenAIRE

    D. Fuentes Estaban; R. Navarro Suay; C. Mestre Moreiro; Fernández González, J.; M. Villena Martín

    2014-01-01

    La fractura de apófisis odontoides de la segunda vértebra cervical representa entre el 10 y el 15% de todas las fracturas cervicales. En el medio militar, esta lesión puede ser originada por la práctica de deportes, actividades de especial riesgo como el paracaidismo y armas de fuego o artefacto explosivo. Un diagnóstico precoz y un adecuado tratamiento multidisciplinar pueden colaborar para el correcto manejo integral de una baja. Se ha realizado una revisión de la literatura en la base de d...

  8. What you need to know about ossification of the posterior longitudinal ligament to optimize cervical spine surgery: A review.

    Science.gov (United States)

    Epstein, Nancy E

    2014-01-01

    What are the risks, benefits, alternatives, and pitfalls for operating on cervical ossification of the posterior longitudinal ligament (OPLL)? To successfully diagnose OPLL, it is important to obtain Magnetic Resonance Images (MR). These studies, particularly the T2 weighted images, provide the best soft-tissue documentation of cord/root compression and intrinsic cord abnormalities (e.g. edema vs. myelomalacia) on sagittal, axial, and coronal views. Obtaining Computed Tomographic (CT) scans is also critical as they best demonstrate early OPLL, or hypertrophied posterior longitudinal ligament (HPLL: hypo-isodense with punctate ossification) or classic (frankly ossified) OPLL (hyperdense). Furthermore, CT scans reveal the "single layer" and "double layer" signs indicative of OPLL penetrating the dura. Documenting the full extent of OPLL with both MR and CT dictates whether anterior, posterior, or circumferential surgery is warranted. An adequate cervical lordosis allows for posterior cervical approaches (e.g. lamionplasty, laminectomy/fusion), which may facilitate addressing multiple levels while avoiding the risks of anterior procedures. However, without lordosis and with significant kyphosis, anterior surgery may be indicated. Rarely, this requires single/multilevel anterior cervical diskectomy/fusion (ACDF), as this approach typically fails to address retrovertebral OPLL; single or multilevel corpectomies are usually warranted. In short, successful OPLL surgery relies on careful patient selection (e.g. assess comorbidities), accurate MR/CT documentation of OPLL, and limiting the pros, cons, and complications of these complex procedures by choosing the optimal surgical approach. Performing OPLL surgery requires stringent anesthetic (awake intubation/positioning) and also the following intraoperative monitoring protocols: Somatosensory evoked potentials (SSEP), motor evoked potentials (MEP), and electromyography (EMG). PMID:24843819

  9. What you need to know about ossification of the posterior longitudinal ligament to optimize cervical spine surgery: A review

    Directory of Open Access Journals (Sweden)

    Nancy E Epstein

    2014-01-01

    Full Text Available What are the risks, benefits, alternatives, and pitfalls for operating on cervical ossification of the posterior longitudinal ligament (OPLL? To successfully diagnose OPLL, it is important to obtain Magnetic Resonance Images (MR. These studies, particularly the T2 weighted images, provide the best soft-tissue documentation of cord/root compression and intrinsic cord abnormalities (e.g. edema vs. myelomalacia on sagittal, axial, and coronal views. Obtaining Computed Tomographic (CT scans is also critical as they best demonstrate early OPLL, or hypertrophied posterior longitudinal ligament (HPLL: hypo-isodense with punctate ossification or classic (frankly ossified OPLL (hyperdense. Furthermore, CT scans reveal the "single layer " and "double layer" signs indicative of OPLL penetrating the dura. Documenting the full extent of OPLL with both MR and CT dictates whether anterior, posterior, or circumferential surgery is warranted. An adequate cervical lordosis allows for posterior cervical approaches (e.g. lamionplasty, laminectomy/fusion, which may facilitate addressing multiple levels while avoiding the risks of anterior procedures. However, without lordosis and with significant kyphosis, anterior surgery may be indicated. Rarely, this requires single/multilevel anterior cervical diskectomy/fusion (ACDF, as this approach typically fails to address retrovertebral OPLL; single or multilevel corpectomies are usually warranted. In short, successful OPLL surgery relies on careful patient selection (e.g. assess comorbidities, accurate MR/CT documentation of OPLL, and limiting the pros, cons, and complications of these complex procedures by choosing the optimal surgical approach. Performing OPLL surgery requires stringent anesthetic (awake intubation/positioning and also the following intraoperative monitoring protocols: Somatosensory evoked potentials (SSEP, motor evoked potentials (MEP, and electromyography (EMG.

  10. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... United States to have recurrence of her cervical cancer in the anterior portion of the cervix and the anterior vagina and it invading into ... involving the posterior bladder, the vagina and the cervix completely ... negative for cancer. She was surgically cured with this procedure that ...

  11. 磷酸钙骨水泥对颈椎前路螺钉置入体强化作用的生物力学分析%Biomechanical analysis of calcium phosphate cement in augmentation of anterior cervical screw

    Institute of Scientific and Technical Information of China (English)

    陈跃平; 朱勇; 张超

    2008-01-01

    BACKGROUND: Calcium phosphate cement (CPC) can strengthen the immediate and early fixation of screws by improving the quality of bone and the surface of screws. OBJECTIVE: To evaluate the biomechanical efficacy of CPC in augmentation of anterior cervical unicortical screw fixation. DESIGN: A study of controlled observation. SETTING: Department of Orthopaedics of First Xiangya Hospital of Xiangya Medical College of Central South University. MATERIALS: Experiments were performed at the Room of Electromechanical Tensile Property of College of Material Science and Engineering of Central South University from September 2003 to January 2004. Anterior cervical unicortical screw (pure titanium) was produced by Zhangjiagang Xinda Medical Equipment Co., Ltd. Injectable calcium phosphate cement was produced by Shanghai Ruibang Biomaterial Co., Ltd. Axial pull-out sleeve was produced by Machine Manufacture Center of Central South University. METHODS: ①Sixteen cervical vertebrae (C3-6) of four fresh young man cadavers with fine results in bone mineral density (BMD) test and sixteen cervical vertebrae (C3-6) of 4 fresh old man cadavers with poor results in BMD test were selected. Specimens were provided by Department of Anatomy of Xiangya Medical College of Central South University. Mortal remains of the deceased were donated according to the will of the dead. Informed consents were obtained from their family members. Twelve vertebrae were selected in each group for three tests. Six vertebrae were selected in pull-out test, and six vertebrae in cyclic bending test and shearing test. Screw holes, which were 8 mm apart from the midline and 5°inclined centrally, were made on both sides in the front part of the vertebra. Cortical bone was not penetrated. ②A screw was randomly inserted into one side hole, which was considered to be a control group. Pull-out test was performed on material testing machine at 5 mm/min. The screw hole was filled with CPC (0.10-0.15 mL) to repair the

  12. Restablecimiento del soporte posterior con prótesis parcial removible inferior y manejo estético anterior con prótesis tipo collar less y carillas directas: reporte de caso

    OpenAIRE

    Mendoza García, Jesús Enrique

    2014-01-01

    Este reporte de caso de elabora con el fin de optar al título de especialización en Operatoria Dental Estética de la Universidad Nacional de Colombia. Paciente masculino de 61 años se presenta en la Clínica de Especialización en Operatoria dental Estética de la UNAL; presenta como características, ausencia de soporte posterior estable, coronas metal cerámicas y temporales acrílicas en zona anterosuperior desadaptada, atrición en zona antero-inferior y removible superior adaptado y fu...

  13. Clinical and Radiological Comparison of Femur and Fibular Allografts for the Treatment of Cervical Degenerative Disc Diseases

    OpenAIRE

    Oh, Hyeong-Seok; Shim, Chan Shik; Kim, Jin-Sung; Lee, Sang-Ho

    2013-01-01

    Objective This consecutive retrospective study was designed to analyze and to compare the efficacy and outcomes of anterior cervical discectomy and fusion (ACDF) using a fibular and femur allograft with anterior cervical plating. Methods A total of 88 consecutive patients suffering from cervical degenerative disc disease (DDD) who were treated with ACDF from September 2007 to August 2010 were enrolled in this study. Thirty-seven patients (58 segments) underwent anterior interbody fusion with ...

  14. Anterior tarsaltunnelsyndrom

    DEFF Research Database (Denmark)

    Miliam, Palle B; Basse, Peter N

    2009-01-01

    Anterior tarsal tunnel syndrome is a rare entrapment neuropathy of the deep peroneal nerve beneath the extensor retinaculum of the ankle. It may be rare because it is underrecognized clinically.We present a case regarding a 29-year-old man, drummer, who for one and a half year experienced clinical...

  15. Ganglion cyst of the spinal anterior longitudinal ligament presenting as a retropharyngeal mass.

    Science.gov (United States)

    Giger, Roland; Szalay-Quinodoz, Ildiko; Haenggeli, André; Dulguerov, Pavel

    2002-01-01

    Cervical spinal synovial and/or ganglion cysts can occur at various periarticular sites and should be considered in the differential diagnosis of intraspinal-extradural or paraspinal masses of the cervical spine. The first report of a ganglion cyst of the cervical anterior longitudinal ligament presenting as a retropharyngeal mass, is presented. The histopathology, etiology, and clinical aspects of synovial and ganglion cysts of the cervical spine are briefly reviewed. PMID:12430135

  16. Ganglion cyst of the spinal anterior longitudinal ligament presenting as a retropharyngeal mass

    OpenAIRE

    Giger, Roland; Szalay-Quinodoz, Ildiko; Haenggeli, André; Dulguerov, Pavel

    2002-01-01

    Cervical spinal synovial and/or ganglion cysts can occur at various periarticular sites and should be considered in the differential diagnosis of intraspinal-extradural or paraspinal masses of the cervical spine. The first report of a ganglion cyst of the cervical anterior longitudinal ligament presenting as a retropharyngeal mass, is presented. The histopathology, etiology, and clinical aspects of synovial and ganglion cysts of the cervical spine are briefly reviewed.

  17. Cervical Cancer

    Science.gov (United States)

    ... to see your doctor. www.cdc.gov/cancer/knowledge 1-800-CDC-INFO Are there tests that can prevent cervical cancer or find it early? There are two tests that can either help prevent cervical cancer or find it early: • The Pap test (or Pap smear)looks for precancers, cell changes, on the cervix ...

  18. 桥形椎间锁定融合器(ROI-C)在颈椎病前路减压融合术中应用的临床研究%Bridge Intervertebral Fusion Lock Device (ROI - C) in Cervical Spondylosis Anterior Decompression Fusion Application in Clinical Research

    Institute of Scientific and Technical Information of China (English)

    何彦国

    2015-01-01

    objective to study and analyze the bridge between vertebra locking fusion in cervical spondylosis application of the clinical effect of anterior decompression fusion.Methods to collect a total of 100 patients with cervical spondylosis, randomly divided into observation group and control group, the 50 cases, control group patients with cage combined anterior internal fixation with titanium plate, observation group carries on the bridge a locked intervertebral fusion, both before and after operation for X-ray inspection, two group of patients with cervical physiological curvature and lesion intervertebral height, the incidence of dysphagia observation and comparison.Results the observation group of patients with cervical physiological curvature of the improvement of the degree of improvement and pathology of the intervertebral height was significantly higher than that of control group, the incidence of dysphagia in patients with significantly lower than the control group,P<0.05).Conclusion in the cervical spine anterior decompression fusion, application of bridge intervertebral target fusion can make cervical physiological curvature and pathological changes of intervertebral height effectively restore, and lower the incidence of postoperative patients with dysphagia, shorter operation time, simple operation, is worthy of popularization and application.%目的:研究和分析桥形椎间锁定融合器在颈椎病前路减压融合术中应用的临床效果。方法收集颈椎病患者共100例,随机分为观察组与对照组,各50例,对照组患者进行cage联合前路钛板内固定,观察组进行桥形椎间锁定融合器固定,手术前后均进行了X线片的检查,将两组患者的颈椎生理曲度、病变椎间高度、吞咽困难发生率等进行观察和对比。结果观察组患者的颈椎生理曲度的改善程度、病变椎间高度的改善程度明显高于对照组,患者的吞咽困难发生

  19. Tratamiento multidisciplinar del traumatismo cervical con fractura de apófisis odontoides en militar: a propósito de un caso

    Directory of Open Access Journals (Sweden)

    D. Fuentes Estaban

    2014-12-01

    Full Text Available La fractura de apófisis odontoides de la segunda vértebra cervical representa entre el 10 y el 15% de todas las fracturas cervicales. En el medio militar, esta lesión puede ser originada por la práctica de deportes, actividades de especial riesgo como el paracaidismo y armas de fuego o artefacto explosivo. Un diagnóstico precoz y un adecuado tratamiento multidisciplinar pueden colaborar para el correcto manejo integral de una baja. Se ha realizado una revisión de la literatura en la base de datos del PUBMED, utilizado la palabra clave "fractura odontoides", "sedación", "Halo-Jacket".

  20. The anterior cingulate cortex

    Directory of Open Access Journals (Sweden)

    Pavlović D.M.

    2009-01-01

    Full Text Available The anterior cingulate cortex (ACC has a role in attention, analysis of sensory information, error recognition, problem solving, detection of novelty, behavior, emotions, social relations, cognitive control, and regulation of visceral functions. This area is active whenever the individual feels some emotions, solves a problem, or analyzes the pros and cons of an action (if it is a right decision. Analogous areas are also found in higher mammals, especially whales, and they contain spindle neurons that enable complex social interactions. Disturbance of ACC activity is found in dementias, schizophrenia, depression, the obsessive-compulsive syndrome, and other neuropsychiatric diseases.

  1. Síndrome de Brown-Séquard por hérnia discal cervical a duplo nível: caso clínico e revisão da literatura Síndrome de Brown-Séquard por hernia discal cervical en nivel doble: caso clínico y revisión de la literatura Brown-Séquard syndrome by double level cervical disc herniation: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Jorge Miguel Silva Ribeiro Olliveira Alves

    2012-09-01

    Full Text Available Descrição do caso clínico de um paciente com síndrome de Brown-Séquard por hérnia de disco cervical em duplo nível, 40 anos, do sexo masculino, sem história de patologia prévia da coluna cervical; teve início insidioso de paresia nos membros direitos, associada à diminuição da sensibilidade dolorosa e térmica do hemicorpo esquerdo, após mergulho que ocasionou trauma indireto da coluna cervical. A RM da coluna cervical mostrou hérnias discais paramedianas direitas nos níveis C4-C5 e C5-C6 com compressão da metade direita do cordão medular e hiperintensidade em T2. Foi realizada descompressão por via anterior e artrodese dos níveis afetados. O paciente recuperou-se parcialmente dos déficits neurológicos, após um longo programa de reabilitação funcional. O tratamento cirúrgico e um programa de reabilitação precoce são da maior importância para a recuperação neurológica de paciente com síndrome de Brown-Séquard por hérnia de disco cervical.Descripción del caso clínico de un paciente con síndrome de Brown-Séquard por hernia de disco cervical en nivel doble, 40 años, del sexo masculino, sin historial de patología previa de la columna cervical; tuvo inicio insidioso de paresia en los miembros derechos, vinculada con la disminución de la sensibilidad dolorosa y térmica del hemicuerpo izquierdo, después de zambullida que ocasionó traumatismo indirecto de la columna vertebral. La RM de la columna cervical mostró hernias discales paramedianas derechas, en los niveles C4-C5 y C5-C6, con compresión de la mitad derecha del cordón medular e hiperintensidad en T2. Se realizó descompresión por vía anterior y artrodesis de los niveles afectados. El paciente se recuperó, parcialmente, de los déficits neurológicos, después de un programa prolongado de rehabilitación funcional. El tratamiento quirúrgico y un programa de rehabilitación precoz son de máxima importancia para la recuperación neurológica del

  2. Cervical Spine Instrumentation in Children.

    Science.gov (United States)

    Hedequist, Daniel J; Emans, John B

    2016-06-01

    Instrumentation of the cervical spine enhances stability and improves arthrodesis rates in children undergoing surgery for deformity or instability. Various morphologic and clinical studies have been conducted in children, confirming the feasibility of anterior or posterior instrumentation of the cervical spine with modern implants. Knowledge of the relevant spine anatomy and preoperative imaging studies can aid the clinician in understanding the pitfalls of instrumentation for each patient. Preoperative planning, intraoperative positioning, and adherence to strict surgical techniques are required given the small size of children. Instrumentation options include anterior plating, occipital plating, and a variety of posterior screw techniques. Complications related to screw malposition include injury to the vertebral artery, neurologic injury, and instrumentation failure. PMID:27097300

  3. Generalized cervical root resorption associated with periodontal disease

    NARCIS (Netherlands)

    Beertsen, W; Piscaer, M; Van Winkelhoff, AJ; Everts, P. A. M.

    2001-01-01

    Background and description of case: The etiology and pathogenesis of generalized cervical root resorptions is not well understood. In the present report, a case of severe cervical root resorption involving 24 anterior and posterior teeth is presented. The lesions developed within a period of 2 years

  4. Pediatric Upper Cervical Spine Giant Cell Tumor: Case Report

    OpenAIRE

    Alfawareh, Mohammad D.; Shah, Irfanullah D.; Orief, Tamer I.; Halawani, Mohammad M.; Attia, Walid I.; Almusrea, Khaled N.

    2014-01-01

    Study Design Case report. Objective The purpose of this work is to report the case of a giant cell tumor involving the second cervical vertebra in a pediatric patient. Surgical management included a combined posterior and anterior cervical approach. There has been no recurrence in 2 years of follow-up. Case Report A 13-year-old girl presented with scoliosis with incidentally lytic lesion involving the second cervical vertebra. The radiologic investigations and biopsy result indicated a giant ...

  5. Operative techniques for cervical radiculopathy and myelopathy.

    LENUS (Irish Health Repository)

    Moran, C

    2012-02-01

    The surgical treatment of cervical spondylosis and resulting cervical radiculopathy or myelopathy has evolved over the past century. Surgical options for dorsal decompression of the cervical spine includes the traditional laminectomy and laminoplasty, first described in Asia in the 1970\\'s. More recently the dorsal approch has been explored in terms of minimally invasive options including foraminotomies for nerve root descompression. Ventral decompression and fusion techniques are also described in the article, including traditional anterior cervical discectomy and fusion, strut grafting and cervical disc arthroplasty. Overall, the outcome from surgery is determined by choosing the correct surgery for the correct patient and pathology and this is what we hope to explain in this brief review.

  6. Artroplastia total de disco cervical com prótese de Bryan: resultados clínicos e funcionais Artroplastía cervical total con prótesis de Bryan: resultados clínicos y funcionales Cervical total disc arthroplasty with Bryan disc: clinical and functional outcomes

    OpenAIRE

    Eduardo Machado de Menezes; Rafael Ozório Rocha; Aline Aparecida Depiante Moreira; Deusdeth Gomes Nascimento; Antonio Eulálio Pedrosa Araujo; Luiz Carlos Santeli Maia

    2012-01-01

    OBJETIVO: Avaliar resultados da artroplastia total disco cervical com a prótese de Bryan para tratamento da cervicobraquialgia (radiculopatia) e da mielopatia compressiva. MÉTODOS: No período de 2002 a 2007, a equipe da CECOL operou 65 pacientes. Somente 28 pacientes foram localizados em 2010 para uma nova coleta de dados. Foi feita avaliação pré e pós-operatória, utilizando-se o questionário CSOQ (Cervical Spine Outcomes Questionnaire). Os critérios de Odom foram utilizados somente na avalia...

  7. Fatores prognósticos associados ao tratamento cirúrgico da mielorradiculopatia espondilótica cervical Factores pronósticos asociados con el tratamiento quirúrgico de la mielorradiculopatía cervical espondilótica Prognostic factors associated with surgical treatment of cervical spondylotic myeloradiculopathy

    OpenAIRE

    Alexandre Meluzzi; Mário Augusto Taricco; Roger Schimidth Brock; Mário Rubem Pena Dias; Gilberto Nakaguawa; Vinícius Monteiro de Paula Guirado; Manoel Jacobsen Teixeira

    2012-01-01

    OBJETIVO: Identificar os fatores clínicos dos indivíduos, fatores sociais, ambientais e dos exames de imagem que se correlacionam ao resultado final de melhora neurológica em pacientes submetidos ao tratamento cirúrgico da mielopatia espondilótica cervical. MÉTODOS: A avaliação clínica foi quantificada pela escala deficitária da JOA. Analisamos 200 casos de mielorradiculopatia cervical, operados no HC-FMUSP, no período de janeiro de 1993 a janeiro de 2007. A média de segmento foi de 06 anos e...

  8. A comparative study on the treatment of cervical spondylosis with the surgery of dynamic cervical implant implantation and anterior decompression fusion with cage%颈椎动态稳定器植入与颈前路减压融合内固定治疗脊髓型颈椎病的比较

    Institute of Scientific and Technical Information of China (English)

    贾杰; 刘宏建; 尚国伟; 吴志彬; 王俊魁; 周权发; 皮国富

    2015-01-01

    目的 比较颈椎动态稳定器(DCI)植入术与颈前路减压融合内固定术(ACDF)治疗单节段脊髓型颈椎病的中期疗效.方法 对行DCI植入术(DCI组)的23例患者,与行颈前路减压融合内固定术(ACDF组)的47例患者进行随访,分别于术后24、36、48个月末行日本矫形外科协会(JOA)评分,并拍摄X线片观察手术节段椎间隙的高度和活动度以及上下邻近节段的活动度.结果 两组术后各期的JOA评分和椎间隙高度与术前比较差异均有统计学意义(P<0.05),随访各期组间比较差异无统计学意义(P>0.05).DCI组手术节段的活动度在各随访期末与术前比较差异无统计学意义(P>0.05);其上下邻近节段的活动度在随访期末[(6.99±0.56)°、(6.83±0.35)°]与术前[(6.78±0.51)°、(6.63 ±0.48)°]比较差异无统计学意义(P>0.05),而ACDF组随访期末上下邻近节段活动度[(8.56 ±0.51)°、(8.34±0.43)°]均较术前[(6.81±0.53)°、(6.67±0.49)°]增加(P<0.05).结论 两种手术均能明显缓解患者症状,恢复并维持椎间隙高度.与ACDF比较,DCI为手术节段提供持续的动态稳定,可减缓邻近节段的退变,但手术节段的椎体可能出现退变增生.%Objective To compare post-operative mid-term clinical outcomes between dynamic cervical implant (DCI) non-fusion group and anterior cervical discectomy and fusion (ACDF) group.Methods From March 2011 to January 2013, 23 patients were subjected to DCI non-fusion and 47 to ACDF respectively.The clinical outcomes were evaluated by the Japanese Orthopaedic Association (JOA) scores and all treated patients re-examined by lateral (full extention) views during follow-up at 24th month, 36 month, and 48 month respectively aiming to observe the intervertebral height of the treated level and the segmental range of motion (ROM) of adjacent levels of treated 1 evel in both two groups.Results Both the two groups showed good clinical outcomes by JOA scores.We found no

  9. Cervical spondylosis

    Science.gov (United States)

    ... Past neck injury (often several years before) Past spine surgery Ruptured or slipped disk Severe arthritis Small fractures ... Kshettry VR. Cervical spondylosis. In: Benzel EC, ed. Spine Surgery . 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap ...

  10. Cervical Cancer

    Science.gov (United States)

    ... 162 KB) This information in Spanish (en español) Female reproductive system Select image to view larger Related ... D., FACS, Captain, U.S. Public Health Service Medical Director, National Breast and Cervical Cancer Early Detection Program, ...

  11. Cervical Stenosis

    Science.gov (United States)

    ... Accumulation of pus in the uterus is called pyometra. Symptoms Before menopause, cervical stenosis may cause menstrual ... present but not cause symptoms. A hematometra or pyometra can cause pain or cause the uterus to ...

  12. AgNOR polymorphism association with squamous intraepithelial lesions and invasive carcinoma with HPV infection Asociación de los polimorfismos AgNORs con lesiones intraepiteliales escamosas, carcinoma cervical e infección por VPH

    Directory of Open Access Journals (Sweden)

    Luz del Carmen Alarcón-Romero

    2009-04-01

    Full Text Available OBJECTIVE: Evaluate the relationships between AgNORs polymorphisms and squamous intraepithelial lesions (SIL and squamous cell carcinoma (SCC with HPV infection. MATERIALS AND METHODS: A study was carried out on sixty women from the state of Guerrero, Mexico. HPV detection was performed by PCR. AgNORs were identified by argentic impregnation. One hundred cells per slide were counted and classified according to the polymorphism of AgNORs dots; typical (spherical and atypical (large, kidney-shaped and clustered. RESULTS: A total of 100% of the cases were positive for HPV infection. Nine different high-risk HPV genotypes were found, type16 was the most common (48.6%. The AgNORs showed a significant decrease in spherical shape according to neoplastic development. The three atypical shapes showed a significant increase in SIL and SCC (p-trendOBJETIVO: Evaluar la relación entre los polimorfismos de AgNORs con las lesiones intraepiteliales escamosas (LIE y carcinoma de células escamosas (CCE. MATERIAL Y MÉTODOS: Se estudiaron sesenta mujeres del estado de Guerrero, México. La detección del VPH fue por PCR y los AgNORs por impregnación argéntica; se contaron 100 células y se clasificaron por tipo de polimorfismo de AgNORs: típico (esférico y atípicos (largo, forma de riñón o de racimo. RESULTADOS: El 100% de los casos presentaron infección por VPH, se encontraron nueve genotipos diferentes de VPH de alto riesgo, el 16 fue el más común (48.6%. La forma esférica de los polimorfismos de AgNORs mostró una disminución con el desarrollo neoplásico y las atípicas incrementaron progresivamente con SIL y SCC (p-tendencia<0.001. CONCLUSIONES: Los polimorfismos AgNORs se incrementan progresivamente con el grado de lesión histológica, y pueden ser útiles en el pronóstico de progresión del carcinoma cervical.

  13. General Information about Cervical Cancer

    Science.gov (United States)

    ... Research Cervical Cancer Treatment (PDQ®)–Patient Version General Information About Cervical Cancer Key Points Cervical cancer is ... the NCI website . Cervical Cancer During Pregnancy General Information About Cervical Cancer During Pregnancy Treatment of cervical ...

  14. Langerhans cell histiocytosis of the cervical spine in an adult: a case report.

    Science.gov (United States)

    Sayhan, Salih; Altinel, Deniz; Erguden, Cenk; Kizmazoglu, Ceren; Guray, Merih; Acar, Umit

    2010-07-01

    We present a case of a 47-year-old-woman with a complaint of cervical pain with paresthetic appearance on her left arm. She was treated with analgetics. Further radiological evaluation because of the persistent pain revealed an osteolytic destruction of the fourth cervical vertebra. The patient underwent anterior cervical corpectomy with total excision of the tumor. Stabilization of the cervical spine was performed. Histology confirmed the diagnosis of Langerhans cell histiocytosis (LCH) of the cervical spine. This case report presents the histopathological evaluation, diagnostic work-up and the treatment procedures because of rarity of cervical spinal LCH cases in the literature. PMID:20669118

  15. Fatores associados ao acesso anterior à gestação a serviços de saúde por adolescentes gestantes Factores asociados con el acceso anterior a la gestación a los servicios de salud por adolescentes gestantes Factors associated with access to health services prior to pregnancy by pregnant adolescents

    Directory of Open Access Journals (Sweden)

    Ingrid Espejo Carvacho

    2008-10-01

    ómico, administrativo, psicosocial y de información. Participaron 200 adolescentes primigestas (10 a 19 años atendidas en una unidad básica de salud del municipio de Indaiatuba (Sureste de Brasil, en 2003. Se aplicó a las participantes en el momento de su primera consulta pre-natal un cuestionario con preguntas abiertas y cerradas referentes al acceso al último servicio de salud utilizado, anterior a la gestación. Los datos fueron analizados por medio de la prueba de Chi cuadrado de Pearson o exacto de Fischer y por regresión logística múltiple, considerando las cinco dimensiones del acceso. RESULTADOS: Más de la mitad (63,7% de las adolescentes utilizó algún servicio de salud para consulta ginecológica. Entre las que nunca consultaron un ginecólogo, las justificativas dadas fueron falta de información (43,8% o sentimiento de miedo o vergüenza (37,0%. La principal dificultad de acceso al servicio estuvo relacionada con barreras psicosociales, identificadas por 77,0% de las adolescentes. CONCLUSIONES: Entre las barreras de acceso al servicio de salud, fueron significativas solo las psicosociales. Son necesarias nuevas estrategias para facilitar el acceso al servicio de salud a las adolescentes, incluyendo acciones que disminuyan las barreras de género y que se consideren sus características sociodemográficas y el vínculo con sus parejas.OBJECTIVE: To assess determinants of access to primary care services prior to pregnancy by pregnant adolescents. METHODS: Theory-based cross-sectional study conducted to examine access to heath services at five dimensions: geographic, economic, administrative, psychosocial and information. There were included in the study 200 first-time pregnant adolescents (aged 10 to 19 years who attended a primary care unit in the municipality of Indaiatuba, Southeastern Brazil, in 2003. Data was collected using a semi-structured questionnaire applied in face-to-face interviews conducted just before their first pre-natal care visit. Data analyses

  16. Advantage of one - stage operation through combined anterior and posterior approach for the treatment of pinching cervical spondyiotic myelopathy%“钳夹型”脊髓型颈椎病一期前后路联合手术治疗的优点

    Institute of Scientific and Technical Information of China (English)

    翟明玉; 许少刚; 王春萍; 梅伟

    2012-01-01

    [目的]分析一期前后联合手术治疗“钳夹型”脊髓型颈椎病的治疗效果.[方法]本组72例,男56例,女16例;年龄23 ~ 78岁,平均57岁.病程6~15个月,平均8个月.所有病例全部采用后路椎管扩大及前路减压融合固定术.[结果]术后随访13个月~4年,平均28个月,术后疗效按JOA评分标准评定,术后1周及1、3、6个月评分均较术前增加(P<0.05);术后1周分别测量术前及术后颈椎生理曲度及椎节高度值,均较术前增加(P<0.05).[结论]钳夹型脊髓型颈椎病采用一期前后联合手术治疗是可行的;神经减压及时、充分、彻底;对改善生理曲度及椎节高度较为理想;术后稳定性好,患者康复快;不但缩短了住院时间,避免了二次手术的痛苦,而且节约了医疗费用.%[Objective] To study the feasibility and therapeutic effects of one - stage operation through combined anterior and posterior approach for the treatment of pinching cervical spondylotic myelopathy. [ Methods ] There were 72 patients, 56 were male and 16 were female, ranging in age from 23 to 78 years (average, 57 years) . The disease course ranged from 6 to 15 months ( average, 8 months) . All patients received anterior decompression and fusion , and posterior laminectomy to enlarge the spinal cannal . [Results] All the patients were followed up from 13 to 48 month. According to JOA assessment system, the score was increased at one week, one, three and six months after operation ( P < 0. 05 ) . The cervical curve and intervertebral height in postoperative group was significantly greater than those of preoperative group (P <0. 01 ) . [ Conclusion] The immediate and long - term stability of the diseased segments may be obtained by the combined anterior and posterior internal fixation in the patients with pinching cervical spondylotic myelopathy. This technique is benefit to the patients for the functional recover of the spinal cord and early rehabilitation. It is an

  17. Efecto de la suplementación con antioxidantes sobre el estrés oxidativo y la calidad de vida durante el tratamiento oncológico en pacientes con cáncer cérvico uterino Effect of antioxidant supplementation over oxidative stress and quality of life in cervical cancer

    Directory of Open Access Journals (Sweden)

    V. Fuchs-Tarlovsky

    2011-08-01

    placebo. No se encontraron diferencias significativas en el consumo de alimentos de acuerdo a las encuestas realizadas, la mayoría de las pacientes consumían más energía y proteínas de las necesarias según sus requerimientos, pero no cubrían el mínimo de antioxidantes necesario para su edad según la IDR. La mayoría de las pacientes presentaron concentraciones séricas de antioxidantes menores a las recomendadas. Las concentraciones séricas de los carbonilos libres, marcador de daño oxidativo en proteínas mostró diferencias significativas comparando el grupo placebo con el suplementado (p Background: Mexico has a high rate of cervical cancer which represents an important public health issue. The treatment for this disease depends on the extension of the tumor; for the initial stages surgery is recommended, and for locally advanced tumors, a combination of chemotherapy and radiotherapy is used. All this process affects natural antioxidant consumption and Quality of Life (QoL. Objective: To find out the effect that supplementation with antioxidants (β-carotene, vitamin C y vitamin E has on oxidative stress, and quality of life in patient diagnosed with cervical cancer during treatments with cisplatin and radiotherapy. Materials and methods: We conducted a randomized, blind clinical trial in women with cervical cancer whose antineoplasic treatment was radiotherapy in and radiotherapy with cisplatin. Patients were randomly assigned to receive antioxidant therapy or a placebo. Plasma concentrations of malondialdehyde (MDA, free carbonyls, dityrosines, and carbonyl/protein rate in two different moments, before oncologic therapy, and after finishing oncology treatment, we also evaluated food consumption by using a validated food frequency questionnaire and a QOL questionnaire before treatment and after it was over. The effect of the antioxidant treatment was assessed by the use t-student test for independent and paired samples, as well as frequencies and X² for

  18. Risk factors and treatment strategy for adjacent segment diseases after anterior cervical decompression and fusion%颈椎前路融合术后邻近节段退变性疾病的原因分析及治疗策略

    Institute of Scientific and Technical Information of China (English)

    王洪立; 姜建元; 吕飞舟; 马晓生; 夏新雷; 王立勋

    2014-01-01

    目的 探讨颈椎前路融合术后邻近节段退变性疾病的发生原因及治疗策略.方法 对2005年12月至2012年8月颈椎前路减压融合术后并发邻近节段退变性疾病的14例进行回顾性分析.男10例,女4例,初次手术年龄36~68岁,平均(52.0±11.0)岁.测量初次手术后颈椎整体曲度、手术节段局部曲度、钢板与上、下间隙的距离.二次手术时对节段数量≤2个且不伴严重后纵韧带或黄韧带骨化的9例采用颈椎前路减压融合内固定术,对节段数量≥3个且不伴明显后凸畸形、排列不稳及严重黄韧带骨化的3例采用颈椎后路减压椎管扩大成形术,对伴有明显后凸畸形、排列不稳且因技术原因无法行前路减压及合并严重黄韧带骨化的2例采用颈椎后路全椎板切除减压融合术.结果 初次术后邻近节段退变性疾病的发生时间为(9.3±4.4)年,二次手术时患者年龄(61.3±12.4)岁.初次术后颈椎整体曲度与手术节段局部曲度分别为12.4°±10.8°、1.5°±6.8°;钢板与上、下间隙的距离分别为(0.9±1.8)mm、(3.8±3.2) mm.二次术后平均随访(30.4±17.8)个月,末次随访时日本骨科学会颈椎病疗效评分改善率为73.9%±9.7%.结论 钢板与邻近间隙距离过小、手术节段局部曲度恢复不良可能是前路融合术后邻近节段退变性疾病的发生原因;二次手术方案的选择应根据病变累及节段、致压因素、颈椎曲度等因素进行综合分析.%Objective To investigate the risk factors and treatment strategy in treating adjacent segment diseases (ASD) after anterior cervical decompression and fusion.Methods Fourteen patients with ASD after anterior cervical decompression and fusion from December 2005 to August 2012 were analyzed.The overall curvature of the cervical spine,local curvature of surgical segments,and the distances between the plate and the upper and lower intervertebral space were measured and analyzed.10 males

  19. 用自体骨赘填充椎体护架行颈前路椎间融合手术的临床观察%Clinical observation of treatment with Cage filled with osteophyte in anterior cervical disectomy and fusion

    Institute of Scientific and Technical Information of China (English)

    王兴武; 陆建猛; 俞武良; 韦勇力; 方明

    2014-01-01

    目的 观察单纯采用椎体骨赘填充椎体护架(Cage)行颈前路椎体间融合的融合率.方法 2010年1月至2012年7月,对81例行颈前路椎间盘切除减压、融合、钛板内固定手术的患者单纯采集手术间隙椎体前后缘的骨赘填充Cage.男52例,女29例;年龄55~78岁,平均64.1岁,单节段手术46例,双节段35例.术后3个月、6个月和1年复查颈椎X线片和CT观察重建融合效果.结果 术后3个月总融合率为76.5%(62/81),单节段融合率为78.3%(36/46),双节段融合率为74.3%%(26/35).术后6个月总融合率为93.8%(76/81),单节段融合率为95.7%(44/46),双节段融合率为91.4%(32/35).术后1年总融合率为100%(81/81).不同节段手术的融合率差异无统计学意义. 结论 对颈前路单节段或双节段手术,以骨赘填充Cage进行椎体间融合可获得满意的融合率.%Objective To observe the fusion rate by using cage filled with osteophyte in anterior cervical disectomy and fusion.Methods From January 2010 to July 2012,81 patients receiving anterior cervical disectomy and spine fusion underwent treatment with cages containing exclusively autologous osteophyte collected from both anterior and posterior vertebral edges adjacent to the intervertebral space.There were 52 males and 29 females,aged from 55 to 78 years,average 64.1 years in this study.46 patients received one-level fusion,and 35 patients received two-level fusion respectively.Patients were followed up at 3 months,6 months and 1 year after operation.The fusion was evaluated by X-ray film and reconstructive CT.Results The total fusion rate after 3 months of operation was 76.5% (62/81),the one-level and two-level fusion rate were 78.3% (36/46) and 74.3% (26/35),respectively.The total fusion rate after 6 months of operation was 93.8% (76/81),the one-level and two-level fusion rate were 95.7% (44/46) and 91.4% (32/35),respectively.The total fusion rate was 100% (81/81) after 1 year of

  20. Displaced fracture through the anterior atlantal synchondrosis

    Energy Technology Data Exchange (ETDEWEB)

    Thakar, Chrishan; Allibone, James [Royal National Orthopaedic Hospital NHS Trust, Department of Spinal Deformity, Stanmore, Middlesex (United Kingdom); Harish, Srinivasan [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); Saifuddin, Asif [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); University College, The Institute of Orthopaedics and Musculoskeletal Sciences, London (United Kingdom)

    2005-09-01

    In the acute setting, accurate radiological interpretation of paediatric cervical spine trauma can be difficult due to a combination of normal variants and presence of multiple synchondroses. We present a rare case of a fracture through the anterior atlantal synchondrosis in a paediatric spine. A five-year-old boy, who fell backwards onto the top of his head while swinging across on a monkey bar frame, presented with neck pain, cervical muscle spasm and decreased right lateral rotation and extension of his neck. Computed tomography showed a displaced diastatic fracture through right anterior atlantal synchondrosis. There are only 12 cases of paediatric C1 fractures reported in the world literature. The importance of considering this diagnosis in the appropriate clinical setting, and the normal variants in the paediatric atlas that can cause diagnostic dilemma to the interpreting radiologist, are discussed in this case report. (orig.)

  1. Effects of platelet-rich plasma on subsidence of fiber porous titanium Cage for old dogs with anterior cervical interbody fusion%富血小板血浆对老龄犬纤维多孔钛颈椎椎间融合器沉降的影响

    Institute of Scientific and Technical Information of China (English)

    曹师锋; 谢宁; 宋鑫; 赵振国; 倪明; 焦鲲; 尹伟忠

    2015-01-01

    Objective To observe the effects of platelet-rich plasma (PRP) on subsidence of fiber porous titanium (FPT) Cage for old beagle dogs with anterior cervical interbody fusion.Methods Six old healthy beagle dogs (3 male and 3 female,weighing 12.5-15.0 kg,aged 7-9 years) were selected in this study.Peripheral venous blood from dog's forelimb was collected,PRP was prepared by double centrifugal methods,and blood platelet counts of peripheral venous blood and PRP were recorded.Then the dogs underwent anterior C4/5 and C5/6 discectomy and FPT Cage interbody fusion.FPT Cage was used alone at C4/5 segment,and at C5/6 segment,FPT Cage was augmented with PRP.The animals were sacrificed in 4 months after the surgery,and the subsidence of FPT Cage was evaluated by X-ray and Micro-CT examinations.Results Subsidence of FPT Cage was found at four C4/5 segments,other two FPT Cages at C4/5 segment showed anterior migration; No subsidence of FPT Cage was observed at six C5/6 segments,only one FPT Cage with anterior dislocation was found.Conclusion Compound PRP could reduce the subsidence of FPT Cage in old aged Beagle dogs with anterior cervical interbody fusion.%目的 观察富血小板血浆(PRP)对老龄比格犬颈椎前路椎间融合术纤维多孔钛椎间融合器(FPT Cage)沉降的影响.方法 选取6只7~9岁、12.5~15.0 kg的健康比格犬(雌雄各3只)作为实验动物.取比格犬前肢外周静脉血,采用二次离心法制备PRP,同时对外周静脉血及PRP进行血小板计数.行颈椎前路C4/5、C5/6椎间盘切除、FPT Cage椎间融合术,单纯使用未浸泡PRP的FPT Cage行C4/5椎间融合,采用浸泡激活后的PRP复合FPT Cage融合C5/6,术后4个月处死实验犬后行X线片及Micro-CT检查,观察C4/5、C5/6椎间融合器的沉降情况.结果 C4/5节段有4例出现不同程度的椎间融合器沉降,另2例出现Cage向前移位;C5/6节段未有椎间融合器发生沉降,仅1例出现Cage向前移位.结论 复合PRP可减少老龄比

  2. Typology of the arteries in the human scalenus region, with special reference to the accessory ascending cervical artery.

    OpenAIRE

    Su WD; Ohtsuka A; Taguchi T; Murakami T.

    2000-01-01

    The accessory ascending cervical artery (Murakami et al., 1996), which arises from the subclavian artery and ascends between the scalenus anterior and medius muscles, was studied in 87 Japanese adult cadavers (174 sides), with special attention being given to its origin, distribution, and relationship to other arteries at the cervical or scalenus region. In 154 sides (88.5%), the accessory ascending cervical artery was found to originate from the subclavian artery behind the scalenus anterior...

  3. Cervical disc hernia operations through posterior laminoforaminotomy

    Directory of Open Access Journals (Sweden)

    Coskun Yolas

    2016-01-01

    Full Text Available Objective: The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. Materials and Methods: We retrospectively evaluated 35 patients diagnosed with posterolateral cervical disc herniation and cervical spondylosis with foraminal stenosis causing radiculopathy operated by the posterior cervical keyhole laminoforaminotomy between the years 2010 and 2015. Results: The file records and the radiographic images of the 35 patients were assessed retrospectively. The mean age was 46.4 years (range: 34-66 years. Of the patients, 19 were males and 16 were females. In all of the patients, the neurologic deficit observed was radiculopathy. The posterolaterally localized disc herniations and the osteophytic structures were on the left side in 18 cases and on the right in 17 cases. In 10 of the patients, the disc level was at C5-6, in 18 at C6-7, in 2 at C3-4, in 2 at C4-5, in 1 at C7-T1, in 1 patient at both C5-6 and C6-7, and in 1 at both C4-5 and C5-6. In 14 of these 35 patients, both osteophytic structures and protruded disc herniation were present. Intervertebral foramen stenosis was present in all of the patients with osteophytes. Postoperatively, in 31 patients the complaints were relieved completely and four patients had complaints of neck pain and paresthesia radiating to the arm (the success of operation was 88.5%. On control examinations, there was no finding of instability or cervical kyphosis. Conclusion: Posterior cervical laminoforaminotomy is an alternative appropriate choice in both cervical soft disc herniations and cervical stenosis.

  4. Cervical disc hernia operations through posterior laminoforaminotomy

    Science.gov (United States)

    Yolas, Coskun; Ozdemir, Nuriye Guzin; Okay, Hilmi Onder; Kanat, Ayhan; Senol, Mehmet; Atci, Ibrahim Burak; Yilmaz, Hakan; Coban, Mustafa Kemal; Yuksel, Mehmet Onur; Kahraman, Umit

    2016-01-01

    Objective: The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. Materials and Methods: We retrospectively evaluated 35 patients diagnosed with posterolateral cervical disc herniation and cervical spondylosis with foraminal stenosis causing radiculopathy operated by the posterior cervical keyhole laminoforaminotomy between the years 2010 and 2015. Results: The file records and the radiographic images of the 35 patients were assessed retrospectively. The mean age was 46.4 years (range: 34-66 years). Of the patients, 19 were males and 16 were females. In all of the patients, the neurologic deficit observed was radiculopathy. The posterolaterally localized disc herniations and the osteophytic structures were on the left side in 18 cases and on the right in 17 cases. In 10 of the patients, the disc level was at C5-6, in 18 at C6-7, in 2 at C3-4, in 2 at C4-5, in 1 at C7-T1, in 1 patient at both C5-6 and C6-7, and in 1 at both C4-5 and C5-6. In 14 of these 35 patients, both osteophytic structures and protruded disc herniation were present. Intervertebral foramen stenosis was present in all of the patients with osteophytes. Postoperatively, in 31 patients the complaints were relieved completely and four patients had complaints of neck pain and paresthesia radiating to the arm (the success of operation was 88.5%). On control examinations, there was no finding of instability or cervical kyphosis. Conclusion: Posterior cervical laminoforaminotomy is an alternative appropriate choice in both cervical soft disc herniations and cervical stenosis.

  5. Feasibility of low anterior cervical approach decompression and bone graft fusion for internal fixation in the treatment of patients with spine and spinal cord trauma in cervicothoracic junction%低位颈前入路减压植骨融合内固定治疗颈胸段脊柱脊髓损伤的可行性

    Institute of Scientific and Technical Information of China (English)

    刘明明; 程建; 华臻

    2015-01-01

    Objective:To explore the feasibility of low anterior cervical approach decompression and bone graft fusion for internal fixation in the treatment of patients with spine and spinal cord trauma in cervicothoracic junction.Methods:20 patients with spine and spinal cord trauma in cervicothoracic junction were selected.All patients were treated with low anterior cervical approach decompression and bone graft fusion for internal fixation.We discussed the efficacy and postoperative recovery of the patients. Results:All patients recovered well,and there was no case with loosening of the screws,loss of the titanium plate,the fracture of the titanium plate and other circumstances.Only 1 case with the position of titanium mesh not well fixed when detected by X tablets after operation.It has been adjusted after six months of surgery,after 1 year of operation,it recovered well,no titanium mesh moved. Conclusion:Patients with spine and spinal cord trauma in cervicothoracic junction with low anterior cervical approach decompression and bone graft fusion and internal fixation for the treatment can effectively promote the patients with cervicothoracic spine sequence returned to normal,and improve the patients' postoperative recovery.%目的:探讨低位颈前入路减压植骨融合内固定治疗颈胸段脊柱脊髓损伤的可行性。方法:收治颈胸段脊柱脊髓损伤患者20例,实施低位颈前入路减压植骨融合内固定治疗,对术后疗效及恢复情况进行探讨。结果:所有患者恢复良好,无一例患者出现螺钉松动、脱落、钛板断裂等情况,只有1例在术后经过X片检测后发现其钛网位置固定不佳,术后0.5年对其进行了调整,术后1年检测见其恢复良好,没有出现钛网移动情况。结论:颈胸段脊柱脊髓损伤患者采用低位颈前入路减压植骨融合内固定治疗,可以有效促进患者颈胸段脊柱序列恢复正常,改善患者的术后恢复情况。

  6. Approach-related morbidity in transthoracic anterior spine surgery: a clinical study and review of literature Morbilidad relacionada con el abordaje torácico anterior de la columna: estudio clínico y revisión de la literatura Morbidade relacionada à abordagem transtorácica anterior da coluna: estudo clínico e revisão da literatura

    Directory of Open Access Journals (Sweden)

    Juliane Zenner

    2010-03-01

    presente estudio fue observar los resultados relacionados con la morbilidad de la toracotomía abierta para la corrección de la deformidad de la columna vertebral y toracotomía para la colocación de tubo de drenaje torácica, utilizando ese grupo como Control. MÉTODOS: con base en un cuestionario respondido por los pacientes; y relacionado con la evaluación de la morbilidad del abordaje anterior de la columna torácica y utilizando criterios estrictos de inclusión de los pacientes, fueron evaluados 43 pacientes sometidos a toracotomía abierta para tratamiento de la escoliosis; y 30 pacientes portadores de otras enfermedades de menor gravedad, que fueron sometidos a la toracotomía para la colocación de dreno de tórax después del procedimiento. RESULTADOS: el promedio de edad de los pacientes sometidos al procedimiento en el tórax y a la toracotomía para la colocación de dreno o toracotomía abierta para tratamiento de escoliosis fue, respectivamente: 50.2 años y 16.5 años; el seguimiento clínico fue de 32.2 meses y 54.8 meses; y la extensión de la incisión de la piel 2.5 cm y 25 cm. El promedio del número de vértebras artrosadas fue 5.8 en el grupo sometido a la toracotomía abierta para la corrección de deformidad. La morbilidad promedio (variando de 0% - ninguna morbilidad a 100% - alta morbilidad en el grupo de pacientes sometidos a la toracotomía para colocación de dreno de tórax fue de 10.8±15.4 (0-59.5%, y un 42% de los pacientes no presentaron morbilidad. En el grupo sometido a la toracotomía abierta para la colocación del dreno de tórax fue observada neuralgia intercostal en 16.7%, y 35% de los pacientes presentaron morbilidad mayor que 10% (pormedio de un 27.5%. La morbilidad fue definida como la presencia de dolor crónico después de la toracotomía. En el grupo sometido a la toracotomía abierta para tratamiento de escoliosis el promedio de la morbilidad fue 7.0±12.7% (0-52.1%, y 44% no presentaron morbilidad. Señales de neuralgia

  7. Analysis the Clinical Effect of Single Level and Two Level Anterior Cervical Discectomy and Fusion%单节段与两节段颈前路椎间盘切除和融合术的临床效果分析

    Institute of Scientific and Technical Information of China (English)

    赵亮; 曹竞; 谭洪宇; 宋瑞鹏; 王卫东; 刘屹林; 王利民

    2016-01-01

    Abstract]Objective To compare results of patients undergoing single level and two level anterior cervical discectomy and fusion. Methods 145 cases of patients who accept ACDF were selected. Grouped all the patients single level and two level. Through the two-year follow-up, postoperative clinical results of the two groups of patients were analyzed and compared.Results According to the inclusion criteria, 79 cases of single segments, two segments 66 cases.There was no significant difference in age, sex, BMI between two groups (P>0.05). Preoperative NDI index, JOA score was not statistically significant difference between two groups before the operation,but there has significant inprovement after the operation(P0.05).Conclusion ACDF has been an effective surgical intervention in patients with single level and two level, anterior cervical discectomy and fusion has good way.%目的分析比较颈前路椎间盘切除和融合术治疗单节段和两阶段颈椎病患者的临床效果。方法回顾性分析145例接受颈前路椎间盘切除和融合术的患者,根据手术节段的不同分为单节段组和两节段组。通过2年的随访,对两组患者的术后临床效果进行对比分析。结果根据纳入标准,单节段组79例,两节段组66例,年龄、性别、BMI差异无统计学意义(P>0.05)。两组患者术前NDI指数、JOA评分差异无统计学意义,术后均较术前提高(P<0.05),两组间差异无统计学意义(P>0.05)。结论对于单节段和两节段保守治疗无效的颈椎病患者,颈前路椎间盘切除和融合术是一种行之有效的手术方法。

  8. Risks of Cervical Cancer Screening

    Science.gov (United States)

    ... Treatment Cervical Cancer Prevention Cervical Cancer Screening Research Cervical Cancer Screening (PDQ®)–Patient Version What is screening? Screening ... These are called diagnostic tests . General Information About Cervical Cancer Key Points Cervical cancer is a disease in ...

  9. Cervical spine CT scan

    Science.gov (United States)

    ... cervical spine; Computed tomography scan of cervical spine; CT scan of cervical spine; Neck CT scan ... Risks of CT scans include: Being exposed to radiation Allergic reaction to contrast dye CT scans expose you to more radiation than ...

  10. Open-door laminoplasty for the treatment of failed anterior cervical spine surgery%单开门椎管扩大椎板成形术在颈椎病再手术中的应用及疗效分析

    Institute of Scientific and Technical Information of China (English)

    刘勇; 陈亮; 顾勇; 杨惠林; 唐天驷

    2010-01-01

    Objective To evaluate the outcome of open-door laminoplasty for the treatment of failed anterior cervical spine surgery. Methods From February 2003 to June 2009, 15 patients underwent opendoor laminoplasty for the failed anterior cervical spine surgery. The causes of revision and the progression of disease were analyzed. Japanese Orthopedic Association (JOA)scores and Nurick grade were adopted to record the improvement of neurological status and walking ability. Results Two patients were excluded for analysis because of lost follow-up and follow-up less than 12 months. The mean follow-up period after revision surgery for the other 13 patients was 26 months (ranged 13-52 months). The mean interval between the initial and revision surgery was 24 months ( ranged 5 months to 6 years). The causes of revision were as following: degeneration of the adjacent segment in 2 cases, inadequate decompression in 5 cases, misdiagnosis of ossification of posterior longitudinal ligament(OPLL) as myelopathy in 4 cases, and progression of OPLL in 2 cases. Posterior laminoplasty was recommended for each patient. After the operation,13 patients improved neurologically with respect to JOA score, 12 patients improved their walking ability while 1 remained unchanged. The mean modified JOA scores improved from 10. 5 to 13.8 ( P < 0. 05 ), the average recovery rate was 53.0% after the revision operation. The mean overall Nurick grade was 3.1 preoperatively and 1.9 at the final follow-up ( P < 0.05 ), the mean improvement of the Nurick grade was 1. 2. Complications included cerebrospinal fluid leakage in 1 case, new axial neck pain in 1 case, and transient C5 nerve root palsy in 1 case. Conclusions Open-door laminoplasty is a straightforward and effective treatment for failed anterior cervical spine surgery due to inadequate decompression, progressive OPLL or degeneration of the adjacent segment. The merit of the open-door laminoplasty for failed anterior spine fusion is able to avoid

  11. Anterior Decompression and Anterior Instrumentation of Tuberculosis of Cervicothoracic Spine by Cervicomanubrial Approach

    Directory of Open Access Journals (Sweden)

    Anant Kumar Garg

    2012-04-01

    Full Text Available Background: Evaluation of result of anterior cervical approach with manubriotomy and anterior instrumentation in tuberculosis of cervicothoracic spine in terms of the neurological recovery, reconstruction of spine and prevention of deformity along with relief of pain. Materials and Methods: All five patients with cervicothoracic caries spine had surgery through anterior cervical approach with manubriotomy in our hospital and underwent excision of the involved vertebrae and intervertebral discs followed by anterior spinal reconstruction with titanium spacer cage filled with cancellous iliac crest bone graft and Orion plate with locking screw. Antitubercular drugs were administered for 12 months. The follow-up period ranged from 12 to 36 months. Results: Analysis of result was done on the basis of clinical and radiological criteria. Clinical assessment based on Frankel grade and modified JOA score showed significant improvement from preoperative findings. Radiological assessment showed osteointegration, no spinal instability and no progression of the deformity. The pain control, based on visual analog scale changed from a pre-operative average of 7.5 to 2 at the last follow-up thereby indicating significant improvement and all patients returned to preoperative functional status. One patient had transient hoarseness of voice. No other complication had been encountered in the immediate post operative and during the follow-up period. Conclusions: Our study showed that anterior cervical approach with manubriotomy and anterior insertion of titanium cage, filled with autogenous bone graft, secured with locking plate instrumentation has a successful role in the eradication of infection, neurological recovery, segmental spinal reconstruction and it also reduces surgical time, blood loss, and surgical complications and approach related comorbidity in follow up period. Level of Evidence- Level 4, Case series

  12. Laminoplasty for Cervical Myelopathy

    OpenAIRE

    Ito, Manabu; Nagahama, Ken

    2012-01-01

    This article reviews cervical laminoplasty. The origin of cervical laminoplasty dates back to cervical laminectomy performed in Japan ~50 years ago. To overcome poor surgical outcomes of cervical laminectomy, many Japanese orthopedic spine surgeons devoted their lives to developing better posterior decompression procedures for the cervical spine. Thanks to the development of a high-speed surgical burr, posterior decompression procedures for the cervical spine showed vast improvement from the ...

  13. Phacoemulsification in anterior megalophthalmos.

    Science.gov (United States)

    Lee, Graham A; Hann, Joshua V; Braga-Mele, Rosa

    2006-07-01

    This case outlines the phacoemulsification technique used to overcome the challenge of the hyperdeep anterior chamber, weak zonules, abnormal anterior capsule, and large capsular bag. Key steps included trypan blue staining of the anterior capsule, a large capsulorhexis, prolapse of the nucleus into the anterior chamber with phacoemulsification anterior to the capsulorhexis, and a posterior chamber-placed iris-clip intraocular lens. Successful visual rehabilitation is achievable in these anatomically challenging eyes. PMID:16857490

  14. Insertion of PCB to treat traumatic cervical intervertebral disc herniation

    Institute of Scientific and Technical Information of China (English)

    马远征; 隰建成; 陈兴; 关长勇; 全长彬

    2002-01-01

    Objective: To evaluate the clinical effect of PCB (a new anterior cervical instrumental system combining an intradiscal cage with an integrated plate) in treating traumatic cervical intervertebral disc herniation. Methods: Anterior decompression and PCB internal fixation were used in 22 patients with traumatic cervical intervertebral disc herniation. They were followed up from 3 to 16 months and analyzed by symptom and image data. Among them, 16 patients underwent fixation at one level and 6 patients at two levels. Results: This technique did not cause intraoperative complications. After surgery no screw backout or device failure was found. Based on the JOA grade, 20 patients improved clinically and 2 gently because of serious cervical stenosis. The general excellent rate was 90.9%. Conclusions: PCB internal fixation is stable. Morbidity of donor and acceptor sites is less. No collars are needed after surgery.

  15. Insertion of PCBto treat traumatic cervical intervertebral disc herniation

    Institute of Scientific and Technical Information of China (English)

    马远征; 陈兴; 等

    2002-01-01

    Objective:To evaluate the clinical effect of PCB(a new anterior cervical instrumental system combining an intradiscal cage with an integrated plate)in treating taunatic cervical intervertebral disc herniation.Methods:Anterior decompression and PCB internal fixation were used in 22patients with traumatic cervical intervertebral disc herniation.They were followed up from3to16months and analyzed by symptom and imape data.Among them,16 patients underwent fixation at one level and 6patients at two levels.Results:This technique did not cause intraoperative complications.After surgery on screw backout or device failure was found.Based on the JOAgrade,20 patients improved clinically and 2gently because of serious cervical stenosis.The general excellent rate was90.9%.Conclusions:PCB internal fixation is stable.Morbidity of donor and acceptor sites is less.No collars are needed after surgery.

  16. Usurering af osteosyntesemateriale gennem øsofagus efter anterior cervikalkirurgi

    DEFF Research Database (Denmark)

    Wiis, Julie Therese; Nittby, Henrietta Carolina; Lauritsen, Anne Oberg

    can give false negative results. We present a case of a 74-year-old male, who was readmitted with sepsis and abscess in the operation area three weeks after anterior cervical surgery. Veillonella parvula was found in the abscess material and computed tomography confirmed the diagnosis of oesophageal...

  17. Value of preoperative cervical discography

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Jong Won; Kim, Sung Hyun; Lee, Joon Woo [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)] (and others)

    2006-07-15

    The aim of this study was to describe the method and the value of cervical discography as correlated with the MR findings. Twenty-one discs in 11 consecutive patients who underwent cervical discography were analyzed. MR and CT discography (CTD) were performed in all patients. Discography was performed after swallowing barium for visualizing the pharynx and the esophagus to prevent penetration. We also analyzed the preceding causes of the subjects' cervical pain. The results of the pain provocation test were classified into concordant pain, discordant pain and a negative test. MRI was analyzed according to the T2-signal intensity (SI) of the disc, disc height, annular bulging and disc herniation. The CTD was analyzed for degeneration or radial tear of the disc, epidural leakage of the contrast agent and pooling of the contrast agent at the periphery of the disc. The pain provocation tests were correlated with the MR and CTD findings. We used the chi-square test to analyze the results. Concordant pain was observed in 14 cases, discordant pain in 3 cases and there were negative tests in 4 cases. There were no complications related to the procedure. Four patients had undergone anterior cervical fusion and four patients that developed after traffic injuries. The decreased T2-SI and annular bulging on MRI, disc degeneration and peripheral pooling of the contrast agent on CT were significantly correlated with pain provocation. When the diagnosis of disc disease is difficult with performing MRI, cervical discography with using swallowed barium solution to reduce the penetration of the esophagus or hypopharynx may play be helpful. The decreased T2-SI and annular bulging on MRI correlated significantly with a positive result on the pain provocation test.

  18. Anestesia para tratamento intraparto extra-útero em feto com diagnóstico pré-natal de higroma na região cervical: relato de caso Anestesia para tratamiento intraparto extraútero en feto con diagnóstico prenatal de higroma en la región cervical: relato de caso Anesthesia for ex utero intrapartum treatment of fetus with prenatal diagnosis of cervical hygroma: case report

    Directory of Open Access Journals (Sweden)

    Angélica de Fátima de Assunção Braga

    2006-06-01

    ós-operatória. CONCLUSÕES: As principais recomendações para a realização do EXIT são segurança materno-fetal, relaxamento uterino para manutenção do seu volume, da circulação útero-placentária e imobilidade fetal para facilitar o manuseio das vias aéreas.JUSTIFICATIVA Y OBJETIVOS: El tratamiento intraparto extraútero (EXIT constituye un procedimiento realizado durante la cesária, con preservación de la circulación feto-placentaria, que permite el manejo seguro de la vía aérea del feto, con riesgo de obstrucción de las vías aéreas. El objetivo de este relato fue el de presentar un caso de anestesia para EXIT, en feto con higroma cístico en la región cervical. RELATO DEL CASO: Paciente con 22 años, 37 semanas de gestación, sin antecedentes anestésicos, estado físico ASA I, sometida a EXIT para manejo de vía aérea e intubación traqueal en feto con riesgo para obstrucción de vías aéreas. El procedimiento se realizó bajo anestesia general asociada a peridural continua. En el preoperatorio fueron utilizados metoclopramida (10 mg y ranitidina (50 mg, por vía venosa. En el espacio peridural se administró bupivacaína a 0,25% con adrenalina (30 mg asociada a fentanil (100 µg, seguida de la introducción de catéter cefálico, para analgesia postoperatoria. El útero fue desplazado para la izquierda. La inducción anestésica se hizo en secuencia rápida, con fentanil, propofol y rocuronio y el mantenimiento con isoflurano en 2,5% a 3%, en O2 y N2O (50%. Después de la histerotomía, se procedió a la liberación parcial del feto, asegurando la circulación útero placentaria, siguiendo las maniobras de laringoscopia e intubación traqueal fetal. A continuación se realizó la liberación total del feto, con pinzamiento del cordón umbilical, administración de ocitocina (20 UI en infusión venosa continua seguida de metil-ergonovina (0,2 mg por vía venosa. Durante el procedimiento, la presión arterial sistólica materna se mantuvo por encima de 100 mm

  19. Cervical facet joint kinematics during bilateral facet dislocation

    OpenAIRE

    Panjabi, Manohar M.; Simpson, Andrew K.; Ivancic, Paul C.; Pearson, Adam M.; Tominaga, Yasuhiro; Yue, James J.

    2007-01-01

    Previous biomechanical models of cervical bilateral facet dislocation (BFD) are limited to quasi-static loading or manual ligament transection. The goal of the present study was to determine the facet joint kinematics during high-speed BFD. Dislocation was simulated using ten cervical functional spinal units with muscle force replication by frontal impact of the lower vertebra, tilted posteriorly by 42.5°. Average peak rotations and anterior sliding (displacement of upper articulating facet s...

  20. Cervical facet dislocation adjacent to the fused motion segment

    OpenAIRE

    Kunio Yokoyama; Masahiro Kawanishi; Makoto Yamada; Hidekazu Tanaka; Yutaka Ito; Toshihiko Kuroiwa

    2016-01-01

    This study reports on a case that forces re-examination of merits and demerits of anterior cervical fusion. A 79-year-old male was brought to the emergency room (ER) of our hospital after he fell and struck the occipital region of his head following excessive alcohol consumption. Four years prior, he had undergone anterior cervical discectomy and fusion of C5/6 and a magnetic resonance imaging (MRI) performed 3 years after this surgery indicated that he was suffering from degeneration of C6/7...

  1. Typology of the arteries in the human scalenus region, with special reference to the accessory ascending cervical artery.

    Directory of Open Access Journals (Sweden)

    Su WD

    2000-12-01

    Full Text Available The accessory ascending cervical artery (Murakami et al., 1996, which arises from the subclavian artery and ascends between the scalenus anterior and medius muscles, was studied in 87 Japanese adult cadavers (174 sides, with special attention being given to its origin, distribution, and relationship to other arteries at the cervical or scalenus region. In 154 sides (88.5%, the accessory ascending cervical artery was found to originate from the subclavian artery behind the scalenus anterior muscle, and to branch out to the scalenus anterior and medius muscles as well as those entering the 5th and 6th intervertebral foramens along the 6th and 7th cervical nerves. This artery arose independently in 105 sides. The accessory ascending cervical artery issued off or formed a common trunk with the transverse cervical artery and/or costocervical trunk in 49 sides. In cases lacking the accessory ascending cervical artery, it was usually compensated for by the costocervial trunk and/or transverse cervical artery (18 sides. Common trunk formation with the vertebral, internal thoracic, or suprascapular arteries was not observed. The authors suggest that the accessory ascending cervical artery, the transverse cervical artery, and the costocervical trunk should be grouped into one arterial system, a system that may be a remnant of the precostal longitudinal anastomoses of intersegmental arteries of the dorsal aorta behind the scalenus anterior muscle.

  2. Resultados imediatos da correção cirúrgica de escoliose idiopática do adolescente por via posterior com instrumentação após liberação anterior por videotoracoscopia Resultados inmediatos de la corrección quirúrgica de escoliosis idiopática del adolescente por vía posterior con instrumentación después de liberación anterior por videotoracoscopia Short term results of surgical correction of adolescents' idiopathic scoliosis by posterior approach instrumentation following videothoracoscopic anterior release

    Directory of Open Access Journals (Sweden)

    Eduardo Barros Puertas

    2009-12-01

    Full Text Available OBJETIVO: descrever os resultados imediatos da aplicação da liberação anterior por videotoracoscopia, seguida de instrumentação por via posterior para correção cirúrgica da escoliose idiopática do adolescente. MÉTODOS: foram selecionados 20 pacientes, no período de agosto de 1989 a maio de 2001, com escoliose idiopática do adolescente, padrão de curva torácica direita rígida, King III. Inicialmente realizou-se a abordagem pela via anterior com liberação por videotoracoscopia e depois a via posterior para correção e fixação com instrumental de Hartshill, em um mesmo tempo cirúrgico. RESULTADOS: todos os procedimentos foram completados com sucesso com videotoracoscopia, sem necessidade de conversão para toracotomia. A média de idade dos pacientes foi de 15,7 anos (12 a 21 anos. Em relação aos dias de internação, obteve-se um tempo médio de permanência de 9,45 dias (5 a 26 dias. A média entre os valores angulares foi, no pré-operatório, de 66,25º Cobb (48º a 92º Cobb, e no pós-operatório, de 31,2º Cobb (15º a 45º Cobb. Como complicações, quatro pacientes tiveram nevralgia intercostal (20% e um caso de atelectasia (5%. CONCLUSÕES: a discectomia por videotoracoscopia é um método efetivo e seguro para tornar flexíveis as curvas escolióticas rígidas. No entanto, trata-se de um procedimento tecnicamente difícil, que requer treinamento árduo e prolongado, com curva de aprendizado extensa.OBJETIVO: describir los resultados inmediatos de la aplicación de la liberación anterior por videotoracoscopia, seguida de instrumentación por vía posterior para corrección quirúrgica de escoliosis idiopática del adolescente. MÉTODOS: fueron seleccionados 20 pacientes, en el periodo de agosto de 1989 a mayo de 2001, con escoliosis idiopática del adolescente, con un padrón de curva torácica derecha rígida, King III. Inicialmente se realizó un abordaje por la vía anterior con liberación por

  3. Successful Treatment of Severe Sympathetically Maintained Pain Following Anterior Spine Surgery

    OpenAIRE

    Woo, Jae Hee; Park, Hahck Soo

    2014-01-01

    Sympathetic dysfunction is one of the possible complications of anterior spine surgery; however, it has been underestimated as a cause of complications. We report two successful experiences of treating severe dysesthetic pain occurring after anterior spine surgery, by performing a sympathetic block. The first patient experienced a burning and stabbing pain in the contralateral upper extremity of approach side used in anterior cervical discectomy and fusion, and underwent a stellate ganglion b...

  4. Cost-effectiveness of conventional cytology and HPV DNA testing for cervical cancer screening in Colombia Costo-efectividad de la citología y la tamización con pruebas de ADN-VPH para cáncer de cuello uterino en Colombia

    Directory of Open Access Journals (Sweden)

    Oscar Andrés-Gamboa

    2008-08-01

    Full Text Available OBJECTIVE: To assess cost-effectiveness of conventional cytology and HPV DNA testing for cervical-cancer screening in Colombia. MATERIAL AND METHODS: The National Cancer Institute of Colombia (NCIC in 2007 developed a Markov model on the natural history of cervical cancer; no screening, conventional cytology, and HPV DNA testing were compared. Only direct costs were used. Outcomes comprise cervical cancer mortality, years of life saved, and lifetime costs. Discounted incremental cost-effectiveness ratios were estimated and sensitivity analyses were conducted for key parameters. RESULTS: Depending on the screening strategy a 69-81% mortality reduction might be expected. The HPV DNA testing every five years is a cost-effective strategy (Incremental Cost-Effectiveness Ratio (ICER: USD$44/YLS if the cost per test is under USD$31. The effectiveness was sensitive to coverage and primarily to follow-up. CONCLUSIONS: HPV DNA testing is a cost-effective alternative for screening in Colombia. Not only high coverage but high follow-up rates are critical for successful screening programs.OBJETIVO: evaluar el costo-efectividad de la citología convencional y la prueba de ADN-VPH para tamización de cáncer cervical en Colombia. MATERIAL Y MÉTODOS: el Instituto Nacional de Cancerología de Colombia construyó en 2007 un modelo de Markov de historia natural del cáncer cervical. Se comparó "no tamización", citología convencional y prueba de ADN-VPH. Se utilizaron costos directos. Los desenlaces fueron mortalidad, años de vida ganados y costos. Se calcularon razones de costo-efectividad incremental. Se realizaron análisis de sensibilidad para parámetros clave. RESULTADOS: la mortalidad se redujo 69-81% según la estrategia. La tamización con ADN-VPH cada cinco años es costo-efectiva (ICER (Razón de Costo-Efectividad incremental por sus siglas en inglés: 44 dólares por año de vida saludable si los costos por prueba son menores a 31 dólares. La

  5. Sub-axial cervical spine injuries: Modified Stellerman′s algorithm

    Directory of Open Access Journals (Sweden)

    Arjun Shetty

    2011-01-01

    Conclusion: We feel that on table decompression and reduction followed by anterior stabilization can be used as the initial surgical approach to manage most types of cervical injuries. In rotation/translational cases where reduction cannot be achieved, monitored cervical traction on the decompressed spine can safely achieve reduction and hence avoid the need for a posterior facetectomy in a large percentage of cases.

  6. The Incidence of Infection after Posterior Cervical Spine Surgery: A 10 Year Review

    OpenAIRE

    Barnes, Matt; Liew, Sue

    2012-01-01

    Background The incidence of infection after posterior cervical spine surgery ranges from 0 to 18%. Higher rates have been reported after posterior procedures compared with anterior procedures, but these studies have been for small series. We report on our rate of surgical site infection (SSI) after posterior cervical spine surgery and the risk factors that influence these infections. Methods We retrospectively reviewed the records of 90 consecutive patients who underwent posterior cervical sp...

  7. 节段型严重颈椎后纵韧带骨化症前路、后路手术的疗效比较与选择策略%Anterior or posterior approach for segmental severe ossification of posterior longitudinal ligament of the cervical spine: the efficacy and selection strategy

    Institute of Scientific and Technical Information of China (English)

    雷涛; 申勇; 王林峰; 丁文元; 张为; 张迪

    2013-01-01

    Objective To investigate the efficacy and selection of anterior and posterior approaches for segmental severe ossification of posterior longitudinal ligament (OPLL)of the cervical spine.Method From January 2007 to May 2011,59 patients with segmental severe OPLL underwent surgical treatment,including 41 males and 18 females,with an average age of 55.7 years.Among them,24 patients underwent anterior corpectomy and fusion,and 35 patients underwent laminectomy and lateral mass screw fixation.In two groups,the operation time,intraoperative blood loss,change of cervical curvature,neck axial symptoms,and JOA (Japanese Orthopaedic Association) score were recorded and compared.Result All patients were followed up for 12 to 18 months (average,15.4 months).The average JOA score in anterior approach group increased from preoperative 7.33 ± 1.09 to 13.63±0.82 at final follow-up,with an average improvement rate of 65.16% ±7.50%; the average JOA score in posterior approach group increased from preoperative 7.20 ± 1.05 to 12.23 ± 1.11 at final follow-up,with an improvement rate of 51.46%±9.64%; and the difference between two groups was statistically significant.Immediately after the operation,the segmental curvature of the operative site was 5.38°±1.14° in anterior approach group and 3.89°±1.65° in posterior approach group,and the difference was statistically significant.At final follow-up,the rate of neck axial symptoms was 20.83% in anterior approach group and 51.43% in posterior approach group,and the difference was also statistically significant.Conclusion For severe OPLL with not more than 3 segments of ossification,the anterior approach can remove the ossified mass directly,get a better neurological recovery,provide a good biomechanical alignment,and decrease the postoperative axial symptoms.However,posterior laminectomy and lateral mass screw fixation also can obtain enough decompression and maintain the segmental curvature.%目的 探讨前路和

  8. Laminoplasty Techniques for the Treatment of Multilevel Cervical Stenosis

    Directory of Open Access Journals (Sweden)

    Lance K. Mitsunaga

    2012-01-01

    Full Text Available Laminoplasty is one surgical option for cervical spondylotic myelopathy. It was developed to avoid the significant risk of complications associated with alternative surgical options such as anterior decompression and fusion and laminectomy with or without posterior fusion. Various laminoplasty techniques have been described. All of these variations are designed to reposition the laminae and expand the spinal canal while retaining the dorsal elements to protect the dura from scar formation and to preserve postoperative cervical stability and alignment. With the right surgical indications, reliable results can be expected with laminoplasty in treating patients with multilevel cervical myelopathy.

  9. Postoperative cine-MRI for patients with cervical myelopathy

    Energy Technology Data Exchange (ETDEWEB)

    Honjo, Yasuomi [Okayama Univ. (Japan). School of Medicine

    1995-07-01

    The usefulness of cine-MRI using motion pictures was studied on 75 patients with postoperative cervical myelopathy, and morphology of cervical spine and cervical cord, postoperative MRI, and postoperative outcome were investigated. T1-weighted images by SE method and T2-weighted images by gradient field echo were obtained. Cine-MR images were classified into 5 according to the site of cerebrospinal fluid flow void and its degree (anterior type, 21; anteroposterior type, 30; posterior type, 7; incomplete block type, 15; complete block type, 2), and relationship between clinical features were studied. This method enabled dynamic noninvasive evaluation of spinal cord compression by cerebrospinal fluid flow. (S.Y.).

  10. Enterobius vermicularis infestation masquerading as cervical carcinoma: A cytological diagnosis.

    Science.gov (United States)

    Raju, Kalyani; Verappa, Seema; Venkataramappa, Srinivas Murthy

    2015-01-01

    Although prevalence of Enterobius vermicularis (EV) infestation in Intestines ranges from 35% to 70%, its prevalence in female genital tract is not known despite several incidental findings. Acute inflammatory cells in the background of cervical Pap smear indicate infestation and should not be neglected as contamination. A 40-year-woman presented with white vaginal discharge persistent for past 1 year. Local examination showed hypertrophied cervix with eversion of both lips and hard consistency of the anterior lip of cervix. A clinical diagnosis of cervical carcinoma was made. However, cervical Pap smear indicated EV eggs in an inflammatory background, treatment to which resulted in completely recovery. PMID:26283859

  11. Activ C cervical disc replacement for myelopathy

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    L McGonagle

    2011-01-01

    Full Text Available Background: Cervical disc replacement is becoming an increasingly popular treatment option for cervical myelopathy. It retains motion at the affected segment, unlike anterior cervical discectomy and fusion. The aim of this study is to assess the outcomes of a series of patients who underwent Activ C disc replacement for cervical myelopathy. Materials and Methods: A series of patients at the above Trust with clinical and radiological evidence of cervical myelopathy who were suitable for cervical disc replacement from 2007 to 2009 were included. Implants were inserted by one of two consultant surgeons {IMS, MO′M}. Patients were assessed preoperatively and at six, 12 and 24 months, postoperatively, with a visual analogue score (VAS for neck and arm pain severity and frequency, the Neck Disability Index questionnaire (NDI and the Centre for Epidemiologic Studies Depression questionnaire (CES-D. Results: Ten patients underwent surgery between May 2007 and July 2009, 6 women, and 4 men. Average age was 54 years (40-64. Disc levels replaced were: four at C4-5; eight at C5-6; seven at C6-7. Three patients had one disc replaced, five patients had two discs replaced, and two patients had three discs replaced. The VAS for neck pain improved from 5.9 pre-operatively to 1.4-24 months postoperatively and the VAS arm pain improved from 5.4 to 2.6. The NDI improved from 51% preoperatively to 26.8% at 24 months postoperatively. The CES-D showed a slight increase from 19.5 preoperatively to 21.7 at 24 months, postoperatively. Conclusion: Cervical decompression and disc replacement improves pain and function in patients with cervical myelopathy. This benefit is maintained at 24 months post op, with no cases requiring revision.

  12. Diagnosing Cervical Fusion: A Comprehensive Literature Review

    OpenAIRE

    Sethi, Nanin; Devney, James; Steiner, Holly L.; Riew, K. Daniel

    2008-01-01

    Study Design Comprehensive literature review. Purpose To document the criteria for fusion utilized in these studies to determine if a consensus on the definition of a solid fusion exists. Overview of Literature Numerous studies have reported on fusion rates following anterior cervical arthrodesis. There is a wide discrepancy in the fusion rates in these studies. While factors such as graft type, Instrumentation, and technique play a factor in fusion rate, another reason for the difference may...

  13. Design and clinical application of cervical hollow threaded fixator

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective Cervical hollow threaded fixator (CHTY) was designed and applied to stabilize tha cervical spine following anterior decompression due to cervical spondylosis or acute cervical disc herniation. Methods Medical use titanium alloy with no magnetism was made into a hollow threaded structure with holes on the wall of the fixator. Forly-two patients with cervical spondylosis and acute cervical disc herniation were stabilized using the CHTF technique after anterior decompression. X-ray films and CT scans were taken after the oberation to observe the stability ann fusion rate of the segments. Results Patients were allowed to walk one day after the operation and were followed up for 6 to 36 months. The operated segments were stable and solid fusion was observed 3-6 months after surgery. Conclusions Immediate stability of the operated segments can be obtained using the CHTF technique. Patients ware easy to manage after5 the operation and returned to their jobs in a short time.The CHTF technique is safe and simpa to perfoirme and eliminates the complications of an autograft.It may be an alternative to traditional cervical interbody fusion with bone graft.

  14. Lesiones del ligamento cruzado anterior

    OpenAIRE

    Alejandro Álvarez López; Yenima García Lorenzo

    2015-01-01

    Fundamento: el ligamento cruzado anterior desempeña un papel muy importante en la estabili-dad de la rodilla. La incidencia de esta afección es alta en pacientes que practican deportes de contacto y de no ser tratados de forma adecuada, los resultados son desfavorables. Objetivo: profundizar en los factores necesarios para el tratamiento adecuado de enfermos con esta lesión y evitar las complicaciones. Método: se realizó una revisión bibliográfica de un total de 300 artículos publicados en Pu...

  15. Comparação do Índice de Torg obtido por meio de radiografia e ressonância magnética nos pacientes com mielopatia cervical espondilótica Comparación del Índice de Torg, obtenido por medio de radiografía y resonancia, en los pacientes con mielopatía espondilótica cervical Comparison of the Torg Index obtained by radiography and magnetic resonance in patients with spondylotic cervical myelopathy

    Directory of Open Access Journals (Sweden)

    Alexandre de Oliveira Zam

    2012-01-01

    Full Text Available OBJETIVO: A Mielopatia Cervical Espondilótica (MCE é uma disfunção da medula espinhal relacionada à degeneração típica do envelhecimento. No estudo de imagem podemos obter a medida do Índice de Torg, para estimar a estenose cervical. Objetivamos, assim, medir o Índice de Torg através de radiografia e ressonância magnética (RM, possibilitando verificar possíveis discrepâncias entre os métodos de medida. MÉTODOS: Realizada mensuração do Índice de Torg na radiografia e na RM da coluna cervical, sendo obtido através da relação entre a superfície posterior do corpo vertebral e o ponto mais próximo à linha laminar correspondente, dividido pelo diâmetro sagital do corpo vertebral. RESULTADOS: Participaram 29 pacientes, sendo 10 mulheres e 19 homens, com médias de idade 48,1 ± 11 anos, de peso 68,7 ± 5 Kg e de altura 1,68 ± 0,6 m. Houve diferença significativa entre o Índice de Torg calculado através de radiografia e RM, sendo menores os índices observados na RM (radiografia: 0,73 ± 0,17 vs. RM: 0,48 ± 0,14, pOBJETIVO: La Mielopatía Cervical Espondilótica (MCE es un trastorno relacionado con la degeneración de la médula espinal, típica del envejecimiento. En el estudio de imagen se puede obtener la medida del Índice de Torg para estimar la estenosis cervical. Nuestro objetivo es, por tanto, medir el índice de Torg mediante rayos-X y resonancia magnética (RM, posibilitando verificar posibles discrepancias entre los métodos de medición. MÉTODOS: Se realiza la medición del Índice de Torg en la radiografía y en la resonancia magnética de la columna cervical, siendo obtenido mediante la determinación de la relación entre la superficie posterior del cuerpo vertebral y el punto más cercano a la línea de la lámina correspondiente, dividido por el diámetro sagital del cuerpo vertebral. RESULTADOS: Participó un total de pacientes 29, siendo 10 mujeres y 19 hombres, edad promedio de 48,1 ± 11 años, peso

  16. Cognition of cervical spondylosis%颈椎病之我见

    Institute of Scientific and Technical Information of China (English)

    赵定麟

    2015-01-01

    In 1976, Dr. Zhao Dinglin and Dr. Zhang Wenming made the breakthrough. Based on the purpose of releasing bone induced pressure they had completed the first anterior radical cervical decompression and bone grafting + partial rotation. Since then, chinese scholars had continuously explored the pathogenesis, pathological anatomy, pathophysiological features, reasonable classiifcation and many other related issues of cervical spondylosis. In several years from 1970s, the author proposed the concept of cervical nonfusion technology, to accomplish various designs and producing, which was subsequently used in clinical treatment. We brought forward Luschka’s joint diseases and anterior-lateral decompression surgery on the purpose of resecting Luschka’s joints. To reduce the damage to the cervical spine anatomy, we had designed a cervical anterior undermining decompression instrument ( including “L” shape, “T” shape, “Y” shape and single vertebrae ). We cooperated with Shanghai No. Six Surgical Instruments Factory and produced both conventional and special instruments on cervical spine surgery to improve the accuracy and security in operations. After that, we designed cervical hollow threaded ifxator, artiifcial cervical vertebra body and artiifcial vertebra plate. Combined with the research results concluded by three national forums, we elaborated basic concepts and definitions of cervical researches at different periods. On this basis we introduced those crucial issues such as the natural outcome of the cervical spondylosis, pathological anatomy features, pathogenesis and so on. Also, for some related trending topics we expressed personal viewpoints. For instance, selection of operative approach ( anterior or posterior ), origin, choice and effectiveness of nonfusion technique, and operative essentials of less invasion. Furthermore we put forward the main points on more common clinical diseases: Luschka’s joint diseases and anterior central spinal artery

  17. Anterior approach on protrusion of intervertebral disc and early rehabilitation training after operation%颈椎间盘突出症的前路手术与术后早期康复训练

    Institute of Scientific and Technical Information of China (English)

    方军; 高克海; 李华壮; 褚俊良

    2002-01-01

    Backgroud: The main causes of protrusion of cervical intervertebral disc are degenerations such as osteophymas on degenerated protruded intervertebral disc and vertebral body anterior to vertebral canal. Decompression via cervical anterior approach and fusion of implanted bone are effective methods. And it is very important for surgical effect and functional restoration to make sufficient preoperative preparation and consummate postoperative rehabilitation.

  18. Analysis of amelioration of neurological function on cervical degeneration disease after treatment with cervical spine locking plate%颈椎带锁钢板内固定术对颈椎退变性疾病神经功能改善的分析

    Institute of Scientific and Technical Information of China (English)

    赖志军; 谢惠缄; 谢唏衷; 肖建如

    2002-01-01

    Objective To discuss the clinical effect of treatment with anterior decompression, bone graft and cervical locking plate fixation for cervical degeneration disease.Method 23 patients with cervical spondylotic myelopathy and cervical ossification of the posterior longitudinal ligament have undergone the treatment of anterior cervical spine locking plate fusion.Neurological signs and symptoms were evaluated before and after surgery, and mean follow up time was 11.3 months.Result In all cases,radiography demonstrated a solid bony fusion.Additional general complications include a large wound hematoma in one and hoarseness in one.All patients' neurological function were improved.Conclusion The clinical effect of treatment with anterior decompression, bone graft and cervical locking plate fixation for cervical degeneration disease is satisfactory.

  19. Comparison of adjacent segment degeneration five years after single level cervical fusion and cervical arthroplasty:a retrospective controlled study

    Institute of Scientific and Technical Information of China (English)

    SUN Yu; ZHAO Yan-bin; PAN Sheng-fa; ZHOU Fei-fei; CHEN Zhong-qiang; LIU Zhong-jun

    2012-01-01

    Background Cervical arthroplasty is indicated to preserve cervical motion and prevent accelerated adjacent segment degeneration.Whether accelerated adjacent segment degeneration is prevented in the long term is unclear.This trial compared adjacent segment degeneration in Bryan disc arthroplasty with that in anterior cervical decompression and fusion five years after the surgery.Methods We studied patients with single level degenerative cervical disc disease.The extent of adjacent segment degeneration was estimated from lateral X-rays.Results Twenty-six patients underwent single level Bryan disc arthroplasty and twenty-four patients underwent single level anterior cervical decompression and fusion.All patients were followed up for an average of sixty months.In the Bryan arthroplasty group,nine(17.6%)segments developed adjacent segment degeneration,which was significantly lower than that(60.4%)in the anterior cervical decompression and fusion group.Eleven segments in the Bryan arthroplasty group developed heterotopic ossification according to McAfee's classification and two segments had range of motion less than 2°.In the heterotopic ossification group,four(19.5%)segments developed adjacent segment degeneration,similar to the number in the non-heterotopic ossification group(16.7%).Adjacent segment degeneration rate was 50% in gradeⅣ?group but 11.8% in gradeⅡ?to Ⅲ.Conclusions Adjacent segment degeneration was accelerated after anterior cervical decompression and fusion.However,Bryan disc arthroplasty avoided accelerated adjacent segment degeneration by preserving motion.Patients with gradeⅣ?heterotopic ossification lost motion,and the rate of adjacent segment degeneration was higher than that in patients without heterotopic ossification.

  20. Using Intervention Mapping as a Participatory Strategy: Development of a Cervical Cancer Screening Intervention for Hispanic Women

    Science.gov (United States)

    Byrd, Theresa L.; Wilson, Katherine M.; Smith, Judith Lee; Heckert, Andrea; Orians, Carlyn E.; Vernon, Sally W.; Fernandez-Esquer, Maria E.; Fernandez, Maria E.

    2012-01-01

    Cervical cancer is preventable with treatment of precancerous lesions and treatable at early stages. Hispanics have higher rates of cervical cancer and lower rates of screening. "Ayndando a las Mujeres con Informaccion, Guia, y Amor para su Salud" (AMIGAS) is an intervention to increase cervical cancer screening in U.S. women of Mexican origin.…

  1. Short-term risk of cervical intraepithelial neoplasia grades 2 and 3 for women with normal cytology and human papillomavirus infection Riesgo a corto plazo de lesiones intraepiteliales cervicales grados 2 y 3 en mujeres con citología vaginal normal e infección por el virus del papiloma humano

    Directory of Open Access Journals (Sweden)

    Gustavo Hernández-Suárez

    2010-12-01

    Full Text Available OBJECTIVE. To assess the risk of cervical intraepithelial neoplasia grades 2, 3 or higher (CIN 2/3+ for women with normal cytology and concurrent high-risk human papillomavirus infection (HR-HPV. MATERIAL AND METHODS. We examined 2 200 women every 6 months for an average of 9 years. Cervical smears and samples for HPV DNA were obtained at each visit. Absolute risk of subsequent CIN2/CIN3+ was estimated using the Kaplan-Meier method. RESULTS. The absolute risk of CIN2/CIN3+ among HR-HPV-positive women with normal Pap smear results was 1.06% (95%CI, 0.57-2.20, 5 times higher the risk among all women with normal Pap smears (0.20%; 95%CI, 0.12-0.32 but 7 times lower than that for women with HR-HPV infection and LSIL (7.24%; 95%CI, 3.78-15.2. CONCLUSION. Short-term absolute risk of CIN2/3+ after a normal Pap smear with concurrent HR-HPV infection is low (~1%, suggesting that the HR-HPV test has limited utility in short-term clinical decision-making for women with normal cytology.OBJETIVO. Evaluar el riesgo a corto plazo de neoplasia intraepitelial cervical de alto grado (CIN2/CIN3+ en mujeres con citologí-a cervicouterina normal e infección por virus del papiloma humano de alto riesgo (HR-HPV. MATERIAL Y MÉTODOS. Cohorte prospectiva de 2200 mujeres evaluadas cada seis meses durante 9 años en promedio. En cada visita se tomó muestra cervical para extendido y detección de HPV DNA. El riesgo absoluto de CIN2/CIN3+ a la siguiente visita fue calculado utilizando el método de Kaplan-Meier. RESULTADOS. En mujeres con citologí-a normal e infección concomitante por HR-HPV el riesgo absoluto de presentar CIN2/CIN3+ fue de 1.06% (95%CI, 0.57-2.20. Este riesgo fue cinco veces mayor al observado en todas las mujeres con citologí-a normal (0.20%; 95%CI, 0.12-0.32 pero siete veces menor que el observado en mujeres con lesiones intraepiteliales escamosas de bajo grado con infección concomitante (7.24%; 95%CI, 3.78-15.2. CONCLUSIÓN. El riesgo absoluto de

  2. Diffuse idiopathic skeletal hyperostosis of cervical spine - An unusual cause of difficult flexible fiber optic intubation

    Directory of Open Access Journals (Sweden)

    Baxi Vaibhavi

    2010-01-01

    Full Text Available This is a report of anterior osteophytes on the cervical vertebra resulting in distortion of the airway and leading to difficulty during intubation. The osteophytes associated with the syndrome of diffuse idiopathic skeletal hyperostosis were at the C2-3 and C6-7, T1 level and resulted in anterior displacement of the pharynx and the trachea respectively.

  3. Artrodese na coluna cervical utilizando SICAP como substituto de enxerto ósseo Artrodesis en la columna cervical utilizando SICAP como sustituto de injerto óseo Cervical spine fusion utilizing silicated calcium phosphate bone graft substitute (SICAP

    Directory of Open Access Journals (Sweden)

    Juliano Fratezi

    2011-01-01

    Tech EE.UU, Reino Unido es un injerto óseo compuesto de calcio-fosfato con una sustitución de silicato en la estructura química, con una estructura tridimensional que parece hueso natural. MÉTODOS: 19 pacientes fueron sometidos a fusión ósea cervical y analizados retrospectivamente. La evaluación radiográfica y la evaluación clínica fueron realizadas utilizandose el cuestionario Neck Disability Index y la escala análoga del dolor (VAS pre y postoperación. RESULTADOS: El período promedio de seguimiento postoperatorio fue de 14 meses ± 5 meses (7-30 meses. Once pacientes fueron sometidos a fusión vía anterior; 5 pacientes vía posterior y 3 pacientes vía anterior y posterior. La revisión radiográfica mostró 19/19 (100% de fusión ósea, ningún caso presentó subsidencia, rotura o soltura de material de implante o movimiento en los niveles fusionados. Ningún ejemplo de osificación heterotópica o de crecimiento óseo intracanal fue observado. Clínicamente, el promedio de las puntuaciones del Neck Disability disminuyeron 13,3 puntos (promedio preop. de 34,5, postop. de 21,2, mejora de 39%, el promedio de VAS para dolor cervical disminuyó 2 puntos (2,7 preop. para 0,7 postop.; mejora de 74,1%. No fueron observadas complicaciones como infección, osteólisis o edema excesivo de las partes blandas. CONCLUSIÓN: Los resultados preliminares obtenidos en esta serie feuron estimulantes con el uso de SICaP como injerto óseo, con sólida fusión ósea obtenida en todos los casos y sin formación de osificación heterotópica o crecimiento de hueso intracanal. SIcaP demuestra ser un sustituto confiable para el injerto óseo autólogo en la columna cervical.OBJECTIVE: Bone graft substitutes have been developed to obviate the need for autograft from the iliac crest and its resultant complications. SiCaP (Actifuse, ApaTech US, UK is a calcium phosphate bone graft substitute with selective controlled silicate substitution in a patented 3-dimensional structure

  4. Dolor anterior de la rodilla

    Directory of Open Access Journals (Sweden)

    Alejandro Álvarez López

    2010-01-01

    Full Text Available Introducción:el dolor anterior de la rodilla constituye una importante causa de consulta en la especialidad de Ortopedia y Traumatología. La incidencia de otras enfermedades relacionadas con este síntoma es cada vez mayor, ejemplo de ello es la condromalacia de rótula, tendinitis patelar, osteoartritis patelofemoral entre otras, el diagnóstico de estas enfermedades se debe al cúmulo de experiencia y a la introducción de técnicas y equipos imagenológicos de avanzada. Desarrollo: se realizó una revisión bibliográfica sobre el dolor anterior de la rodilla, con especial énfasis en las teorías involucradas en su fisiopatología, entre las que se encuentran la mala-alineación patelo-femoral, equilibrio de la homeostasis tisular y aumento de la presión intra-ósea, además de brindar brevemente el cuadro clínico de la enfermedad. Para finalizar se expone el enfoque terapéutico que se basa fundamentalmente en el tratamiento conservador, se mencionan además las modalidades de tratamiento quirúrgico.

  5. Diferencias en el rendimiento en el salto entre jugadores de balomnano de élite con o sin reconstrucción previa del ligamento cruzado anterior de la rodilla (LCA)

    OpenAIRE

    Setuain Chourraut, Igor

    2012-01-01

    El balonmano es considerado uno de los deportes más exigentes para la articulación de la rodilla, donde la incidencia lesión del LCA es relativamente alta en comparación con otras disciplinas deportivas. No resulta infrecuente la convivencia con déficits de fuerza y control neuromuscular en atletas que han sufrido la lesión del LCA. La medición de variables relativas al rendimiento en el salto podría resultar de gran ayuda durante el proceso rehabilitador para garantizar una óp...

  6. Cervical Cancer Screening

    Science.gov (United States)

    ... Cancer found early may be easier to treat. Cervical cancer screening is usually part of a woman's health ... may do more tests, such as a biopsy. Cervical cancer screening has risks. The results can sometimes be ...

  7. Cervical Cancer Stage IVB

    Science.gov (United States)

    ... of the body, such as the lymph nodes, lung, liver, intestine, or bone. Stage IVB cervical cancer. Topics/Categories: Anatomy -- Gynecologic Cancer Types -- Cervical Cancer Staging Type: Color, Medical Illustration Source: National Cancer Institute ...

  8. Longitud de las raíces cervicales en resonancia magnética: relación con la parálisis postoperatoria de la quinta raíz cervical Medida do comprimento das raízes cervicais pela ressonância magnética: relação com a paralisia pós-operatória e a quinta raiz cervical Cervical nerve root length in magnetic resonance imaging: its relationship with postoperative fifth root palsy

    Directory of Open Access Journals (Sweden)

    Juan José Mezzadri

    2010-03-01

    Full Text Available OBJETIVO: determinar la longitud de la raíz C5. MÉTODOS: se estudiaron con resonancia magnética (Signa 1,5 T, cortes axiales de 5 mm de espesura, TR=850, TE=26, FOV=200 las columnas cervicales de 50 pacientes (29 hombres - 21 mujeres entre 26 y 68 años. Se incluyeron solo casos con cervicalgia y/o cervicobraquialgia. Se midió (en mm la longitud de las raíces cervicales tercera a séptima, derechas e izquierdas. La comparación de los promedios se realizó a través del análisis de varianza, para un nivel de significación α=0,05 con IC de 95%. Las comparaciones post-hoc se hicieron empleando el test de Bonferroni. RESULTADOS: se observó que el lado (derecho o izquierdo y el sexo (varón o mujer no tuvieron incidencia estadísticamente significativa en el valor de la longitud de las raíces (p>0,05. La raíz C5 tuvo un tamaño significativamente diferente (pOBJETIVO: determinar o comprimento da raiz C5. MÉTODOS: as colunas cervicais de 50 pacientes (29 homens - 21 mulheres, com idades entre 26 e 68 anos foram analisadas com ressonância magnética (Signa 1,5 T, cortes axiais de 5 mm de espessura, TR=850, TE=26, FOV=200. Foram incluídos casos com dor cervical e/ou cervicobraquial. O comprimento das raízes C3 a C7, à direita e esquerda, foi medido. A comparação das médias foi realizada com uma análise de variância para um nível de significação α = 0,05 com IC de 95%. As comparações post-hoc foram feitas com o teste de Bonferroni. RESULTADOS: foi observado que o lado (direito ou esquerdo e o sexo (homem ou mulher não tiveram incidência estatística significante em relação ao valor do comprimento das raízes. A raiz C5 evidenciou um tamanho significativamente diferente (pOBJECTIVE: to determine the length of the C5 root. METHODS: the cervical spines of 50 patients (29 male and 21 female, between 26 and 68 years old, were studied with magnetic resonance imaging (Signa 1.5 T, axial images with 5 mm thickness, TR=850, TE=26

  9. Early detection of cervical cancer with visual inspection methods: a summary of completed and on-going studies in India Detección oportuna de cáncer cervical con métodos de inspección visual: un resumen de estudios en India

    OpenAIRE

    Sankaranarayanan, R.; BM Nene; K Dinshaw; R. Rajkumar; Shastri, S.; Wesley, R.; Basu, P.; Sharma, R.; S Thara; A Budukh; Parkin DM

    2003-01-01

    India is a high-risk country for cervical cancer which accounts a quarter (126 000 new cases, 71 000 deaths around 2 000) of the world burden. The age-standardized incidence rates range from 16-55 per 100 000 women in different regions with particularly high rates in rural areas. Control of cervical cancer by early detection and treatment is a priority of the National Cancer Control Programme of India. There are no organized cytology screening programmes in the country. The technical and fina...

  10. MRI findings in posterior disc prolapse associated with cervical fracture dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Maeda, Go; Shiba, Keiichiro; Ueta, Takayoshi; Shirasawa, Kenzo; Ohta, Hideki; Mori, Eiji; Rikimaru, Shunichi; Hida, Shinichi; Tokunaga, Masami (Spinal Injuries Center, Fukuoka (Japan))

    1994-03-01

    Although disc injury is common in cervical spinal fractures the mechanism of disc herniation in cervical fracture dislocations is not known. This study evaluated the pathogenesis of disc hernia in cervical fracture dislocations. Twenty-two patients who underwent anterior and posterior spinal fixation were studied. Findings of preoperative magnetic resonance imaging (MRI) were compared with surgical findings. During surgery, cervical disk hernia were found in six patients (27 %), and the MRI finding of these patients were evaluated in detail. We concluded that the characteristic MRI findings of cervical disc hernia are as follows: (1) discontinuity of injured disc, (2) anterior indentation of spinal cord at the site of dislocated vertebral body, and (3) signal irregularity at the site of interspace between dislocated vertebral body and spinal cord. (author).

  11. MRI findings in posterior disc prolapse associated with cervical fracture dislocation

    International Nuclear Information System (INIS)

    Although disc injury is common in cervical spinal fractures the mechanism of disc herniation in cervical fracture dislocations is not known. This study evaluated the pathogenesis of disc hernia in cervical fracture dislocations. Twenty-two patients who underwent anterior and posterior spinal fixation were studied. Findings of preoperative magnetic resonance imaging (MRI) were compared with surgical findings. During surgery, cervical disk hernia were found in six patients (27 %), and the MRI finding of these patients were evaluated in detail. We concluded that the characteristic MRI findings of cervical disc hernia are as follows: 1) discontinuity of injured disc, 2) anterior indentation of spinal cord at the site of dislocated vertebral body, and 3) signal irregularity at the site of interspace between dislocated vertebral body and spinal cord. (author)

  12. Chronic hypertrophic nonunion of the Type II odontoid fracture causing cervical myelopathy: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Mohammed F Shamji

    2016-01-01

    Conclusion: Rarely, nonunion of Type II odontoid fractures may be hypertrophic where both instability and compression cause neurological morbidity. Such cases require anterior transoral decompression, posterior cervical decompression, and instrumented fusions.

  13. Cervical Cancer Stage IA

    Science.gov (United States)

    ... historical Searches are case-insensitive Cervical Cancer Stage IA Add to My Pictures View /Download : Small: 720x576 ... Large: 3000x2400 View Download Title: Cervical Cancer Stage IA Description: Stage IA1 and IA2 cervical cancer; drawing ...

  14. Bilateral anterior shoulder dislocation

    OpenAIRE

    Meena, Sanjay; Saini, Pramod; Singh, Vivek; Kumar, Ramakant; Trikha, Vivek

    2013-01-01

    Shoulder dislocations are the most common major joint dislocations encountered in the emergency departments. Bilateral shoulder dislocations are rare and of these, bilateral posterior shoulder dislocations are more prevalent than bilateral anterior shoulder dislocations. Bilateral anterior shoulder dislocation is very rare. We present a case of 24-year-old male who sustained bilateral anterior shoulder dislocation following minor trauma, with associated greater tuberosity fracture on one side...

  15. Evaluation of arthrodesis and cervical alignment in the surgical results of cervical discectomy using polymethylmetacrylate Avaliação da artrodese e do alinhamento cervical após discectomia cervical com interposição de polimetilmetacrilato

    Directory of Open Access Journals (Sweden)

    Marcelo Luis Mudo

    2009-09-01

    Full Text Available BACKGROUND AND OBJECTIVES: Surgical treatment of cervical radiculopathy with or without myelopathy is a controversy issue, although anterior discectomy is the most common form of treatment. METHOD: We present the evaluation of the arthrodesis' rate and cervical alignment in 48 patients with cervical degenerative disease (CDD submitted to anterior cervical discectomy with interposition of polymethylmetacrylate (PMMA. Odom and Nürick scales were used to evaluation of functional status before and after surgery. Cervical spine X-rays were used to access arthrodesis and alignment, at least 2 years after the procedure. RESULTS: Excellent and good results (Odom I and II were obtained in 91% of the patients with radiculopathy and in 69% of those with myelopathy. Using the chi square test of independence (1% of significance, there was no association between excellent and good clinical results with the presence of arthrodesis verified in cervical X-rays. The presence of cervical alignment had association with good results, whereas the misalignment was associated with unfavorable outcomes. Two patients died: one cervical hematoma and other from graft migration with cord compression. CONCLUSIONS: Cervical alignment was more important than fusion to achieve good surgical results in CDD.TEMA E OBJETIVO: O tratamento cirúrgico da radiculopatia cervical com ou sem mielopatia é um tema controverso, embora a discectomia por via anterior seja uma das formas mais comuns de tratamento. MÉTODO: Apresentamos a avaliação da artrodese cervical e do alinhamento pós operatório em 48 pacientes com doença degenerativa cervical (DDC submetidos a discectomia por via anterior seguida da interposição de polimetilmetacrilato (PMMA. As escalas de Odom e de Nurick foram utilizadas para avaliar o status funcional dos pacientes antes e após a cirurgia. Radiografias da coluna cervical foram utilizadas para avaliar a artrodese e o alinhamento cervical, pelo menos 2 anos ap

  16. 360-degree cervical spinal arthrodesis for treatment of pediatric cervical spinal tuberculosis with kyphosis

    OpenAIRE

    Zeng, Hao; Shen, Xiongjie; Luo, Chengke; Xu, Zhengquan; Zhang, Yupeng; Liu, Zheng; Wang, Xiyang; Cao, Yong

    2016-01-01

    Background There is limited evidence to guide treatment for pediatric cervical spinal tuberculosis with kyphosis (PCSTK). This study retrospectively evaluates the safety, feasibility and efficacy of 360-degree arthrodesis combined with anterior debridement and decompression for treating PCSTK, while simultaneously emphasizing the role of posterior fixation for the correction and maintenance of the kyphosis angle. Methods From May 2006 to December 2012, a total of 12 children with PCSTK underw...

  17. 上颈椎3D打印模型的精确性验证及在前路枕-寰-枢螺钉内固定术中的可行性%3D-printed upper cervical models: accuracy validation and feasibility study into anterior occiput-to-axis screw fixation on them

    Institute of Scientific and Technical Information of China (English)

    吴爱悯; 金海明; 车灿文; 吴立军; 林仲可; 倪文飞; 徐华梓; 池永龙; 王向阳

    2016-01-01

    Objective To validate the accuracy of 3D-printed upper cervical models and investigate the feasibility of use of the models in anterior occiput-to-axis screw fixation, in an attempt to provide a protocol of pre-operative plan for surgeons.Methods Forty-five adult atlantoaxial CT scans were obtained, imported into Mimics software for 3 D reconstruction, successively imported into 3 D printer to print the 3D models.Fourteen parameters were measured on both imaging system and 3D-printed models to validate the accuracy of 3D-printed models.Thirty upper cervical CT data were obtained and imported into Mimics software for 3D reconstruction.Cylinders in 1.75 mm radius were drawn to simulate the trajectory of anterior occiput-to-axis screw fixation.Anteroposterior view of the minimum lateral angle (α1) and maximum lateral angle (α2) and lateral view of the minimum posterior angle (β1) and maximum posterior angle (β2) were measured.Mean value of α1 and α2 was calculated as α3 and mean value of β1 and β2 as β3.Meanwhile, the 3D models were printed, and an angle guide device was used to introduce the anterior occiput-to-axis screws into the 3D models in reference to the angles of α3 and β3.Anteroposterior view of lateral angle (α4) and lateral view of posterior angle (β4) were measured.Differences in α3 vs.α4 and β3 vs.β4 were compared.Results All above 14 parameters did not differ significantly between radiographic images and 3D-printed models (P > 0.05).Intraclass correlation coefficient (ICC) values of 13 parameters were > 0.800.On the 3D digital models, the α3 was (12.6 ± 3.7) ° (left) and (12.0 ±4.2) ° (right), and the β3 was (23.9 ± 4.8) ° (left) and (23.4 ± 4.9) ° (right).On the 3 D-printed models, the α4 was (12.0 ± 4.1) ° (left) and (12.3 ± 4.1) ° (right), and β4 was (23.4 ± 4.2) ° (left) and (22.8 ± 4.4)° (right).There were no significant differences in both comparisons of α3 vs.α4 and β3 vs.β4 (P > 0.05).Conclusions

  18. Motor tic disorder and traumatic cervical myelopathy: a case report Trastorno de tic motor y mielopatía cervical traumática: relato de caso Transtorno de tique motor e mielopatia cervical traumática: relato de caso

    Directory of Open Access Journals (Sweden)

    Ericson Sfredo

    2011-01-01

    Full Text Available The association between motor tics and cervical myelopathy is rare and not well understood. Only a few papers in the literature reported this disorder until the present date. This is a case report of a cervical myelopathy case secondary to a motor tic disorder. A 23-year-old male with a 10-year history of motor tic disorder, involving sudden forced extension of the head and cervical spine. Disturbed tactile sensation and kinetic posturing that progressed to the Lhermitte sign every time he made the movement were detected over the last six months. Magnetic resonance imaging (MRI showed hyperintense intramedullary lesion at C2-C3, degeneration at C3-C4, and no signs of spinal cord compression. On sagittal view, functional MRI with head extension showed anterior compression with protrusion of the intervertebral disc and posterior compression of the yellow ligaments causing spinal cord stenosis. Anterior discectomy and fixation of C3-C4 were performed. There were no complications. The patient showed improvement and the motor tics were controlled by haloperidol. The patient remains symptom-free after 2 years of follow-up. Uncontrolled motor tics can compromise spinal cord function. Functional MRI can reproduce the abnormal movements and clarify the physiopathology.La asociación entre tics motores y mielopatía cervical es rara y no es bien comprendida. Pocos estudios, que analizan este disturbio, han sido encontrados en la literatura hasta el momento. Este es el relato de un caso de mielopatía cervical secundaria a tics motores. Paciente masculino de 23 años con historial de trastorno de tic motor desde hace diez años, involucrando extensión forzada de la cabeza y columna cervical. En los últimos seis meses, se diagnosticaron deficiencias de sensaciones táctiles y postura cinética que progresaron hacia la señal de Lhermitte, cada vez que el paciente se movía. La Resonancia Magnética (RM reveló lesión intramedular hiperintensa al nivel de

  19. Surgical staged treatment for moderate to severe adolescent cervical kyphosis

    Institute of Scientific and Technical Information of China (English)

    LIANG Lei; ZHOU Xu-hui; LIU Yang; GAO Rui; CHEN Hua-jiang; YANG Li-li; SHI Sheng; YUAN Wen

    2011-01-01

    Background Adolescent cervical kyphosis refers to manifestation characterized by loss of physiological cervical lordosis with involvement of multiple cervical vertebrae.There is no standard treatment strategy for this disease,especially in those patients who need surgical intervention.The aim of this study was to evaluate the surgical staged treatment for moderate to severe adolescents cervical kyphosis.Methods A total of 26 adolescent with cervical kyphosis were retrospectively assigned into following two groups according to the magnitude of kyphosis:moderate group (n=17),the Cobb angle was 46.6°±4.8°.The surgical procedure was that skull traction was first carried out for 5-7 days and then the anterior fusion and instrumentation were performed.Severe group (n=9),the Cobb angle was 61.6°±4.8°.The treatment strategy was that the anterior release were first performed,followed by skull traction for 7-10 days,and then anterior fusion were performed.Radiographic evaluation was performed postoperatively.Results Three days after surgery,the X-ray examination showed that the Cobb angle was -8.9°±6.8° in the moderate group and -6.0°±6.3° in the severe group.The deformed appearance was obviously corrected,with neck pain and neurologic function improved significantly.Further magnetic resonance imaging (MRI) indicated the physiology curvature of the cervical spine had been reconstructed.Conclusion Surgical staged treatment may be an ideal therapeutic intervention for cervical kyphosis patients with a Cobb angle exceeding 35° in adolescents.

  20. Cervical computed tomography

    International Nuclear Information System (INIS)

    This book describes the possibilities of cervical computed tomography with the apparatus available at present. The normal anatomy of the cervical region as it appears in computed tomography is described with special regard to its compartimental structure and functional aspects; this is supplemented by anatomically normal measures obtained from cervical computed tomograms of 60 healthy individuals of different age and both sexes. The morphology of cervical anomalies obtained via CT and of the various acquired cervical disease processes is discussed and illustrated by means of the authors' own observations; the diagnostic value of the findings obtained by CT is discussed, a diagnosis is set up. (orig./MG)

  1. Simulated Automobile and Rotary-Wing Aircraft Impacts: Dynamic Neck Response after Surgical Treatment for Cervical Spondylosis

    OpenAIRE

    White, Nicholas Alan

    2014-01-01

    Degeneration of the cervical spine is part of the normal aging process, usually occurring without clinical symptoms. Symptomatic degeneration most often occurs in the lower cervical spine, presenting as axial neck pain, radiculopathy, myelopathy, or any combination of the three. When conservative treatment does not adequately manage these symptoms, surgical intervention may be required. The longstanding surgical treatment for cervical degeneration is arthrodesis achieved through anterior cerv...

  2. A radiological study on the cervical spine in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Taketomi, Eiji; Sakoh, Takashi; Sunahara, Nobuhiko [Kagoshima Univ. (Japan). Faculty of Medicine

    1995-03-01

    The cervical spine was examined with the magnetic resonance imaging (MRI) and the conventional roentgenograms in 95 patients with rheumatoid arthritis. The MRI findings of upper cervical disorders were compared with various values determined in roentgenograms: the atlanto-dental interval (ADI), the space available for the spinal cord (SAC), and the Ranawat and Redlund-Johnell values. In patients with vertical setting (VS), MRI showed medullary compression in all those with abnormal Redlund-Johnell values and Ranawat values of 7 mm or less. In patients with anterior atlanto-axial subluxation, compression of the upper cervical cord was observed in all patients with SAC of 13 mm or less. In subaxial lesion of the cervical spine, MRI was found to be as good as roentgenograms in evaluating plate erosion and disc space narrowing and MRI showed extradural pannus. (author).

  3. Avaliação das técnicas cirúrgicas para tratamento da mielorradiculopatia espondilótica cervical Evaluación de las técnicas quirúrgicas para el tratamiento de la mielorradiculopatía cervical espondilótica Evaluation of surgical techniques for treatment of cervical spondylotic myeloradiculopathy

    Directory of Open Access Journals (Sweden)

    Alexandre Meluzzi

    2012-01-01

    de 200 pacientes sometidos a tratamiento quirúrgico de la mielorradiculopatía cervical en el HC-FMUSP, desde enero de 1993 a enero de 2007. La evaluación clínica se cuantificó mediante la escala de la JOA, con un segmento promedio de 06 años y 08 meses. RESULTADOS: Se observó una mejoría neurológica posoperatoria en las vías anterior y posterior, con excepción de las laminectomías sin fusión, donde hubo deterioro neurológico tardío. La vía anterior mostró una tasa significativamente mayor de complicaciones relacionadas con el déficit de fusión intervertebral, desplazamiento del injerto, síndrome de disco adyacente, disfonía, disfagia, o mala posición de injerto y placas, lesión de la raíz del nervio y tasa significativamente mayor de nueva intervención quirúrgica. En la vía posterior, mayor incidencia de inestabilidad en la cifosis posoperatoria, en la laminectomía, y en la laminoplastia no se observó esto, teniendo esta última tasas similares a las encontradas en la vía anterior. No hubo mejoría en el dolor axial en las laminoplastias y se agravó en las laminectomías, mientras que en las discectomías y las corpectomías se produjo una mejoría significativa de los síntomas. CONCLUSIÓN Las vías anterior y posterior fueron eficaces en la producción de mejoría neurológica, con excepción de las laminectomías sin fusión. La vía anterior produjo más complicaciones, pero el dolor es mejor tratado.OBJECTIVE: To evaluate the efficacy of surgical treatment of cervical spondylotic myeloradiculopathy in the production of postoperative neurological improvement, measured in points by the scale of JOA (Japanese Orthopaedic Association and the recovery rate and complications of therapy. METHODS: Analysis of medical records and imaging studies of 200 patients undergoing surgical treatment of cervical myeloradiculopathy in HC-FMUSP, from January 1993 to January 2007. Clinical evaluation was quantified by the scale of the JOA, with an

  4. The 100 Most Influential Articles in Cervical Spine Surgery.

    Science.gov (United States)

    Skovrlj, Branko; Steinberger, Jeremy; Guzman, Javier Z; Overley, Samuel C; Qureshi, Sheeraz A; Caridi, John M; Cho, Samuel K

    2016-02-01

    Study Design Literature review. Objective To identify and analyze the top 100 cited articles in cervical spine surgery. Methods The Thomson Reuters Web of Knowledge was searched for citations of all articles relevant to cervical spine surgery. The number of citations, authorship, year of publication, journal of publication, country of publication, and institution were recorded for each article. Results The most cited article was the classic from 1991 by Vernon and Mior that described the Neck Disability Index. The second most cited was Smith's 1958 article describing the anterior cervical diskectomy and fusion procedure. The third most cited article was Hilibrand's 1999 publication evaluating the incidence, prevalence, and radiographic progression of symptomatic adjacent segment disease following anterior cervical arthrodesis. The majority of the articles originated in the United States (65), and most were published in Spine (39). Most articles were published in the 1990s (34), and the three most common topics were cervical fusion (17), surgical complications (9), and biomechanics (9), respectively. Author Abumi had four articles in the top 100 list, and authors Goffin, Panjabi, and Hadley had three each. The Department of Orthopaedic Surgery at Hokkaido University in Sapporo, Japan, had five articles in the top 100 list. Conclusion This report identifies the top 100 articles in cervical spine surgery and acknowledges those individuals who have contributed the most to the advancement of the study of the cervical spine and the body of knowledge used to guide evidence-based clinical decision making in cervical spine surgery today. PMID:26835204

  5. [Laminoplasty for cervical spondylotic myelopathy].

    Science.gov (United States)

    Fransen, P

    2014-10-01

    Cervical spondylotic myelopathy (CSM) is a common condition. Uninstrumented laminectomy may be complicated by postoperative instability, whereas anterior or posterior decompression with fusion may be associated with stiffness and adjacent segment disease. Cervical laminoplasty, initially oriented towards pediatric patients and ossification of the posterior longitudinal ligament, becomes an interesting surgical alternative to decompress and reconstruct cervical anatomy without fusion. Eighteen patients (12 men, 6 women), mean age 64.2 who presented with CSM were treated surgically using multilevel laminoplasty, and reviewed after 1 month, 6 months, 1 year and 2 years. Clinical evaluation was performed based on the Benzel-JOA and Nurick scores. The preoperative mean Benzel-JOA score was 13.55; Preoperative mean Nurick score was 1.88. Preoperative MRI was carried-out in 16/18 patients. Intramedullary hyperintensity in T2 was observed in 6 patients. The operation was performed on 2 levels (4 patients) 3 levels (11 patients) and 4 levels (3 patients). We used the open-door hinged laminoplasty technique, using metallic implants, without bone graft. At one month FU, mean JOA score was 15.44, and Nurick dropped to 1.05. At 6 months, mean JOA was 16.28 and Nurick was 0.71. At one year, the mean JOA score was 16.16, and Nurick was 0.83. At 2 years, mean JOA was 17.5, and Nurick was 0.25. One infection, one dural tear and one transient episode of C5 paresthesia were observed. We conclude that spinal cord decompression by open-door laminoplasty for CSM allows significant clinical improvement observed progressively in the two years following surgery. PMID:25239380

  6. Comparison of Cervical Spine Anatomy in Calves, Pigs and Humans.

    Directory of Open Access Journals (Sweden)

    Sun-Ren Sheng

    Full Text Available Animals are commonly used to model the human spine for in vitro and in vivo experiments. Many studies have investigated similarities and differences between animals and humans in the lumbar and thoracic vertebrae. However, a quantitative anatomic comparison of calf, pig, and human cervical spines has not been reported.To compare fundamental structural similarities and differences in vertebral bodies from the cervical spines of commonly used experimental animal models and humans.Anatomical morphometric analysis was performed on cervical vertebra specimens harvested from humans and two common large animals (i.e., calves and pigs.Multiple morphometric parameters were directly measured from cervical spine specimens of twelve pigs, twelve calves and twelve human adult cadavers. The following anatomical parameters were measured: vertebral body width (VBW, vertebral body depth (VBD, vertebral body height (VBH, spinal canal width (SCW, spinal canal depth (SCD, pedicle width (PW, pedicle depth (PD, pedicle inclination (PI, dens width (DW, dens depth (DD, total vertebral width (TVW, and total vertebral depth (TVD.The atlantoaxial (C1-2 joint in pigs is similar to that in humans and could serve as a human substitute. The pig cervical spine is highly similar to the human cervical spine, except for two large transverse processes in the anterior regions ofC4-C6. The width and depth of the calf odontoid process were larger than those in humans. VBW and VBD of calf cervical vertebrae were larger than those in humans, but the spinal canal was smaller. Calf C7 was relatively similar to human C7, thus, it may be a good substitute.Pig cervical vertebrae were more suitable human substitutions than calf cervical vertebrae, especially with respect to C1, C2, and C7. The biomechanical properties of nerve vascular anatomy and various segment functions in pig and calf cervical vertebrae must be considered when selecting an animal model for research on the spine.

  7. Anterior approach to the cervicothoracic junction: case series and literature review Acceso anterior de las lesiones de la unión cérvicotoracica: serie de casos y revisión de la literatura Acesso anterior das lesões da junção cérvicotorácica: série de casos e revisão da literatura

    Directory of Open Access Journals (Sweden)

    Asdrubal Falavigna

    2009-06-01

    intensity, analgesic drugs intake and the length of hospital stay.OBJETIVO: relatar la experiencia de los autores en el acceso anterior de la unión cérvicotoracica C7 a T4, en relación a la definición de cuánto es necesaria la realización de la manubriotomía, cuáles las particularidades de esta cirugía y la evaluación de los resultados. MÉTODOS: estudio de cohorte prospectivo de 14 pacientes que fueron tratados quirúrgicamente de enfermedades de la transición cérvicotoracica, durante el periodo de Enero de 1996 a Enero de 2009. Los pacientes fueron evaluados en el pre operatorio con tomografía computadorizada y resonancia magnética, a fin de identificar en cuáles casos la manubriotomía sería necesaria. La cirugía fue realizada preferiblemente por el lado izquierdo utilizando la vía de acceso anterior de Smith-Robinson y en caso de necesidad, sería combinado con una abertura del manubrio. Cuando realizada la corpectomía fueron utilizados Mesh y placa cervical para estabilización, mientras que en la cirugía de hernia discal C7-T1 la reconstrucción fue hecho con PEEK y placa cervical. RESULTADOS: la edad promedio fue de 63 años, siendo siete de sexo masculino. La patología más común fue la enfermedad metastásica (n=8, seguida por la hernia discal C7-T1 (n=4. Las complicaciones relacionadas al procedimiento quirúrgico fueron dos: un paciente con disfonía causada por hematoma local y otro caso con infección pulmonar. El tiempo promedio de cirugía, el volumen de sangramiento, la intensidad del dolor, la necesidad de medicación analgésica y el tiempo de hospitalización fueron menores en los pacientes en que la manubriotomía no fue necesaria. CONCLUSIÓN: el acceso anterior a la unión cérvicotoracica es un acceso rápido y de baja morbilidad. Lesiones que envuelven el cuerpo vertebral de T1 o el espacio discal de C7-T1 fueron abordadas solamente por la vía cervical sin abertura del manubrio. Las lesiones del cuerpo de T1 y/o de T2 fueron

  8. Anterior Cruciate Ligament (ACL) Injuries

    Science.gov (United States)

    ... Help a Friend Who Cuts? Anterior Cruciate Ligament (ACL) Injuries KidsHealth > For Teens > Anterior Cruciate Ligament (ACL) ... and Recovery Coping With an ACL Injury About ACL Injuries A torn anterior cruciate ligament (ACL) is ...

  9. Cervical instability in Klippel-Feil syndrome:case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Aaron Wessell; Peter DeRosa; Abraham Cherrick; Jonathan H.Sherman

    2015-01-01

    Background: The authors present a case of cervical myelopathy and radiculopathy in the setting of multiple Klippel-Feil syndrome abnormalities treated surgically with a single-level C3-C4 anterior cervical discectomy and fusion.We discuss the clinical presentation, radiographic findings, and various treatment options for cervical spine abnormalities in Klippel-Feil syndrome.Case Presentation: This 22-year-old female with Klippel-Feil syndrome presented with intermittent neck pain, left upper extremity weakness, and paresthesias.Preoperative MRI, CT, and X-rays of the cervical spine revealed anterolisthesis at C3/4 with unstable movement on flexion and extension imaging.In addition, there were multiple segmental fusion abnormalities including hemivertebrae and other congenital fusion abnormalities.A C3-C4 anterior cervical discectomy and fusion was performed with intervertebral disc spacer.Adequate decompression was achieved with postoperative resolution of the patient's symptoms and improvement in neurological exam.Conclusions: Single-level anterior cervical discectomy and fusion can be utilized for treatment of cervical myelopathy and radiculopathy in the setting of multiple congenital Klippel-Feil syndrome abnormalities.

  10. Ossified Posterior Longitudinal Ligament With Massive Ossification of the Anterior Longitudinal Ligament Causing Dysphagia in a Diffuse Idiopathic Skeletal Hyperostosis Patient

    OpenAIRE

    Murayama, Kazuhiro; Inoue, Shinichi; Tachibana, Toshiya; Maruo, Keishi; Arizumi, Fumihiro; Tsuji, Shotaro; Yoshiya, Shinichi

    2015-01-01

    Abstract Descriptive case report. To report a case of a diffuse idiopathic skeletal hyperostosis (DISH) patient with both massive ossification of the anterior longitudinal ligament (OALL) leading to severe dysphagia as well as ossification of the posterior longitudinal ligament (OPLL) causing mild cervical myelopathy, warranting not only an anterior approach but also a posterior one. Although DISH can cause massive OALL in the cervical spine, severe dysphagia resulting from DISH is a rare occ...

  11. Intradiscal Pressure Changes during Manual Cervical Distraction: A Cadaveric Study

    Directory of Open Access Journals (Sweden)

    M. R. Gudavalli

    2013-01-01

    Full Text Available The objective of this study was to measure intradiscal pressure (IDP changes in the lower cervical spine during a manual cervical distraction (MCD procedure. Incisions were made anteriorly, and pressure transducers were inserted into each nucleus at lower cervical discs. Four skilled doctors of chiropractic (DCs performed MCD procedure on nine specimens in prone position with contacts at C5 or at C6 vertebrae with the headpiece in different positions. IDP changes, traction forces, and manually applied posterior-to-anterior forces were analyzed using descriptive statistics. IDP decreases were observed during MCD procedure at all lower cervical levels C4-C5, C5-C6, and C6-C7. The mean IDP decreases were as high as 168.7 KPa. Mean traction forces were as high as 119.2 N. Posterior-to-anterior forces applied during manual traction were as high as 82.6 N. Intraclinician reliability for IDP decrease was high for all four DCs. While two DCs had high intraclinician reliability for applied traction force, the other two DCs demonstrated only moderate reliability. IDP decreases were greatest during moving flexion and traction. They were progressevely less pronouced with neutral traction, fixed flexion and traction, and generalized traction.

  12. Return to Play After Cervical Disc Surgery.

    Science.gov (United States)

    Kang, Daniel G; Anderson, Justin C; Lehman, Ronald A

    2016-10-01

    Criteria for return to sports and athletic activities after cervical spine surgery are unclear. There is limited literature regarding the outcomes and optimal criteria. Determining return to play criteria remains a challenge and continues to depend on the experience and good judgment of the treating surgeon. There is strong consensus in the literature, despite lack of evidence-based data, that athletes after single-level anterior cervical discectomy and fusion (ACDF) may safely return to collision and high-velocity sports. The athlete should be counseled and managed on a case-by-case basis, taking into consideration the type of sport, player-specific variables, and type of surgery performed. PMID:27543397

  13. [Langerhans cell histiocytosis causing cervical myelopathy].

    Science.gov (United States)

    Doléagbénou, A K; Mukengeshay Ntalaja, J; Derraz, S; El Ouahabi, A; El Khamlichi, A

    2012-08-01

    Langerhans cell histiocytosis (LCH), a disorder of the phagocytic system, is a rare condition. Moreover, spinal involvement causing myelopathy is even rare and unusual. Here, we report a case of atypical LCH causing myelopathy, which was subsequently treated by corporectomy and fusion. An 8-year-old boy presented with 3 weeks of severe neck pain and limited neck movement accompanying upper and lower limbs motor weakness. CT scans revealed destruction of C5 body and magnetic resonance imaging showed a tumoral process at C5 with cord compression. Interbody fusion using anterior cervical plate packed by autologus iliac bone was performed. Pathological examination confirmed the diagnosis of LCH. After the surgery, the boy recovered from radiating pain and motor weakness of limbs. Despite the rarity of the LCH in the cervical spine, it is necessary to maintain our awareness of this condition. When neurologic deficits are present, operative treatment should be considered. PMID:22552159

  14. Get Tested for Cervical Cancer

    Science.gov (United States)

    ... Cervical Cancer Print This Topic En español Get Tested for Cervical Cancer Browse Sections The Basics Overview ... be cured. How often should I get screened (tested)? How often you should get screened for cervical ...

  15. Cervical cancer - screening and prevention

    Science.gov (United States)

    Cancer cervix - screening; HPV - cervical cancer screening; Dysplasia - cervical cancer screening ... Almost all cervical cancers are caused by HPV (human papilloma virus). HPV is a common virus that spreads through sexual contact. Certain ...

  16. Treatment Option Overview (Cervical Cancer)

    Science.gov (United States)

    ... Cancer Prevention Cervical Cancer Screening Research Cervical Cancer Treatment (PDQ®)–Patient Version General Information About Cervical Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) depends on ...

  17. One stage solution and posterior fusion surgery through the high anterior cervical retropharyngeal approach for irreducible atlantoaxial dislocation%一期前方咽后入路松解后路融合治疗难复性寰枢椎脱位

    Institute of Scientific and Technical Information of China (English)

    徐峰; 蔡贤华; 陈庄洪; 康辉; 黄勇

    2011-01-01

    Objective To explore the feasibility of one stage solution and posterior fusion surgery through the high anterior cervical retropharyngeal approach for irreducible atlantoaxial dislocation and its curative effect. Method The solution and posterior fusion surgery was performed in 12 patients (age range, 26~58 years; mean age, 46 years) with irreducible atlantoaxial dislocation, of whom, 8 were males and 4 females. All the patients received skull traction and the translocation and rotation of the atlas were assessed by X-ray, MRI and CT three-dimensional reconstruction before the surgery in all the patients. The articular capsules of articulatio atlantoepistrophicas were exposed and the scar tissue and steophyma were resected by the surgery. With continuous skull traction, the atlas was reduced and fixed with pedicle screws and the atlantoaxial fusion was performed by iliac bone graft during one stage surgery. Japanese orthopaedic Association (JOA) score system was used to evaluate the clinical outcomes before the surgery and 12 months after the surgery. Results All the patients were followed up from 12 to 28 months (mean, 18 months). Hypoglossal palsy occurred in one patient, who recovered from hypoglosed palsy 2 months after the surgery. The nerves, vertebral arteries and esophagus injuries, and leakage of cerebrospinal fluid were not observed in all the patients. JOA score [(15.6±l.l)points] was significantly higher 12 months after the surgery than that [(9.3±l.l)points] before the surgery (P<0.05). The grafted bones was well fused into the receptor bones and there was good internal fixation in all the patients. Conclusion The one stage solution and posterior fusion surgery through the high anterior cervical retropharyngeal approach is an effective method to treat the irreducible atlantoaxial dislocation.%目的 探讨一期颈椎前方高位咽后入路松解后路寰枢椎融合治疗难复性寰枢椎脱位的可行性及效果.方法 本组共收治

  18. Anterior transarticular screw fixation as a conventional operation for rigid stabilization

    OpenAIRE

    Manabu Sasaki; Katsumi Matsumoto; Koichiro Tsuruzono; Kazuhiro Yoshimura; Katsuhiko Shibano; Kazuo Yonenobu

    2014-01-01

    Background: Anterior transarticular screw (ATS) fixation is a useful surgical option for atlantoaxial (AA) stabilization. This report presents a revised ATS method for AA fusion. Methods: A 79-year-old male presented with AA instability attributed both to an old odontoid fracture and severe degeneration of the lateral atlantoaxial joints (LAAJs). ATS fixation was performed through the conventional anterior cervical approach. The longest screw trajectories were planned preoperatively using...

  19. Artificial cervical disc replacement: Principles, types and techniques

    Directory of Open Access Journals (Sweden)

    Sekhon L

    2005-01-01

    Full Text Available Cervical arthroplasty after anterior decompression with insertion of a prosthetic total disc replacement has been suggested as an alternate to anterior cervical fusion. Currently there are four cervical arthroplasty devices available on the market whose results in clinical use have been reported. Each device varies in terms of materials, range of motion, insertion technique and constraint. It is not known which device is ideal. Early studies suggest that in the short term, the complication rate and efficacy is no worse than fusion surgery. Long-term results have not yet been reported. This review examines the current prostheses available on the market as well as discussing issues regarding indications and technique. Pitfalls are discussed and early experiences reviewed. In time, it is hoped that a refinement of cervical arthroplasty occurs in terms of both materials and design as well as in terms of indications and clinical outcomes as spinal surgeons enter a new era of the management of cervical spine disease.

  20. 电针合谷和内关穴对颈椎前路手术后急性疼痛的影响%Electro Acupuncture on Hegu Point and Neiguan Point to Treat Acute Pain after Surgery on Anterior Cervical Spine

    Institute of Scientific and Technical Information of China (English)

    周伟; 陈耀雄; 区锦燕

    2014-01-01

    目的:观察电针合谷和内关穴对颈椎前路手术后急性疼痛的有效性和安全性。方法:选择因颈椎骨折入院,择期经颈前路行骨折切开复位内固定术的患者60例,随机分为电针组(30例)和药物组(30例)。电针组使用电针刺激合谷和内关穴,分别于术前30 min,手术结束缝皮时继续电针治疗。麻醉方式及用药两组相同。结果:1)平均动脉压、心率变化:电针组术前、拔管前、拔管后平均动脉压、心率与术中比较P<0.01,拔管后与拔管前比较P>0.05。药物组拔管后与拔管前比较平均动脉压P<0.01,心率P<0.05。2)意识恢复,拔管时间:电针组明显短于药物组,组间比较差异有统计学意义P<0.01。3)对两组患者拔管即刻,拔管后2 h,4 h,8 h,12 h,24 h进行VAS和Ramsay评分显示,电针组在拔管后4 h内镇痛镇静优于药物组,差异有统计学意义P<0.05,拔管后2 h内镇痛差异有统计学意义P<0.01。药物组6例发生恶心、呕吐、便秘等不良反应,电针组1例。术后24 h PCA按压次数药物组共计116次,电针组21次,两组比较差异有统计学意义P<0.05。结论:电针刺激合谷和内关穴可有效减轻颈椎手术后急性疼痛,患者血流动力学平稳,意识恢复和拔管时间短,苏醒快,镇痛效果显著,不良反应降低,提高了手术安全性。%Objective:To observe the effectiveness and safety of electro acupuncture on Hegu point and Neiguan point to treat acute pain after surgery on anterior cervical spine .Methods:Sixty patients with cervical spine fracture who were about to be given relocation and in -ternal fixation were randomly divided into electro acupuncture group (n=30) and drug group (n=30).Patients in electro acupuncture group were given electro acupuncture on Neigu point and Neiguan point 30 mins before the surgery and after surgery being sutured .The anesthesia

  1. Acupoints for cervical spondylosis

    OpenAIRE

    Zhu, Jihe; Arsovska, Blagica; Vasileva, Dance; Petkovska, Sofija; Kozovska, Kristina

    2015-01-01

    Cervical spondylosis is a chronic degenerative condition of the cervical spine that affects the vertebral bodies and intervertebral disks of the neck, as well as the contents of the spinal canal. This is one of the most common degenerative disorders of the spine. The disease can be symptomatic and asymptomatic. Symptoms that are distinctive for cervical spondylosis are: tingling, numbness and weakness in the limbs, lack of coordination, stiff neck, shoulder pain, occipital pain, vertigo, poor...

  2. Tuina treatment in cervical spondylosis

    OpenAIRE

    Florin Mihai Hinoveanu

    2010-01-01

    Cervical spondylosis is a common, chronic degenerative condition of the cervical spine that affects the vertebral bodies and intervertebral disks of the neck as well as the contents of the spinal canal. Common clinical syndromes associated with cervical spondylosis include cervical pain, cervical radiculopathy and/or mielopathy. This study show the main principles, indication and side effects of tuina in cervical spondylosis´ treatment; tuina is one of the external methods based on the princ...

  3. Anterior knee pain

    Science.gov (United States)

    Patellofemoral syndrome; Chondromalacia patella; Runner's knee; Patellar tendinitis; Jumper's knee ... or playing soccer). You have flat feet. Anterior knee pain is more ... skiers, bicyclists, and soccer players who exercise often ...

  4. Anterior knee pain

    Science.gov (United States)

    ... or playing soccer). You have flat feet. Anterior knee pain is more common in: People who are overweight People who have had a dislocation, fracture, or other injury to the kneecap Runners, jumpers, ...

  5. Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI

    International Nuclear Information System (INIS)

    A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass from

  6. Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Seok Nam [Kwandong Univ. College of Medicine, Seoul (Korea, Republic of)

    2012-09-15

    A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass

  7. Surgical Management of Subaxial Cervical Spine Trauma: A Case Report

    Directory of Open Access Journals (Sweden)

    Hasan Emre Aydın

    2015-04-01

    Full Text Available These days, as a consequence of the improvement in technology and increase in the use of motor vehicles, spine injuries have become common. Spine traumas, which often occur after motor vehicle accidents, are observed mostly in cervical regions, particularly in the subaxial cervical region, which is also known as the subcervical region, and neurological damage occurs in 70% of the patients. Despite still being controversial, the common ranging for neurological evaluation is the American Spinal Injury Association ranging, which includes the motor and sensory loss and accordingly, the impairment rate. In subaxial cervical traumas, acute neurological deterioration is an indication and therefore requires urgent surgical treatment. The choice of anterior or posterior approach substantially depends on the traumatization mechanism, affected tissues, and neurological deterioration occurring after. The state of patient and instability are the most two important factors affecting the treatment decision. Although the anterior approach is accepted as a routinely available and easily applicable surgical technique, it lacks in the burst fractures involving the three colons, which shows a stabilization disorder. The anterior plate screw technique and posterior lateral mass screw application applied in our clinic are reviewed in literature and are discussed in two cases. Although the best clinical results are achieved in cases where only anterior surgery is performed and in cases where instability is excessive, in unstable compression and blow-out fractures, even if neurological deficit and three colon involvement are not observed in the patient, the requirement of posterior fusion is observed.

  8. CLINICOPATHOLOGICAL STUDY OF CERVICAL LYMPHADENOPATHY

    Directory of Open Access Journals (Sweden)

    Pradeep Kulal

    2015-07-01

    calls for meticulous attention, analysis and treatment FNAC is found to be a frontline investigation of choice with biopsy and histopathological examination done for con firmation. Most of the non - neoplastic lesions are medically curable with limited role for surgery. KEYWORDS : Cervical lymphadenopathy; FNAC; Histopathological examination .

  9. Pros, cons, and costs of INFUSE in spinal surgery

    OpenAIRE

    Nancy E Epstein

    2011-01-01

    Background: INFUSE (recombinant human bone morphogenetic protein-2 [rh-BMP-2]; Medtronic, Memphis, TN, USA) is approved by the Federal Drug Administration (FDA) only for use with the lumbar tapered fusion device (LT Cage; Medtronic) to perform single-level anterior lumbar interbody fusions (ALIF: L2-S1 levels). INFUSE, however, is widely utilized in an “off-label” capacity for anterior and/or posterior cervical, thoracic, and lumbar surgery. Nevertheless, Medicare and other insurance companie...

  10. Intradural tumor and concomitant disc herniation of cervical spine

    Directory of Open Access Journals (Sweden)

    Mihir R Bapat

    2011-01-01

    Full Text Available We report a rare patient of a simultaneous extradural and intradural compression of the cervical spinal cord due to co-existent intervertebral disc herniation and an intradural schwannoma at the same level. The intradural lesion was missed resulting in recurrence of myelopathy after a surprisingly complete functional recovery following anterior cervical discectomy. Retrospectively, it was noted that the initial cord swelling noticed was tumor being masked by the compression produced by the herniated disc. A contrast magnetic resonance imaging scan is important in differentiating intradural tumors of the spinal cord. A high index of suspicion is often successful in unmasking both the pathologies.

  11. Cervical neurofibromatosis with quadriparesis: Management by fibular strut graft

    Directory of Open Access Journals (Sweden)

    Laohacharoensombat Wichien

    2010-01-01

    Full Text Available This is a case report of an eight-year old boy with neurofibromatosis and a 120º dystrophic kyphosis of the cervical spine. He presented with progressive quadriparesis caused by spondyloptosis of the C2/C3, and was successfully treated by skull traction and one-stage anterior fibular strut graft lying between the tubercle of the atlas through the C2 body slot and lower vertebrae. At seven years follow-up there was, loosening of lower vertebral screws which allowed growth and residual mobility of lower vertebral joints while the fusion of upper cervical spines was still solid.

  12. Novel Intraoperative Technique to Visualize the Lower Cervical Spine: A Case Series.

    Science.gov (United States)

    Rauck, Ryan; Stammen, Kari; Yu, Elizabeth; Khan, Safdar N

    2016-02-01

    Visualization of the lower cervical spine with a lateral radiograph poses a challenge secondary to encroachment of the shoulders. Applying traction to the arms or taping the shoulders down provides adequate visualization in most patients, but imaging the mid- to lower cervical levels presents a significant challenge in patients with stout necks. We present a variation of the lateral radiograph that is 30º oblique from horizontal and 30º cephalad from neutral and used in a series of patients with stout necks that require anterior instrumentation of the lower cervical spine. We reviewed intraoperative images of 2 patients who underwent anterior cervical spine surgery at our institution, and assessed type of procedure, body mass index, and outcome scores. Our variation provided improved visualization relative to a lateral view and was used intraoperatively to confirm correct-level hardware placement in both patients. PMID:26866322

  13. Clinical and radiologic comparison of dynamic cervical implant arthroplasty and cervical total disc replacement for single-level cervical degenerative disc disease.

    Science.gov (United States)

    Shichang, Liu; Yueming, Song; Limin, Liu; Lei, Wang; Zhongjie, Zhou; Chunguang, Zhou; Xi, Yang

    2016-05-01

    Anterior cervical discectomy and fusion, to date the most successful spine procedure for the surgical treatment of cervical radiculopathy, has limitations that have led to the development of non-fusion cervical procedures, such as cervical total disc replacement (TDR) and dynamic cervical implant (DCI) arthroplasty. We compared the clinical and radiological results of DCI and cervical TDR for the treatment of single-level cervical degenerative disc disease in Chinese patients. A retrospective review of 179 patients with cervical spondylotic myelopathy who underwent DCI or TDR between April 2010 and October 2012 was conducted, and 152 consecutive patients (67 patients single-level DCI and 85 single-level TDR) who completed at least 2years of follow-up were included. Clinical and radiological assessments were performed preoperatively and at 1week and 3, 6, 12, and 24months postoperatively. The most common operative level was C5/C6 (49.3%). The differences in blood loss, duration of surgery, and duration of hospitalization were not statistically significant. The Japanese Orthopaedic Association scale, Visual Analog Scale, Neck Disability Index, and Short Form-36 scores improved significantly after surgery in both the DCI and TDR groups (P<0.05), but the differences were not statistically significant at the final follow-up. The rate of occurrence of heterotopic ossification was 22.4% and 28.2% in the DCI and TDR groups, respectively. As an effective non-fusion technique, DCI is a more economical procedure. Further prospective, randomized studies with long-term follow-up periods are needed to determine the long-term effects. PMID:26928156

  14. CDC's Cervical Cancer Study

    Science.gov (United States)

    ... in Cancer Moonshot Stay Informed CDC’s Cervical Cancer Study Language: English Español (Spanish) Recommend on Facebook Tweet ... year. As part of CDC’s Cervical Cancer (Cx3) Study, we surveyed a sample of both health care ...

  15. Cervical cancer and the HPV link: identifying areas for education in Mexico City's public hospitals El cáncer cervicouterino y su relación con el VPH: identificación de temas de actualización en hospitales públicos de la Ciudad de México

    Directory of Open Access Journals (Sweden)

    Tess Aldrich

    2006-06-01

    Full Text Available OBJECTIVE:To assess Mexico City physicians' knowledge and practices regarding cervical cancer and human papillomavirus (HPV to compare obstetricians/gynecologists (ob/gyns and general practitioners (GPs on these variables MATERIAL AND METHODS: In April 2003, 187 ob/gyns and GPs working in 15 hospitals affiliated with the Federal District Secretary of Health (SSDF completed a self-administered questionnaire. Pearson's chi-square tests were used to compare ob/ gyns and GPs on outcome variables RESULTS: Nearly all providers (93% identified HPV as the principal cause of cervical cancer. Ob/gyns had more detailed knowledge about HPV than GPs and were more likely to have heard of common oncogenic strains (p=.000. Sixteen percent of all physicians incorrectly stated that Pap tests should be performed every six months regardless of previous results, and 17% recommended hysterectomy as an option for treating mild or moderate dysplasia CONCLUSIONS: While SSDF physicians had basic knowledge about the cervical cancer-HPV link, screening and management norms are priority areas for educational interventions.OBJETIVO: Evaluar el conocimiento y las prácticas de los proveedores de servicios de salud en la Ciudad de México sobre el cáncer cervicouterino y el virus del papiloma humano (VPH; comparar a este respecto a ginecoobstetras (GO y médicos generales (MG MATERIAL Y MÉTODOS: En abril del 2003, 187 GO y MG empleados en 15 hospitales afiliados a la Secretaría de Salud del Distrito Federal (SSDF completaron un cuestionario autoaplicado. Se utilizó la prueba de ji cuadrada de Pearson para evaluar las diferencias entre GO y MG RESULTADOS: Casi todos los participantes (93% identificaron el VPH como la causa principal del cáncer cervicouterino. Los GO mostraron un conocimiento más detallado del VPH que los MG, con más probabilidad de haber escuchado de las cepas oncogénicas comunes del VPH (p= 0.000. Un 16% de los médicos contestó incorrectamente que

  16. Posterior compact Cotrel-Dubousset instrumentation for occipitocervical, cervical and cervicothoracic fusion

    OpenAIRE

    Korovessis, Panagiotis; Katonis, Pavlos; Aligizakis, Agisilaos; Christoforakis, Josef; Baikousis, Andreas; Papazisis, Zisis; Petsinis, Giorgos

    2001-01-01

    The authors report on 32 consecutive patients with instability at the craniocervical, cervical and cervicothoracic regions suffering from various pathologies, who were treated with posterior instrumentation and fusion using the posterior hooks-rods-plate cervical compact Cotrel-Dubousset (CCD) instrumentation alone or, in three patients, in combination with anterior operation. The patients were observed postoperatively for an average of 31 months (range 25–44 months) and evaluated both clinic...

  17. Posterior approach for cervical fracture–dislocations with traumatic disc herniation

    OpenAIRE

    NAKASHIMA, HIROAKI; Yukawa, Yasutsugu; Ito, Keigo; Machino, Masaaki; El Zahlawy, Hany; Kato, Fumihiko

    2010-01-01

    In the treatment algorithm for cervical spine fracture–dislocations, the recommended approach for treatment if there is a disc fragment in the canal is the anterior approach. The posterior approach is not common because of the disadvantage of potential neurological deterioration during reduction in traumatic cervical herniation patients. However, reports about the frequency of this deterioration and the behavior of disc fragments after reduction are scarce. Forty patients with traumatic disc ...

  18. Cervical spine arthrodesis in rheumatoid arthritis: a long-term follow-up.

    OpenAIRE

    Krieg, J. C.; Clark, C. R.; Goetz, D. D.

    1993-01-01

    Forty-one patients with rheumatoid arthritis involving the cervical spine had a posterior cervical arthrodesis. They were followed for a minimum period of seven years. The diagnoses prior to surgery included cranial settling, atlantoaxial subluxation, subaxial subluxation, and any combination of these three. All patients had posterior arthrodesis, with or without methylmethacrylate, and iliac crest autogenous bone graft. In addition, one patient had an anterior vertebrectomy, and two had tran...

  19. Detección y seguimiento con inspección visual del cérvix para la prevención del cáncer cervicouterino en las zonas rurales de México Screening and follow-up for cervical cancer prevention in rural Mexico using visual inspection

    Directory of Open Access Journals (Sweden)

    Eduardo Pérez-Cruz

    2005-02-01

    Full Text Available OBJETIVO: Se comparan los nuevos métodos de detección de lesiones preneoplásicas del cérvix-inspección visual con ácido acético (IVAA e inspección visual con ácido acético y magnificación (IVAM con el aparato AviScopeMR- y el método tradicional de detección por citología. MATERIAL Y MÉTODOS: El estudio se llevó a cabo entre octubre de 1998 y diciembre de 2000, en dos zonas de la región de La Mixteca, en Oaxaca, México. El diseño de estudio fue de tipo ensayo comunitario. El IVAA correspondió a un brazo del estudio y el IVAM a otro; ambos métodos de detección se practicaron en mujeres que tenían entre 20 y 65 años de edad. Se incluyeron 2 240 mujeres en el brazo IVAA y 2 542 en el brazo IVAM. Las mujeres en las que la inspección visual dio un resultado positivo y una submuestra de las mujeres con resultado negativo, fueron referidas a colposcopía y, en caso de ser necesario, a biopsia de tejido cervicouterino. El análisis estadístico se presenta descriptivamente y los grupos se compararon con la prueba de Ji-cuadrada. Se presentan además los resultados de los valores diagnósticos de IVAA e IVAM, comparados con el diagnóstico por colposcopía y biopsia. RESULTADOS: El método IVAM detectó un mayor porcentaje de mujeres identificadas con alguna anomalía (16.3% que el IVAA (3.4%, así como de mujeres normales (58.5% vs. 53.8%, respectivamente. Por otra parte, el método IVAA identificó a más mujeres con cambios benignos (41.2% que el IVAM (19.6%. Este último tuvo una mayor sensibilidad (p>0.05 y una menor especificidad (pOBJECTIVE: To compare the standard cervical cancer screening procedure -the Papanicolaou test or Pap smear- with detection through visual inspection using acetic acid (VIA, and visual inspection with acetic acid assisted by Aviscope (VIAM. MATERIAL AND METHODS: The study was conducted between October 1998 and December 2000, in two Mixteca regions in Oaxaca, Mexico. A field trial design was used to

  20. Congenital anterior urethral diverticulum.

    Science.gov (United States)

    Singh, Sanjeet Kumar; Ansari, Ms

    2014-09-01

    Congenital anterior urethral diverticulum (CAUD) may be found all along the anterior urethra and may present itself at any age, from infant to adult. Most children with this condition present with difficulty in initiating micturition, dribbling of urine, poor urinary stream, or urinary tract infection. A careful history will reveal that these children never had a good urinary stream since birth, and the telltale sign is a cystic swelling of the penile urethra. In this paper, we present two cases of CAUD that were managed by excision of the diverticulum with primary repair. PMID:26328174

  1. Abnormal Cervical Cancer Screening Test Results

    Science.gov (United States)

    ... AQ FREQUENTLY ASKED QUESTIONS FAQ187 GYNECOLOGIC PROBLEMS Abnormal Cervical Cancer Screening Test Results • What is cervical cancer screening? • What causes abnormal cervical cancer screening test ...

  2. Post-traumatic cervical spondyloptosis: A rare entity with multiple management options.

    Science.gov (United States)

    Padwal, A; Shukla, D; Bhat, D I; Somanna, S; Devi, B I

    2016-06-01

    Post-traumatic cervical spondyloptosis is a rare condition associated with high energy injuries, and to our knowledge only case reports are available. There are no universally accepted treatment paradigms for these cases and management is individualised according to the case and surgeon preference. We retrospectively analysed our management and clinical outcomes of this condition. From January 2007 to August 2014 we treated eight patients with cervical spondyloptosis at our institute. Only two patients had no neurological deficits; all the remaining patients had partial cord injury. Seven were treated surgically with preoperative traction followed by anterior cervical discectomy and fusion with fixation in three patients, and combined anterior and posterior fusion and fixation in four. Depending on the presence of anterior compression by a disc an anterior first or posterior first approach was advocated. All four combined anterior and posterior fusion and fixation patients needed to be turned more than once (540°). There was no neurological deterioration in any of the patients, as they either improved or remained stable neurologically. Post-traumatic cervical spondyloptosis is a challenging entity to manage. Surgery can be done safely with good clinical and radiological outcome and needs to be tailored to the individual patient. PMID:26922508

  3. Comparative experimental biomechanical study of different types of stabilization methods of the lower cervical spine.

    Science.gov (United States)

    Kalff, R; Ulrich, C; Claes, L; Wilke, H J; Grote, W

    1992-01-01

    In a comparative experimental biodynamic study using thirty-two human cervical spines of cadavers the primary stabilization effect of different types of spondylodesis was examined. Whereas in flexion stress all methods showed a sufficient stability, the rotation tests proved, that in case of a dorsal instability of the lower cervical spine, posterior interlaminar wiring or anterior plate stabilization showed no reliable stabilization effect. However, the compression clamps by ROOSEN and TRAUSCHEL as well as the hook-plates by MAGERL are suitable dorsal stabilization methods with excellent rotation stability. In case of dorsal instability of the lower cervical spine a posterior spondylodesis is necessary and sufficient. PMID:1480272

  4. Plicae palmatae of the cervical canals in uterus didelphys: MR imaging.

    Science.gov (United States)

    Takahata, Akiko; Koyama, Takashi

    2012-10-01

    The plicae palmatae are normal endocervical folds on the anterior and posterior walls. The median longitudinal ridges of the plicae palmatae have been considered to represent a remnant of fused Müllerian ducts. We present a case of uterus didelphys in which the longitudinal ridge of the plicae palmatae were obviously demonstrated on both of the uterine cervices on axial T2-weighted image. The observation of the plicae palmatae on the duplicated uterine cervices indicates the plicae palmatae is an inherent structure of the cervical canal, not a remnant of fused Müllerian duct. PMID:22160342

  5. MRI and PET Imaging in Predicting Treatment Response in Patients With Stage IB-IVA Cervical Cancer

    Science.gov (United States)

    2016-06-24

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Cervical Undifferentiated Carcinoma; Recurrent Cervical Carcinoma; Stage IB2 Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer

  6. Acute monoplegia associated with non-traumatic intradural cervical disc herniation:

    Directory of Open Access Journals (Sweden)

    Ahmet Menkü

    2014-03-01

    Full Text Available Intradural disc herniation has been reported as a rare and particular type of intervertebral disc herniation. It occurs mostly in the lumbar spine, and rarely in the cervical or thoracic spine. Non-traumatic cervical intradural disc herniation is rare, with only 17 cases reported in English literature at the cervical region and can manifest itself by severe symptoms such as Brown-Sequard syndrome, transverse myelopathy and radiculopathy. We present a unique case of intradural cervical disc herniation only causing lower extremity monoplegia. To our knowledge, this is the first case described in the literature. The patient underwent microsurgical removal of the herniated disc via an anterior approach followed by interbody fixation using a cervical cage. J Clin Exp Invest 2014; 5 (1: 112-114

  7. Laminoplasty Techniques for the Treatment of Multilevel Cervical Stenosis

    OpenAIRE

    Mitsunaga, Lance K.; Klineberg, Eric O.; Gupta, Munish C.

    2012-01-01

    Laminoplasty is one surgical option for cervical spondylotic myelopathy. It was developed to avoid the significant risk of complications associated with alternative surgical options such as anterior decompression and fusion and laminectomy with or without posterior fusion. Various laminoplasty techniques have been described. All of these variations are designed to reposition the laminae and expand the spinal canal while retaining the dorsal elements to protect the dura from scar formation ...

  8. Evaluation of characteristics and surgical outcomes in cervical spondylotic amyotrophy

    Directory of Open Access Journals (Sweden)

    Hong-Li Wang

    2014-01-01

    Full Text Available Background: Cervical spondylotic amyotrophy (CSA is a rare clinical syndrome resulting from cervical spondylosis. Surgical treatment includes anterior cervical decompression and fusion (ACDF, and laminoplasty with or without foraminotomy. Some studies indicate that ACDF is an effective method for treating CSA because anterior decompression with or without medial foraminotomy can completely eliminate anterior and/or anterolateral lesions. We retrospectively evaluated outcome of surgical outcome by anterior cervical decompression and fusion (ACDF. Materials and Methods: 28 CSA patients, among whom 12 had proximal type CSA and 16 had distal type CSA, treated by ACDF, were evaluated clinicoradiologically. The improvement in atrophic muscle power was assessed by manual muscle testing (MMT and the recovery rate of the patients was determined on the basis of the Japanese Orthopedic Association (JOA scores. Patient satisfaction was also examined. Results: The percentage of patients, who gained 1 or more grades of muscle power improvement, as determined by MMT, was 91.7% for those with proximal type CSA and 37.5% for those with distal type CSA (P < 0.01. The JOA score-based recovery rates of patients with proximal type and distal type CSA were 60.8% and 41.8%, respectively (P < 0.05. Patient satisfaction was 8.2 for those with proximal type CSA and 6.9 for those with distal type CSA (P < 0.01. A correlation was observed among the levels of improvement in muscle power, JOA score based recovery rate, patient satisfaction and course of disease (P < 0.05. Conclusion: ACDF can effectively improve the clinical function of patients with CSA and result in good patient satisfaction despite the surgical outcomes for distal type CSA being inferior to those for proximal type CSA. Course of disease is the fundamental factor that affects the surgical outcomes for CSA. We recommend that patients with CSA undergo surgical intervention as early as possible.

  9. Therapeutic strategy for traumatic instability of subaxial cervical spine

    Institute of Scientific and Technical Information of China (English)

    CAO Peng; LIANG Yu; GONG Yao-cheng; ZHENG Tao; ZHANG Xin-kai; WU Wen-jian

    2008-01-01

    Background A simple, safe and effective therapeutic strategy for traumatic instability of the subaxial cervical spine, as well as its prognostic assessment, is still controversial.Methods The therapeutic options for 83 patients of traumatic instability of the subaxial cervical spine, whose average age was 35 years, were determined, according to the Allen-Ferguson classification, general health and concomitant traumatic conditions, neurological function, position of compression materials, concomitant traumatic disc herniation/damage, concomitant locked-facet dislocation, the involved numbers and position, and the patients' economic conditions. An anterior, posterior or combination approach was used to decompress and reconstruct the cervical spine. No operations with an anterior-posterior-anterior approach were performed.Results The average follow-up was three years and nine months. Distraction-flexion and compression-flexion were the most frequent injury subtypes. There were 46, 28 and 9 cases of anterior, posterior and combination operations, respectively. The average score of the Japanese Orthopaedics Association, visual analog scale and American Spinal Cord Injury Association (ASIA) motor index improved from 11.2, 7.8 and 53.5, respectively, before operation, to 15.3, 2.6 and 67.8, respectively, at final follow-up. For incomplete spinal cord injury (SCI), the average ASIA neurological function scale was improved by 1-2 levels. Patients with complete SCI had no neurological recovery, but recovery of nerve root function occurred to different extents. After surgery, radiological parameters improved to different extents. Fusion was achieved in all patients and 12 developed complications.Conclusions The best surgical strategy should be determined by the type of subaxial cervical injury, patients' general health, local pathological anatomy and neurological function.

  10. Operative treatment via anterior approaches for cervicothoracic vertebrae tumors: surgical techniques and primary outcome

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To sum up 7 patients with cervicothoracic vertebrae tumors (C7 to T3) from March 1999 and May 2002, who underwent operative treatment via anterior approaches. Methods :The anterior approaches included low anterior cervical approach and high transthoracic approach. In 5 cases of segments of T1 and above involved, the low anterior cervical approaches were adopted, otherwise the high transthoracic approaches were used(2 cases). Excision of tumor was carried out according to demands of the Weinstein-Boriani-Biagini (WBB) staging system. Spine stability was reconstructed by bone autografting and instrumentation. There were 4 cases of primary tumor and 3 of metastases. Their mean age was 45.1 years (23 to 66). The mean follow up was 18.9 months (3 to 45). Results were evaluated by occurrence of complications, improvement of symptoms, local recurrence and mortality. Results: All patients stood surgery well. No significant complications occurred during and after operation. Local pain was significantly alleviated and neurological deficit was improved at least one Frankel grade. Three patients died.Local tumor control was obtained in 6 patients (85.7 %) until the end of follow-up. Conclusion:Our experience showed that via low anterior cervical approach and high transthoracic approach, the cervicothoracic vertebrae tumor could be excised safely and adequately. Moreover, excision of tumor according to the WBB surgical staging system and reconstruction of spine stability have made great contribution to local tumor control and the neurological function improvement.

  11. Anterior vaginal wall repair

    Science.gov (United States)

    ... symptoms will go away. This improvement will often last for years. Alternative Names A/P repair; Vaginal wall repair; Anterior and/ ... writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Contact ... Institutes of Health Page last updated: 23 August 2016

  12. [Toxic anterior segment syndrome].

    Science.gov (United States)

    Cornut, P-L; Chiquet, C

    2011-01-01

    Toxic anterior segment syndrome (TASS) is a general term used to describe acute, sterile postoperative inflammation due to a non-infectious substance that accidentally enters the anterior segment at the time of surgery and mimics infectious endophthalmitis. TASS most commonly occurs acutely following anterior segment surgery, typically 12-72h after cataract extraction. Anterior segment inflammation is usually quite severe with hypopyon. Endothelial cell damage is common, resulting in diffuse corneal edema. No bacterium is isolated from ocular samples. The causes of TASS are numerous and difficult to isolate. Any device or substance used during the surgery or in the immediate postoperative period may be implicated. The major known causes include: preservatives in ophthalmic solutions, denatured ophthalmic viscosurgical devices, bacterial endotoxin, and intraocular lens-induced inflammation. Clinical features of infectious and non-infectious inflammation are initially indistinguishable and TASS is usually diagnosed and treated as acute endophthalmitis. It usually improves with local steroid treatment but may result in chronic elevation of intraocular pressure or irreversible corneal edema due to permanent damage of trabecular meshwork or endothelial cells. PMID:21176994

  13. Satisfacción de los pacientes con cervicalgia y lumbalgia en un servicio de rehabilitación Satisfaction of patients with cervical pain and low back pain in a rehabilitation service

    OpenAIRE

    M. A. González Viejo; Oyarzabal, A.; Z. Fernández Fernández de Leceta; J. Rotinen; N. Arrizabalaga; E. Ibáñez de Garayo

    2005-01-01

    Fundamento. Son objetivos del presente trabajo: reducir el tiempo de espera para iniciar tratamiento de pacientes con lumbalgia/cervicalgia; conocer el grado de satisfacción de los pacientes al ser tratados mediante terapia en grupo; y determinar si existe correlación entre la satisfacción global, mejora del dolor e impacto sobre las actividades de la vida diaria. Material y métodos. Estudio prospectivo observacional. Población a estudio: usuarios de las consultas de un hospital terciario y d...

  14. Brief communication: The distribution of perikymata on Qafzeh anterior teeth.

    Science.gov (United States)

    Guatelli-Steinberg, Debbie; Reid, Donald J

    2010-01-01

    Recent studies have suggested that Neandertals and modern humans differ in the distribution of perikymata (enamel growth increments) over their permanent anterior tooth crowns. In modern humans, perikymata become increasingly more compact toward the cervix than they do in Neandertals. Previous studies have suggested that a more homogeneous distribution of perikymata, like that of Neandertals, characterizes the anterior teeth of Homo heidelbergensis and Homo erectus as well. Here, we investigated whether Qafzeh anterior teeth (N = 14) differ from those of modern southern Africans, northern Europeans, and Alaskans (N = 47-74 depending on tooth type) in the percentage of perikymata present in their cervical halves. Using the normally distributed modern human values for each tooth type, we calculated Z-scores for the 14 Qafzeh teeth. All but two of the 14 Qafzeh teeth had negative Z-scores, meaning that values equal to these would be found in the bottom 50% of the modern human samples. Seven of the 14 would be found in the lowest 5% of the modern human distribution. Qafzeh teeth therefore appear to differ from those of modern humans in the same direction that Neandertals do: with generally lower percentages of perikymata in their cervical regions. The similarity between them appears to represent the retention of a perikymata distribution pattern present in earlier members of the genus Homo, but not generally characteristic of modern humans from diverse regions of the world. PMID:19902531

  15. Immunotherapy for Cervical Cancer

    Science.gov (United States)

    In an early phase NCI clinical trial, two patients with metastatic cervical cancer had a complete disappearance of their tumors after receiving treatment with a form of immunotherapy called adoptive cell transfer.

  16. Screening for Cervical Cancer

    Science.gov (United States)

    ... cervical cancer: • Cytology: This test, also called a Pap test or Pap smear, looks for abnormal changes in cells in ... women ages 21 to 65, screening with a Pap test every 3 years has the highest benefits ...

  17. Anterior cruciate ligament (ACL) injury

    Science.gov (United States)

    Cruciate ligament injury - anterior; ACL injury; Knee injury - anterior cruciate ligament (ACL) ... confirm the diagnosis. It may also show other knee injuries. First aid for an ACL injury may include: ...

  18. Cervical motion segment replacement

    OpenAIRE

    Bryan, Vincent E.

    2002-01-01

    When symptoms bring to light a cervical spine degenerative disc process that requires surgical intervention, a symptom relieving procedure such as decompression, followed by functional restoration, arthroplasty, offers the benefit of prophylaxis of accelerated spondylosis at the operated level. In addition, by altering the biomechanical stress factors at adjacent levels, theoretically it should offer prophylactic benefit at these levels as well. The design requirements for a cervical disc pro...

  19. Anterior Cruciate Ligament Injury

    OpenAIRE

    Vilaseca, Tomas; Chahla, Jorge; Rodriguez, Gustavo Gomez; Arroquy, Damián; Herrera, Gonzalo Perez; Orlowski, Belen; Carboni, Martín

    2015-01-01

    Objectives: The objective of this study was to analyze whether it is more frequent the presence of a decreased range of motion in the hips of recreational athletes with primary injury of the anterior cruciate ligament (ACL) than in a control group of volunteers without knee pathology. Methods: We included prospectively recreational athletes between 18 and 40 years with an acute ACL injury between January 2011 and January 2013. They were compared with a control group of volunteers recreational...

  20. Efecto de la suplementación con antioxidantes sobre el estrés oxidativo y la calidad de vida durante el tratamiento oncológico en pacientes con cáncer cérvico uterino Effect of antioxidant supplementation over oxidative stress and quality of life in cervical cancer

    OpenAIRE

    V. Fuchs-Tarlovsky; M. Bejarano-Rosales; G. Gutiérrez-Salmeán; M.ª A. Casillas; J. C. López-Alvarenga; G. M. Ceballos-Reyes

    2011-01-01

    Introducción: En México el cáncer cérvico uterino representa un grave problema de salud pública. El tratamiento depende de su extensión; para los estadios iniciales, cirugía y para los localmente avanzados combinación de quimioterapia con cisplatino y radioterapia. Ambas terapias producen estrés oxidativo a nivel celular. Todo este proceso afecta el consumo de antioxidantes naturales y la calidad de vida. Objetivo: Conocer el efecto que tiene la suplementación con antioxidantes (β-carote...

  1. Lesiones del ligamento cruzado anterior

    Directory of Open Access Journals (Sweden)

    Alejandro Álvarez López

    2015-01-01

    Full Text Available Fundamento: el ligamento cruzado anterior desempeña un papel muy importante en la estabili-dad de la rodilla. La incidencia de esta afección es alta en pacientes que practican deportes de contacto y de no ser tratados de forma adecuada, los resultados son desfavorables. Objetivo: profundizar en los factores necesarios para el tratamiento adecuado de enfermos con esta lesión y evitar las complicaciones. Método: se realizó una revisión bibliográfica de un total de 300 artículos publicados en Pubmed, Hinari y Medline mediante el localizador de información Endnote, de ellos se utilizaron 52 citas selecciona-das para realizar la revisión, 48 de ellas de los últimos cinco años donde se incluyeron seis libros. Desarrollo: se discuten los aspectos relacionados con el diagnóstico clínico e imaginológico. Se aborda la clasificación de esta lesión en cuanto a varios aspectos como: tiempo, lesión de ligamentos u ósea, aislada o combinada y parcial o total. Se mencionan los parámetros para obtener resultados satisfac-torios al considerar factores como la edad del enfermo, lesiones asociadas y tiempo de la lesión. Se relacio-nan los requisitos para la selección del implante y se mostró las ventajas y desventajas de cada tipo de in-jerto. Las complicaciones de esta cirugía están relacionadas con la técnica quirúrgica y médicas. Conclusiones: las lesiones del ligamento son entidades traumáticas que afectan por lo general a pacientes jóvenes. Para lograr un resultado satisfactorio en el tratamiento es necesario el conocimiento de su anatomía, clasificación, tipo de injerto a emplear según sus ventajas y desventajas.

  2. Cost-effectiveness of conventional cytology and HPV DNA testing for cervical cancer screening in Colombia Costo-efectividad de la citología y la tamización con pruebas de ADN-VPH para cáncer de cuello uterino en Colombia

    OpenAIRE

    Oscar Andrés-Gamboa; Liliana Chicaíza; Mario García-Molina; Jorge Díaz; Mauricio González; Raúl Murillo; Mónica Ballesteros; Ricardo Sánchez

    2008-01-01

    OBJECTIVE: To assess cost-effectiveness of conventional cytology and HPV DNA testing for cervical-cancer screening in Colombia. MATERIAL AND METHODS: The National Cancer Institute of Colombia (NCIC) in 2007 developed a Markov model on the natural history of cervical cancer; no screening, conventional cytology, and HPV DNA testing were compared. Only direct costs were used. Outcomes comprise cervical cancer mortality, years of life saved, and lifetime costs. Discounted incremental cost-effecti...

  3. MRI of cervical spine injuries complicating ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Koivikko, Mika P.; Koskinen, Seppo K. [Helsinki Medical Imaging Center, Helsinki University Central Hospital, Toeoeloe Hospital, Department of Radiology, Helsinki (Finland)

    2008-09-15

    The objective was to study characteristic MRI findings in cervical spine fractures complicating ankylosing spondylitis (AS). Technical issues related to MRI are also addressed. A review of 6,774 consecutive cervical spine multidetector CT (MDCT) scans obtained during 6.2 years revealed 33 ankylosed spines studied for suspected acute cervical spine injury complicating AS. Of these, 20 patients also underwent MRI. On MRI, of these 20 patients, 19 had a total of 29 cervical and upper thoracic spine fractures. Of 20 transverse fractures traversing both anterior and posterior columns, 7 were transdiskal and exhibited less bone marrow edema than did those traversing vertebral bodies. One Jefferson's, 1 atlas posterior arch (Jefferson's on MDCT), 2 odontoid process, and 5 non-contiguous spinous process fractures were detectable. MRI showed 2 fractures that were undetected by MDCT, and conversely, MDCT detected 6 fractures not seen on MRI; 16 patients had spinal cord findings ranging from impingement and contusion to complete transection. Magnetic resonance imaging can visualize unstable fractures of the cervical and upper thoracic spine. Paravertebral hemorrhages and any ligamentous injuries should alert radiologists to seek transverse fractures. Multiple fractures are common and often complicated by spinal cord injuries. Diagnostic images can be obtained with a flexible multipurpose coil if the use of standard spine array coil is impossible due to a rigid collar or excessive kyphosis. (orig.)

  4. [Failed compression osteosynthesis of the dens axis treated by anterior C1-C2 transarticular stabilisation. Case report].

    Science.gov (United States)

    Kočiš, J; Kelbl, M

    2011-01-01

    We describe the case of an 80-year-old female patient who had undergone anterior C1-C2 transarticular stabilisation and was subsequently treated by the triple-screw method for failed compression osteosynthesis of a AO type III dens axis fracture. Key words: dens axis, upper cervical spine fracture, eldery, triple screw technique, anterior transarticular C1-C2 stabilisation. PMID:21729645

  5. Cervical cancer - screening and prevention

    Science.gov (United States)

    Cervical cancer is cancer that starts in the cervix. The cervix is the lower part of the uterus ( ... can do to decrease your chance of having cervical cancer. Also, tests done by your health care provider ...

  6. Failure of cervical arthroplasty in a patient with adjacent segment disease associated with Klippel-Feil syndrome

    Directory of Open Access Journals (Sweden)

    Ioannis D Papanastassiou

    2011-01-01

    Full Text Available Cervical arthroplasty may be justified in patients with Klippel-Feil syndrome (KFS in order to preserve cervical motion. The aim of this paper is to report an arthroplasty failure in a patient with KFS. A 36-year-old woman with KFS underwent two-level arthroplasty for adjacent segment disc degeneration. Anterior migration of the cranial prosthesis was encountered 5 months postoperatively and was successfully revised with anterior cervical fusion. Cervical arthroplasty in an extensively stiff and fused neck is challenging and may lead to catastrophic failure. Although motion preservation is desirable in KFS, the special biomechanical features may hinder arthroplasty. Fusion or hybrid constructs may represent more reasonable options, especially when multiple fused segments are present.

  7. Human Papillomavirus and Cervical Cancer

    OpenAIRE

    D. Jenkins(University of York, UK)

    2003-01-01

    Of the many types of human papillomavirus (HPV), more than 30 infect the genital tract. The association between certain oncogenic (high-risk) strains of HPV and cervical cancer is well established. Although HPV is essential to the transformation of cervical epithelial cells, it is not sufficient, and a variety of cofactors and molecular events influence whether cervical cancer will develop. Early detection and treatment of precancerous lesions can prevent progression to cervical cancer. Ident...

  8. Cervical facet dislocation adjacent to the fused motion segment

    Directory of Open Access Journals (Sweden)

    Kunio Yokoyama

    2016-01-01

    Full Text Available This study reports on a case that forces re-examination of merits and demerits of anterior cervical fusion. A 79-year-old male was brought to the emergency room (ER of our hospital after he fell and struck the occipital region of his head following excessive alcohol consumption. Four years prior, he had undergone anterior cervical discectomy and fusion of C5/6 and a magnetic resonance imaging (MRI performed 3 years after this surgery indicated that he was suffering from degeneration of C6/7 intervertebral discs. After arriving at the ER, he presented motor impairment at level C7 and lower of manual muscle testing grade 1 as well as moderate loss of physical sensation from the trunk and peripheries of both upper limbs to the peripheries of both lower limbs (Frankel B. Cervical computed tomography (CT indicated anterior dislocation of C6/7, and MRI indicated severe spinal cord edema. We performed manipulative reduction of C6/7 with the patient under general anesthesia. Next, we performed laminectomy on C5-T1 and posterior fusion on C6/7. Postoperative CT indicated that ce