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Sample records for cervical interbody fusion

  1. 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

  2. Hydroxyapatite Ceramics in Multilevel Cervical Interbody Fusion – Is There a Role?

    OpenAIRE

    Vukić, Miroslav; Walters, Beverly C; Radić, Ankica; Jurjević, Ivana; Marasanov, Sergej M.; Rožanković, Marjan; Jednačak, Hrvoje

    2011-01-01

    The aim of this study is to evaluate the efficacy of hydroxyapatite grafts in multilevel cervical interbody fusion during the one year follow-up. A total of 86 patients with degenerative cervical disc disease underwent all together 224 cervical interbody fusion procedures in which either Smith-Robinson or Cloward type hydroxyapatite grafts were used. The surgeries included radiculopathy in 38 cases, myelopathy in 20 cases and myeloradicuopathy in 28 patients. In 65 out of 86 patients, fusion ...

  3. 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

  4. 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

  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. The design of a cervical vertebra titanium plate-interbody fusion cage

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To study the biomechanical feature of a newly designed cervical vertebra internal fixation device and its clinical applications Methods: Some functional spinal units were fixed respectively with titanium plate, fusion cage and new device designed by ourselves, then a controlled biomechanical study including flexion, extension, torsion and lateral bending was performed and the results were analyzed. Results: As to the mechanical performance, fusion cage showed poor performance in extension test and so did the titanium plate in the distortion test. However, the new device showed good performance in every test. Conclusion: Both simple titanium plate fixation and simple fusion cage fixation have biomechanical defaults, but they are complementary. The titanium plate-interbody fusion cage avoids the defaults and has specific advantages.

  7. Extreme Lateral Interbody Fusion Procedure

    Medline Plus

    Full Text Available ... for spine surgery called XLIF, extreme lateral interbody fusion. Dr. Juan Uribe will perform the procedure. Dr. ... A better term would be extreme lateral interbody fusion. This is a procedure that has been performed ...

  8. Lateral Lumbar Interbody Fusion.

    Science.gov (United States)

    Pawar, Abhijit; Hughes, Alexander; Girardi, Federico; Sama, Andrew; Lebl, Darren; Cammisa, Frank

    2015-12-01

    The lateral lumbar interbody fusion (LLIF) is a relatively new technique that allows the surgeon to access the intervertebral space from a direct lateral approach either anterior to or through the psoas muscle. This approach provides an alternative to anterior lumbar interbody fusion with instrumentation, posterior lumbar interbody fusion, and transforaminal lumbar interbody fusion for anterior column support. LLIF is minimally invasive, safe, better structural support from the apophyseal ring, potential for coronal plane deformity correction, and indirect decompression, which have has made this technique popular. LLIF is currently being utilized for a variety of pathologies including but not limited to adult de novo lumbar scoliosis, central and foraminal stenosis, spondylolisthesis, and adjacent segment degeneration. Although early clinical outcomes have been good, the potential for significant neurological and vascular vertebral endplate complications exists. Nevertheless, LLIF is a promising technique with the potential to more effectively treat complex adult de novo scoliosis and achieve predictable fusion while avoiding the complications of traditional anterior surgery and posterior interbody techniques. PMID:26713134

  9. 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 ...

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

    Directory of Open Access Journals (Sweden)

    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.    

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

    Directory of Open Access Journals (Sweden)

    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.

  12. 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.

  13. The VariLift® Interbody Fusion System: expandable, standalone interbody fusion

    Directory of Open Access Journals (Sweden)

    Emstad E

    2015-05-01

    Full Text Available Erik Emstad,1 Diana Cardenas del Monaco,1 Louis C Fielding,2 Jon E Block2 1Wenzel Spine, Inc., Austin, TX, 2The Jon Block Group, San Francisco, CA, USA Abstract: Intervertebral fusion cages have been in clinical use since the 1990s. Cages offer the benefits of bone graft containment, restored intervertebral and foraminal height, and a more repeatable, stable procedure compared to interbody fusion with graft material alone. Due to concerns regarding postoperative stability, loss of lordosis, and subsidence or migration of the implant, interbody cages are commonly used with supplemental fixation such as pedicle screw systems or anterior plates. While providing additional stability, supplemental fixation techniques increase operative time, exposure, cost, and morbidity. The VariLift® Interbody Fusion System (VariLift® system has been developed as a standalone solution to provide the benefits of intervertebral fusion cages without the requirement of supplemental fixation. The VariLift® system, FDA-cleared for standalone use in both the cervical and lumbar spine, is implanted in a minimal profile and then expanded in situ to provide segmental stability, restored lordosis, and a large graft chamber. Preclinical testing and analyses have found that the VariLift® System is durable, and reduces stresses that may contribute to subsidence and migration of other standalone interbody cages. Fifteen years of clinical development with the VariLift® system have demonstrated positive clinical outcomes, continued patient maintenance of segmental stability and lordosis, and no evidence of implant migration. The purpose of this report is to describe the VariLift® system, including implant characteristics, principles of operation, indications for use, patient selection criteria, surgical technique, postoperative care, preclinical testing, and clinical experience. The VariLift® System represents an improved surgical option for a stable interbody fusion without

  14. 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.

  15. Minimally invasive transforaminal lumbosacral interbody fusion.

    Science.gov (United States)

    Chang, Peng-Yuan; Wang, Michael Y

    2016-07-01

    In minimally invasive spinal fusion surgery, transforaminal lumbar (sacral) interbody fusion (TLIF) is one of the most common procedures that provides both anterior and posterior column support without retraction or violation to the neural structure. Direct and indirect decompression can be done through this single approach. Preoperative plain radiographs and MR scan should be carefully evaluated. This video demonstrates a standard approach for how to perform a minimally invasive transforaminal lumbosacral interbody fusion. The video can be found here: https://youtu.be/bhEeafKJ370 . PMID:27364426

  16. 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

    ). Preoperative and postoperative differences were statistically sigr:ifican (P<0.05). After operation there was no infection, recurrent laryngeal nerve, the superior laryngeal nerves arid the vertebral artery injury, incision healing period, no revision operation. Conclusion Zero—P zero incisura anterior cervical interbody fusion fixation system (ACIF) can make the fusion segment to obtain Immediate stability, high rate of fusion, the curative effect is satisfied, with less trauma, less risk of nerve Injury, can prevent adjacent segment of ossification, the advantages of easy to operate.

  17. 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

  18. ISASS Policy Statement - Cervical Interbody

    OpenAIRE

    Singh, Kern; Qureshi, Sheeraz

    2014-01-01

    Morgan Lorio, MD, FACS, Chair, ISASS Task Force on Coding & Reimbursement In 2011, CPT code 22551 was revised to combine or bundle CPT codes 63075 and 22554 when both procedures were performed at the same site/same surgical session. The add on code +22552 is used to report each additional interspace. 2014 heralded a downward pressure on this now prime target code (for non-coverage?) 22551 through an egregious insurer attempt to redefine cervical arthrodesis, effectively removing spine surgeon...

  19. 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...

  20. Contralateral radiculopathy after transforaminal lumbar interbody fusion

    OpenAIRE

    Hunt, Travis; Shen, Francis H.; Shaffrey, Christopher I.; Arlet, Vincent

    2007-01-01

    Transforaminal lumbar interbody fusion (TLIF) is an effective treatment for patients with degenerative spondylolisthesis and degenerative disc disease. Opposite side radiculopathy after the TLIF procedure has been recognized in this institution but has not been addressed in the literature. We present a case of opposite side radiculopathy after the TLIF procedure. We believe that this complication is related to asymptomatic stenosis on the contralateral side that is unmasked by the increased l...

  1. The early-to-mid treatment efficacy of applying ROI interbody fusion cage in cervical spondylotic myelopathy%双嵌式颈椎融合器治疗脊髓型颈椎病早中期效果

    Institute of Scientific and Technical Information of China (English)

    李战友; 潘兵; 阮立奇; 张志敬

    2015-01-01

    Objective:To observe the clinical effect and radiological outcomes of ROI interbody fusion cage in cervical spondylotic myelopathy. Methods:21 patients were treated with lumbar disc excision and cervical vertebra fusion with ROI cage trans anterior approach. Clinical effect was evaluated by Japanese Orthopaedic Association (JOA) score for cervical function.Each patient underwent cervical anteroposterior and lateral radiographs,CT scanning before operation,at 3 days,3 months,and 6 months after operation to assess fusion effect. Intervertebral height was measured. The time of operation,in-traoperative blood loss and complication relative to opration were recorded. Results:As time goes on,the score of JOA was increased gradually after operation,and patients were all cured after 6 months. The fusion rate was 100%. No complication was found. Conclusion:Favorable early and midterm outcomes may be yielded in patients with cervical spondylotic myelopathy treated by anterior cervical discectomy and fusion with ROI interbody fusion cage.%目的:评估双嵌式颈椎融合器(ROI-C)治疗脊髓型颈椎病的临床疗效及影像学效果. 方法:2012年5月-2013年6月我科应用颈椎压力固定器对21名患者行颈椎前路减压椎间盘切除椎体融合术.应用JOA功能评分评价临床疗效,并于术前,术后3d、术后3个月、术后6个月行常规X线正侧位片检查,评估椎体间融合情况及椎间高度,并记录每例病例手术时间、出血量及手术相关并发症情况. 结果:JOA评分随时间顺序逐渐升高,6个月内所有病例椎间全部融合,椎间高度在术后3 d即显著恢复,3个月内下降,术后6个月趋于稳定.在随访期间,未发生手术相关并发症.结论:应用双嵌式颈椎融合器治疗脊髓型颈椎病可在早中期达到较好的临床疗效.

  2. Comparison of low back fusion techniques: transforaminal lumbar interbody fusion (TLIF) or posterior lumbar interbody fusion (PLIF) approaches

    OpenAIRE

    Cole, Chad D; McCall, Todd D.; Meic H. Schmidt; Dailey, Andrew T

    2009-01-01

    The authors review and compare posterior lumbar interbody fusion (PLIF) with transforaminal lumbar interbody fusion (TLIF). A review of the literature is performed wherein the history, indications for surgery, surgical procedures with their respective biomechanical advantages, potential complications, and grafting substances are presented. Along with the technical advancements and improvements in grafting substances, the indications and use of PLIF and TLIF have increased. The rate of arthrod...

  3. Mini-open anterior lumbar interbody fusion.

    Science.gov (United States)

    Gandhoke, Gurpreet S; Ricks, Christian; Tempel, Zachary; Zuckerbraun, Brian; Hamilton, D Kojo; Okonkwo, David O; Kanter, Adam S

    2016-07-01

    In deformity surgery, anterior lumbar interbody fusion provides excellent biomechanical support, creates a broad surface area for arthrodesis, and induces lordosis in the lower lumbar spine. Preoperative MRI, plain radiographs, and, when available, CT scan should be carefully assessed for sacral slope as it relates to pubic symphysis, position of the great vessels (especially at L4/5), disc space height, or contraindication to an anterior approach. This video demonstrates the steps in an anterior surgical procedure with minimal open exposure. The video can be found here: https://youtu.be/r3bC4_vu1hQ . PMID:27364424

  4. Extreme Lateral Interbody Fusion Procedure

    Medline Plus

    Full Text Available ... fusion without cutting much of muscle, minimizing the trauma to the soft tissue. And these are different ... approach. You're fusing the spine with minimal trauma to the soft tissue, and that way the ...

  5. Extreme Lateral Interbody Fusion Procedure

    Medline Plus

    Full Text Available ... there, we just get access to the disk space and perform the fusion. And that's all done ... are placed to allow exposure to the disc space. This patient is suffering from severe lumbar spondylosis. ...

  6. Extreme Lateral Interbody Fusion Procedure

    Medline Plus

    Full Text Available ... done for many years, and it's considered a lumber -- it's considered a standard lumbar spine fusion. The ... spondylosis. Again, spondylosis means arthritis, which results in pain, nerve damage, and all of the above. So ...

  7. Extreme Lateral Interbody Fusion Procedure

    Medline Plus

    Full Text Available ... he should allow for bone fusion in both gaps, those little spaces. Okay, so the question is, ... just placed in there. Again, you see the gaps, these gaps have a reason they are there. ...

  8. Extreme Lateral Interbody Fusion Procedure

    Medline Plus

    Full Text Available ... with an open procedure, what we call a standard open procedure, it is always a potential for ... and it's considered a lumber -- it's considered a standard lumbar spine fusion. The difference is the approach, ...

  9. Extreme Lateral Interbody Fusion Procedure

    Medline Plus

    Full Text Available ... perform this operation. Of course, everything requires a learning curve. This is something that is done many ... space so we take advantage on the entire surface in order to obtain a good fusion. So ...

  10. Surgical Results of Lumbar Interbody Fusion Using Calcium Phosphate Cement

    OpenAIRE

    HIRASAWA, Motohiro; Mure, Hideo; Toi, Hiroyuki; Nagahiro, Shinji

    2014-01-01

    Clinical and radiological outcomes of lumbar interbody fusion using artificial fusion cages filled with calcium phosphate cements (CPCs) were retrospectively reviewed. Between 2002 and 2011, 25 patients underwent lumbar interbody fusion at Tokushima University Hospital, and 22 patients were enrolled in this study. Of these, 5 patients received autologous local bone grafts and 17 received CPC. Japan Orthopedic Association (JOA) score was used for clinical outcome assessments. Lumbar radiograph...

  11. Extreme Lateral Interbody Fusion Procedure

    Medline Plus

    Full Text Available ... for adequate fusion. And he's just double-checking. Quality control. The more that you check, the better you do a job, and that's basically the idea. And that's why you use fluoroscopy, that's why you have this many assistants, to make our life a lot easier in surgery. And again, he's ...

  12. Transforaminal lumbar interbody fusion vs. posterolateral instrumented fusion

    DEFF Research Database (Denmark)

    Christensen, A; Høy, K; Bünger, C;

    2014-01-01

    Long-lasting low back pain is an increasing problem, and for some patients surgery is the final option for improvement. Several techniques for spinal fusion are available and the optimal technique remains uncertain. The objective of this study was to assess the cost-effectiveness and cost......-utility of transforaminal lumbar interbody fusion (TLIF) compared to posterolateral instrumented fusion (PLF) from the societal perspective. 100 Patients were randomized to TLIF or PLF (51/49) and followed for 2 years. Cost data were acquired from national registers, and outcomes were measured using the Oswestry Disability...

  13. Relation between radiological assessment and biomechanical stability of lumbar interbody fusion in a large animal model

    NARCIS (Netherlands)

    R.J. Kroeze; A.J. van der Veen; B.J. van Royen; R.A. Bank; M.N. Helder; T.H. Smit

    2013-01-01

    Purpose To relate the progress of vertebral segmental stability after interbody fusion surgery with radiological assessment of spinal fusion. Methods Twenty goats received double-level interbody fusion and were followed for a period of 3, 6 and 12 months. After killing, interbody fusion was assessed

  14. Relation between radiological assessment and biomechanical stability of lumbar interbody fusion in a large animal model

    NARCIS (Netherlands)

    Kroeze, R. J.; van der Veen, A. J.; van Royen, B. J.; Bank, R. A.; Helder, M. N.; Smit, T. H.

    2013-01-01

    To relate the progress of vertebral segmental stability after interbody fusion surgery with radiological assessment of spinal fusion. Twenty goats received double-level interbody fusion and were followed for a period of 3, 6 and 12 months. After killing, interbody fusion was assessed radiographicall

  15. 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

  16. CHANGES IN RADIOGRAPHIC PARAMETERS AFTER MINIMALLY INVASIVE LUMBAR INTERBODY FUSION

    Directory of Open Access Journals (Sweden)

    Emiliano Vialle

    2015-12-01

    Full Text Available Objective : This study aims to evaluate changes in lumbosacral parameters after minimally invasive lumbar interbody fusion. The secondary aim was to evaluate whether interbody cage shape (crescent shaped or rectangular would influence the results. Method : Retrospective analysis of 70 patients who underwent one or two level lumbar interbody fusion through a minimally invasive posterolateral approach. This included midline preservation and unilateral facetectomy. Pre- and postoperative (three to six months postoperative radiographs were used for measuring lumbar lordosis (LL, segmental lordosis (SL at the level of interbody fusion, and sacral slope (SS. Further analyses divided the patients into Roussouly lumbar subgroups. Results : LL was significantly reduced after surgery (59o:39o, p=0.001 as well as the SS (33.8o:31.2o, p=0.05. SL did not change significantly (11.4:11.06, p=0.85. There were no significant differences when comparing patients who received crescent shaped cage (n=27 and rectangular cage (n=43. Hypolordotic patients (Roussouly types 1 and 2 had radiographic improvement in comparison to normolordotic and hyperlordotic groups (types 3 and 4. Conclusion : Minimally invasive lumbar interbody fusion caused reduction in lumbosacral parameters. Cage shape had no influence on the results.

  17. 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.

  18. Transforaminal lumbar interbody fusion: a safe technique with satisfactory three to five year results

    OpenAIRE

    Hackenberg, Lars; Halm, Henry; Bullmann, Viola; Vieth, Volker; Schneider, Marc; Liljenqvist, Ulf

    2005-01-01

    The unilateral transforaminal approach for lumbar interbody fusion as an alternative to the anterior (ALIF) and traditional posterior lumbar interbody fusion (PLIF) combined with pedicle screw instrumentation is gaining in popularity. At present, a prospective study using a standardized tool for outcome measurement after the transforaminal lumber interbody fusion (TLIF) with a follow-up of at least 3 years is not available in the current literature, although there have been reports on specifi...

  19. Complications and Morbidities of Mini-open Anterior Retroperitoneal Lumbar Interbody Fusion: Oblique Lumbar Interbody Fusion in 179 Patients

    OpenAIRE

    Silvestre, Clément; Mac-Thiong, Jean-Marc; Hilmi, Radwan; Roussouly, Pierre

    2012-01-01

    Study Design A retrospective study including 179 patients who underwent oblique lumbar interbody fusion (OLIF) at one institution. Purpose To report the complications associated with a minimally invasive technique of a retroperitoneal anterolateral approach to the lumbar spine. Overview of Literature Different approaches to the lumbar spine have been proposed, but they are associated with an increased risk of complications and a longer operation. Methods A total of 179 patients with previous ...

  20. Review of early clinical results and complications associated with oblique lumbar interbody fusion (OLIF).

    Science.gov (United States)

    Phan, Kevin; Maharaj, Monish; Assem, Yusuf; Mobbs, Ralph J

    2016-09-01

    Lumbar interbody fusion represents an effective surgical intervention for patients with lumbar degenerative diseases, spondylolisthesis, disc herniation, pseudoarthrosis and spinal deformities. Traditionally, conventional open anterior lumbar interbody fusion and posterior/transforaminal lumbar interbody fusion techniques have been employed with excellent results, but each with their own advantages and caveats. Most recently, the antero-oblique trajectory has been introduced, providing yet another corridor to access the lumbar spine. Termed the oblique lumbar interbody fusion, this approach accesses the spine between the anterior vessels and psoas muscles, avoiding both sets of structures to allow efficient clearance of the disc space and application of a large interbody device to afford distraction for foraminal decompression and endplate preparation for rapid and thorough fusion. This review aims to summarize the early clinical results and complications of this new technique and discusses potential future directions of research. PMID:27349468

  1. POSTERIOR LUMBAR INTERBODY FUSION AND INSTRUMENTED POSTEROLATERAL FUSION IN ADULT SPONDYLOLISTHESIS: ASSESSMENT AND CLINICAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Rajarajan

    2015-11-01

    Full Text Available OBJECTIVE: Aim of this study is to assess and compare the outcomes of posterior lumbar interbody fusion (PLIF and posterolateral fusion (PLF in adult isthmic spondylosthesis. BACKGROUND: Posterolateral fusion has been considered the best method and widely been used for surgical treatment of adult spondylolisthesis.Superior results have subsequently been reported with interbody fusion with cages and posterior instrumentation MATERIALS AND METHODS: Thirty six patients with isthmic spondylolisthesis were operated. One group (20 patients had decompression and posterolateral fusion (PLF with a pedicle screw system; other group (16 patients was treated by decompression, posterior lumbar interbody fusion (PLIF and a Pedicle screw system. In both groups adequate decompression was done RESULTS: Seventy seven percent of the patients had a good result with (PLIF and 68 percent with posterolateral fusion (PLF. However there was no statistical difference in cases with low grade slipping, whereas the difference was significant for cases with high grade slipping. Fusion rate was 93% with (PLIF and 68% with (PLF, but without any significant incidence in the functional outcome. 78% has relief of sciatica and neurogenic claudication. CONCLUSION: Based on these findings we found that for high grade spondylolisthesis which requires reduction or if the disc space is still high posterior lumbar inter body fusion is preferable. For low grade spondylolisthesis or if the disc space is narrow posterolateral fusion is preferable. A successful result of fusion operation depends on adequate decompression which relieves radicular symptoms.

  2. Outcome of instrumented lumbar fusion for low grade spondylolisthesis; Evaluation of interbody fusion with & without cages

    Science.gov (United States)

    Fathy, Mostafa; Fahmy, Mohamed; Fakhri, Mazen; Aref, Khaled; Abdin, Khaled; Zidan, Ihab

    2010-01-01

    Object: The aim is to evalute the outcome of posterior lumbar interbody fusion with autologous bone graft versus titanium Cages, BAK system (Bagby – Kuslich, Spine Tech, Inc. Minneapolis, MN) for low grade spondyloisthesis (Grade1,11). Interbody cages have been developed to replace tricortical Interbody grafts in posterior lumbar interbody fusion (PLIF) procedures. The cages provide immediate post operative stability and facilitate bony union with cancellous bone packed in the cage itself. METHOD: We Evaluated 50 consecutive patients in whom surgery was performed between June 2000 to June 2003 in the Main Alexandria University Hospital at EGYPT. Twenty five patients were operated using autologous bone graft and 25 patients using the BAK cages. The neuro–radiologic al work up consisted of; plain X – ray lumbosacral spine including dynamic films preoperative and postoperative follow up; C.T lumbosacral spine and MRI lumbosacral spine. The surgery was performed at L4-5 level in 34 cases and at L5-S1 level in 16 cases. The median follow up was 15 months. RESULTS: Satisfactory fusion was obtained at all levels at a minimum one year follow – up. The fusion rate was 96% (24 patients) for the cage group and 80% (20 patients) for bone graft group however clinical improvement was 64% (16 patients) for those with bone graft group. CONCLUSION: A higher fusion rates and a better clinical outcome have been obtained by Instrumented PLIF with titanium cages that with bone graft. Inderbody fusion cages help to stabilize spainal segment primarily by distracting them as well as by allowing bone ingrowth and fusion. The procedure is safe and effective with 96% fusion rate and 76% overall Satisfactory rate. The use of cages help to distract the space between the vertebral bodies making the correction of the degree of spondylolisthesis easier. Long term follow up revealed better fusion rate and better realignment and less resorption with cages than with bone grafts. PMID

  3. Healing properties of allograft from alendronate-treated animal in lumbar spine interbody cage fusion

    OpenAIRE

    Xue, Qingyun; Li, Haisheng; Zou, Xuenong; Bünger, Mathias; Egund, Niels; Lind, Martin; Christensen, Finn Bjarke; Bünger, Cody

    2004-01-01

    This study investigated the healing potential of allograft from bisphosphonate-treated animals in anterior lumbar spine interbody fusion. Three levels of anterior lumbar interbody fusion with Brantigan cages were performed in two groups of five landrace pigs. Empty Brantigan cages or cages filled with either autograft or allograft were located randomly at different levels. The allograft materials for the treatment group were taken from the pigs that had been fed with alendronate, 10 mg daily ...

  4. TLIF: transforaminal lumbar interbody fusion TLIF: artrodese intersomática lombar transforaminal

    OpenAIRE

    Nicandro Figueiredo; Johnny Wesley G. Martins; Alfredo A. Arruda; Alexandre R. Serra; Marco Antônio A. Figueiredo; Rodrigo C. Diniz; Alessandro A. Cavicchioli

    2004-01-01

    Transforaminal lumbar interbody fusion (TLIF) is a relatively new technique of lumbar arthrodesis via posterior transforaminal approach to the disc, indicated mainly in cases of degenerative disc disease, low grade spondylolisthesis and reoperation for disc herniation, specially when there is indication for interbody fusion and posterior decompression. The main advantage of TLIF is that it allows the complete removal of the intervertebral disc through the vertebral foramen, decompression of t...

  5. Segmental and global lordosis changes with two-level axial lumbar interbody fusion and posterior instrumentation

    OpenAIRE

    Melgar, Miguel A; Tobler, William D.; Ernst, Robert J; Raley, Thomas J; Anand, Neel; Miller, Larry E; Nasca, Richard J

    2014-01-01

    Background Loss of lumbar lordosis has been reported after lumbar interbody fusion surgery and may portend poor clinical and radiographic outcome. The objective of this research was to measure changes in segmental and global lumbar lordosis in patients treated with presacral axial L4-S1 interbody fusion and posterior instrumentation and to determine if these changes influenced patient outcomes. Methods We performed a retrospective, multi-center review of prospectively collected data in 58 con...

  6. Analysis of Internet Information on Lateral Lumbar Interbody Fusion.

    Science.gov (United States)

    Belayneh, Rebekah; Mesfin, Addisu

    2016-07-01

    Lateral lumbar interbody fusion (LLIF) is a surgical technique that is being increasingly used. The authors' objective was to examine information on the Internet pertaining to the LLIF technique. An analysis was conducted of publicly accessible websites pertaining to LLIF. The following search engines were used: Google (www.google.com), Bing (www.bing.com), and Yahoo (www.yahoo.com). DuckDuckGo (www.duckduckgo.com) was an additional search engine used due to its emphasis on generating accurate and consistent results while protecting searchers' privacy and reducing advertisements. The top 35 websites providing information on LLIF from the 4 search engines were identified. A total of 140 websites were evaluated. Each web-site was categorized based on authorship (academic, private, medical industry, insurance company, other) and content of information. Using the search term lateral lumbar interbody fusion, 174,000 Google results, 112,000 Yahoo results, and 112,000 Bing results were obtained. DuckDuckGo does not display the number of results found for a search. From the top 140 websites collected from each website, 78 unique websites were identified. Websites were authored by a private medical group in 46.2% of the cases, an academic medical group in 26.9% of the cases, and the biomedical industry in 5.1% of the cases. Sixty-eight percent of websites reported indications, and 24.4% reported contraindications. Benefits of LLIF were reported by 69.2% of websites. Thirty-six percent of websites reported complications of LLIF. Overall, the quality of information regarding LLIF on the Internet is poor. Spine surgeons and spine societies can assist in improving the quality of the information on the Internet regarding LLIF. [Orthopedics. 2016; 39(4):e701-e707.]. PMID:27111081

  7. 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

  8. Outcomes of extended transforaminal lumbar interbody fusion for lumbar spondylosis.

    Science.gov (United States)

    Talia, Adrian J; Wong, Michael L; Lau, Hui C; Kaye, Andrew H

    2015-11-01

    This study aims to assess the results of extended transforaminal lumbar interbody fusion (TLIF) for a two surgeon, single institution series. In total, extended TLIF with bilateral decompression was performed in 57 patients. Pain, American Spinal Injury Association scores, patient demographics, body mass index (BMI), perioperative indices and radiographic measurements were recorded and analysed. The surgeries were performed between February 2011 and January 2014 on 38 women and 19 men. The mean patient age was 62.86 years, and the mean BMI was 30.31 kg/m(2). In 49 patients, spondylolisthesis was the primary indication. The mean intraoperative time was 284.65 min, and this decreased as the series progressed. The median length of stay was 5 days (range: 2-9). The surgical complication rate was 19.3%. Two patients died from cardiopulmonary complications. Single level TLIF was performed in 78.9% of the cohort, with L4/5 the most commonly fused level. Significant pain reduction was achieved from a mean (± standard deviation) preoperative visual analogue scale (VAS) of 8.28 ± 1.39 to 1.50 ± 1.05 at 12 months postoperatively. No patients deteriorated neurologically. Spondylolisthesis was significantly corrected from a preoperative mean of 6.82 mm to 2.80 mm postoperatively. Although there is a learning curve associated with the procedure, extended TLIF with bilateral facet joint removal and decompression appeared to be a safe and effective alternative to other fusion techniques, and our results were comparable to other published case series. The stabilisation and correction of spinal deformity reduces pain, aids neurologic recovery and improves quality of life. PMID:26358199

  9. Minimally invasive L5-S1 oblique lumbar interbody fusion with anterior plate.

    Science.gov (United States)

    Pham, Martin H; Jakoi, Andre M; Hsieh, Patrick C

    2016-07-01

    Lumbar interbody fusion is an important technique for the treatment of degenerative disc disease and degenerative scoliosis. The oblique lumbar interbody fusion (OLIF) establishes a minimally invasive retroperitoneal exposure anterior to the psoas and lumbar plexus. In this video case presentation, the authors demonstrate the techniques of the OLIF at L5-S1 performed on a 69-year-old female with degenerative scoliosis as one component of an overall strategy for her deformity correction. The video can be found here: https://youtu.be/VMUYWKLAl0g . PMID:27364428

  10. Minimally invasive transforaminal lumbar interbody fusion with percutaneous navigated guidewireless lumbosacral pedicle screw fixation.

    Science.gov (United States)

    Chen, Kevin S; Park, Paul

    2016-07-01

    This video details the minimally invasive approach for treatment of a symptomatic Grade II lytic spondylolisthesis with high-grade foraminal stenosis. In this procedure, the use of a navigated, guidewireless technique for percutaneous pedicle screw placement at the lumbosacral junction is highlighted following initial decompression and transforaminal interbody fusion. Key steps of the procedure are delineated that include positioning, exposure, technique for interbody fusion, intraoperative image acquisition, and use of a concise 2-step process for navigated screw placement without using guidewires. The video can be found here: https://youtu.be/2u6H4Pc_8To . PMID:27364422

  11. Healing properties of allograft from alendronate-treated animal in lumbar spine interbody cage fusion.

    Science.gov (United States)

    Xue, Qingyun; Li, Haisheng; Zou, Xuenong; Bünger, Mathias; Egund, Niels; Lind, Martin; Christensen, Finn Bjarke; Bünger, Cody

    2005-04-01

    This study investigated the healing potential of allograft from bisphosphonate-treated animals in anterior lumbar spine interbody fusion. Three levels of anterior lumbar interbody fusion with Brantigan cages were performed in two groups of five landrace pigs. Empty Brantigan cages or cages filled with either autograft or allograft were located randomly at different levels. The allograft materials for the treatment group were taken from the pigs that had been fed with alendronate, 10 mg daily for 3 months. The histological fusion rate was 2/5 in alendronate-treated allograft and 3/5 in non-treated allograft. The mean bone volume was 39% and 37.2% in alendronate-treated or non-treated allograft (NS), respectively. No statistical difference was found between the same grafted cage comparing two groups. The histological fusion rate was 7/10 in all autograft cage levels and 5/10 in combined allograft cage levels. No fusion was found at all in empty cage levels. With the numbers available, no statistically significant difference was found in histological fusion between autograft and allograft applications. There was a significant difference of mean bone volume between autograft (49.2%) and empty cage (27.5%) (P<0.01). In conclusion, this study did not demonstrate different healing properties of alendronate-treated and non-treated allograft for anterior lumbar interbody fusion in pigs. PMID:15248057

  12. Postoperative Flat Back: Contribution of Posterior Accessed Lumbar Interbody Fusion and Spinopelvic Parameters

    OpenAIRE

    Kim, Jin Kwon; Moon, Byung Gwan; Kim, Deok Ryeng; Kim, Joo Seung

    2014-01-01

    Objective Posterior accessed lumbar interbody fusion (PALIF) has a clear objective to restore disc height and spinal alignment but surgeons may occasionally face the converse situation and lose lumbar lordosis. We analyzed retrospective data for factors contributing to a postoperative flat back. Methods A total of 105 patients who underwent PALIF for spondylolisthesis and stenosis were enrolled. The patients were divided according to surgical type [posterior lumbar inter body fusion (PLIF) vs...

  13. Porous Biodegradable Lumbar Interbody Fusion Cage Design and Fabrication Using Integrated Global-Local Topology Optimization With Laser Sintering

    OpenAIRE

    Kang, Heesuk; Hollister, Scott J; La Marca, Frank; Park, Paul; Lin, Chia-Ying

    2013-01-01

    Biodegradable cages have received increasing attention for their use in spinal procedures involving interbody fusion to resolve complications associated with the use of nondegradable cages, such as stress shielding and long-term foreign body reaction. However, the relatively weak initial material strength compared to permanent materials and subsequent reduction due to degradation may be problematic. To design a porous biodegradable interbody fusion cage for a preclinical lar...

  14. Set screw fracture with cage dislocation after two-level transforaminal lumbar interbody fusion (TLIF): a case report

    OpenAIRE

    Leute, Philip Johannes Felix; Hammad, Ahmed; Hoffmann, Isabel; Hoppe, Sebastian; Klinger, Hans-Michael; Lakemeier, Stefan

    2015-01-01

    Introduction Transforaminal lumbar interbody fusion is a popular procedure used to achieve spondylodesis in patients with degenerative lumbar spinal diseases. We present a rare case of a patient with a set screw fracture with cage dislocation after an open transforaminal lumbar interbody fusion procedure. To the best of our knowledge, this case is the first of its kind to be reported. Case presentation A 44-year-old Caucasian woman attended a follow-up appointment at our hospital 3 months aft...

  15. Rate of graft bone filling by transforaminal lumber interbody fusion (TLIF) with mesh cages

    International Nuclear Information System (INIS)

    Compared to posterior lumber interbody fusion (PLIF), the transforaminal lumber interbody fusion (TLIF) procedure has a latent disadvantage in terms of bone grafting because of being a unilateral approach. We calculated the rate of graft bone filling in TLIF cases by postoperative CT and evaluated the clinical results. The rate of filling in the TLIF cases was not significantly less than in the PLIF cases. The results also showed no significant difference between TLIF and PLIF. An adequate amount of bone were grafted into the intervertebral space even by the unilateral TLIF approach, however the procedure is not easy. An incidental dural tear occurred in 1 case each treated by TLIF and PLIF. The exposure of the dural tube increases the risk of epidural bleeding and neural tissue injury. We recommend TLIF for discopathy, foraminal stenosis, and repeat surgery to avoid latent risk. (author)

  16. Effect of Psychological Status on Outcome of Posterior Lumbar Interbody Fusion Surgery

    OpenAIRE

    Pollock, Raymond; Lakkol, Sandesh; Budithi, Chakra; Bhatia, Chandra; Krishna, Manoj

    2012-01-01

    Study Design Prospective longitudinal study. Purpose To determine if preoperative psychological status affects outcome in spinal surgery. Overview of Literature Low back pain is known to have a psychosomatic component. Increased bodily awareness (somatization) and depressive symptoms are two factors that may affect outcome. It is possible to measure these components using questionnaires. Methods Patients who underwent posterior interbody fusion (PLIF) surgery were assessed preoperatively and ...

  17. Improvement of Segmental Lordosis in Transforaminal Lumbar Interbody Fusion: A Comparison of Two Techniques

    OpenAIRE

    Rice, James W.; Sedney, Cara L.; Daffner, Scott D.; Arner, Justin W.; Emery, Sanford E.; France, John C.

    2015-01-01

    Study Design Retrospective review. Objective The purpose of this study was to determine the radiographic impact of a transforaminal lumbar interbody fusion (TLIF) versus a cantilever TLIF technique on segmental lordosis, segmental coronal alignment, and disk height. Methods A retrospective review was done of all patients undergoing TLIF procedures from 2006 to 2011 by three spine surgeons. Traditional TLIF versus cantilever TLIF results were compared, and radiographic outcomes were assessed. ...

  18. Factors affecting the accurate placement of percutaneous pedicle screws during minimally invasive transforaminal lumbar interbody fusion

    OpenAIRE

    Kim, Moon-Chan; Chung, Hung-Tae; Cho, Jae-Lim; Kim, Dong-jun; Chung, Nam-Su

    2011-01-01

    We retrospectively evaluated 488 percutaneous pedicle screws in 110 consecutive patients that had undergone minimally invasive transforaminal lumbar interbody fusion (MITLIF) to determine the incidence of pedicle screw misplacement and its relevant risk factors. Screw placements were classified based on postoperative computed tomographic findings as “correct”, “cortical encroachment” or as “frank penetration”. Age, gender, body mass index, bone mineral density, diagnosis, operation time, esti...

  19. Stand-Alone Lateral Interbody Fusion for the Treatment of Low-Grade Degenerative Spondylolisthesis

    OpenAIRE

    Luis Marchi; Nitamar Abdala; Leonardo Oliveira; Rodrigo Amaral; Etevaldo Coutinho; Luiz Pimenta

    2012-01-01

    The purpose of this paper was to investigate the stand-alone lateral interbody fusion as a minimally invasive option for the treatment of low-grade degenerative spondylolisthesis with a minimum 24-month followup. Prospective nonrandomized observational single-center study. 52 consecutive patients (67.6 ± 10 y/o; 73.1% female; 27.4 ± 3.4 BMI) with single-level grade I/II single-level degenerative spondylolisthesis without significant spine instability were included. Fusion procedures were perf...

  20. Imaging evaluation strategy of spinal interbody fusion%对脊柱椎间融合的影像学评价策略

    Institute of Scientific and Technical Information of China (English)

    高志强; 李洋; 罗飞

    2015-01-01

    背景:椎间融合是脊柱外科常用的修复方式,融合失败会导致多种并发症。对融合的正确判断非常重要。目前临床常使用影像学方法对融合情况进行判断。在评价融合时,X射线片、CT、MRI等检查手段拥有各自特殊的方法、特点,从而导致了其在敏感性、特异性等方面存在诸多差异。  目的:综述影像学检查手段在脊柱椎间融合评价中的研究进展。  方法:以英文关键词“lambar fusion,cervical fusion,interbody fusion,evaluation method”为检索词,在PubMed 数据库中进行检索。筛选出对椎间融合方法进行详细描述的文献进行综述,包含影像学手段的多种评价方法的对比研究。  结果与结论:依据纳入标准及排除标准,共入选40篇文献进行综述。X射线片和CT是使用最为广泛的判定手段,CT的判断结果更加可靠。MRI、骨扫描等其他影像学检查无法准确、直接的对脊柱融合情况进行评价。综合判断症状、体征和各种影像资料是更为合理的脊柱椎间融合评价策略。%BACKGROUND:Interbody fusion is widely used in spine surgeries. Failed fusion may cause many complications, so it is very important to evaluate fusion before surgery. Imaging methods are commonly used to evaluate fusion, including X ray, CT and MRI. Above methods have their own specific methods and characteristics, which cause their differences in sensibility and specificity. OBJECTIVE:To review the research progress of imaging methods in interbody fusion. METHODS:The English key words were“lambar fusion, cervical fusion, interbody fusion, evaluation method”in the PubMed database. The literatures with detailed description of interbody fusion were selected for further review, including comparative study on a variety of evaluation methods of imaging means. RESULTS AND CONCLUSION:According to the inclusion criteria and exclusion criteria, a total of 40

  1. Single-level transforaminal interbody fusion for traumatic lumbosacral fracture-dislocation: a case report.

    Science.gov (United States)

    Herrera, Anthony J; Berry, Chirag A; Rao, Raj D

    2013-02-01

    L5S1 fracture-dislocations are rare three-column injuries. The infrequency of this injury has led to a lack of a universally accepted treatment strategy. Transforaminal lumbar interbody fusion (TLIF) has been shown to be an effective approach for interbody fusion in degenerative indications, but has not been previously reported in the operative management of traumatic lumbosacral dislocation. The authors report a case of traumatic L5S1 fracture-dislocation in a 30-year-old male, presenting with a right-sided L5 neurologic deficit, following a street sweeper accident. Imaging revealed an L5S1 fracture-dislocation with fracture of the S1 body. Open reduction with TLIF and L5S1 posterolateral instrumented fusion was carried out within 24 hours of injury. Excellent reduction was obtained, and maintained at long-term follow-up, with complete resolution of pain and neurologic deficit. In this patient, L5S1 fracture-dislocation was treated successfully, with an excellent outcome, with a single level TLIF and instrumented posterolateral fusion at L5S1. PMID:23547528

  2. Intervertebral disk-like biphasic scaffold—demineralized bone matrix cylinder and poly(polycaprolactone triol malate)—for interbody spine fusion

    OpenAIRE

    Li Jin; Yuqing Wan; Shimer, Adam L.; Shen, Francis H.; Li, Xudong J

    2012-01-01

    Interbody fusion is an established procedure to preserve disk height and anterior fusion, but fusion with autografts, allografts, and metallic cages has its endogenous shortcomings. The objective of this study is to investigate whether a biphasic scaffold model, the native demineralized bone matrix cylinder in conjunction with degradable biomaterial poly(polycaprolactone triol malate), can be employed as a biological graft for interbody fusion. The poly(polycaprolactone triol malate) was synt...

  3. Evaluation of ABM/P-15 versus autogenous bone in an ovine lumbar interbody fusion model

    OpenAIRE

    Sherman, Blake P.; Lindley, Emily M.; Turner, A. Simon; Seim III, Howard B.; Benedict, James; Burger, Evalina L; Patel, Vikas V.

    2010-01-01

    A prospective, randomized study was performed in an ovine model to compare the efficacy of an anorganic bovine-derived hydroxyapatite matrix combined with a synthetic 15 amino acid residue (ABM/P-15) in facilitating lumbar interbody fusion when compared with autogenous bone harvested from the iliac crest. P-15 is a biomimetic to the cell-binding site of Type-I collagen for bone-forming cells. When combined with ABM, it creates the necessary scaffold to initiate cell invasion, binding, and sub...

  4. 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

  5. Axial lumbar interbody fusion: a 6-year single-center experience

    Directory of Open Access Journals (Sweden)

    Zeilstra DJ

    2013-08-01

    Full Text Available Dick J Zeilstra,1 Larry E Miller,2,3 Jon E Block3 1Bergman Clinics, Naarden and NedSpine, Ede, The Netherlands; 2Miller Scientific Consulting, Inc, Arden, NC, USA; 3The Jon Block Group, San Francisco, CA, USA Introduction: The aim of this study is to report our 6-year single-center experience with L5–S1 axial lumbar interbody fusion (AxiaLIF. Methods: A total of 131 patients with symptomatic degenerative disc disease refractory to nonsurgical treatment were treated with AxiaLIF at L5–S1, and were followed for a minimum of 1 year (mean: 21 months. Main outcomes included back and leg pain severity, Oswestry Disability Index score, working status, analgesic medication use, patient satisfaction, and complications. Computed tomography was used to determine postoperative fusion status. Results: No intraoperative complications, including vascular, neural, urologic, or bowel injuries, were reported. Back and leg pain severity decreased by 51% and 42%, respectively, during the follow-up period (both P < 0.001. Back function scores improved 50% compared to baseline. Clinical success, defined as improvement ≥30%, was 67% for back pain severity, 65% for leg pain severity, and 71% for back function. The employment rate increased from 47% before surgery to 64% at final follow-up (P < 0.001. Less than one in four patients regularly used analgesic medications postsurgery. Patient satisfaction with the AxiaLIF procedure was 83%. The fusion rate was 87.8% at final follow-up. During follow-up, 17 (13.0% patients underwent 18 reoperations on the lumbar spine, including pedicle screw fixation (n = 10, total disc replacement of an uninvolved level (n = 3, facet screw fixation (n = 3, facet screw removal (n = 1, and interbody fusion at L4–L5 (n = 1. Eight (6.1% reoperations were at the index level. Conclusion: Single-level AxiaLIF is a safe and effective means to achieve lumbosacral fusion in patients with symptomatic degenerative disc disease. Keywords: Axia

  6. Neurological complications using a novel retractor system for direct lateral minimally invasive lumbar interbody fusion.

    Science.gov (United States)

    Sedra, Fady; Lee, Robert; Dominguez, Ignacio; Wilson, Lester

    2016-09-01

    We describe our experience using the RAVINE retractor (K2M, Leesburg, VA, USA) to gain access to the lateral aspect of the lumbar spine through a retroperitoneal approach. Postoperative neurological adverse events, utilising the mentioned retractor system, were recorded and analysed. We included 140 patients who underwent minimally invasive lateral lumbar interbody fusion (MI-LLIF) for degenerative spinal conditions between 2011 and 2015 at two major spinal centres. A total of 228 levels were treated, 35% one level, 40% two level, 20% three level and 5% 4 level surgeries. The L4/5 level was instrumented in 28% of cases. 12/140 patients had postoperative neurological complications. Immediately after surgery, 5% of patients (7/140) had transient symptoms in the thigh ranging from sensory loss, pain and paraesthesia, all of which recovered within 12weeks following surgery. There were five cases of femoral nerve palsy (3.6% - two ipsilateral and three contralateral), all of which recovered completely with no residual sensory or motor deficit within 6months. MI-LLIF done with help of the described retractor system has proved a safe and efficient way to achieve interbody fusion with minimal complications, mainly nerve related, that recovered quickly. Judicious use of the technique to access the L4/5 level is advised. PMID:27349467

  7. Clinical Outcomes of Extreme Lateral Interbody Fusion in the Treatment of Adult Degenerative Scoliosis

    Directory of Open Access Journals (Sweden)

    Adam M. Caputo

    2012-01-01

    Full Text Available Introduction. The use of extreme lateral interbody fusion (XLIF and other lateral access surgery is rapidly increasing in popularity. However, limited data is available regarding its use in scoliosis surgery. The objective of this study was to evaluate the clinical outcomes of adults with degenerative lumbar scoliosis treated with XLIF. Methods. Thirty consecutive patients with adult degenerative scoliosis treated by a single surgeon at a major academic institution were followed for an average of 14.3 months. Interbody fusion was completed using the XLIF technique with supplemental posterior instrumentation. Validated clinical outcome scores were obtained on patients preoperatively and at most recent follow-up. Complications were recorded. Results. The study group demonstrated improvement in multiple clinical outcome scores. Oswestry Disability Index scores improved from 24.8 to 19.0 (P < 0.001. Short Form-12 scores improved, although the change was not significant. Visual analog scores for back pain decreased from 6.8 to 4.6 (P < 0.001 while scores for leg pain decreased from 5.4 to 2.8 (P < 0.001. A total of six minor complications (20% were recorded, and two patients (6.7% required additional surgery. Conclusions. Based on the significant improvement in validated clinical outcome scores, XLIF is effective in the treatment of adult degenerative scoliosis.

  8. 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.

  9. Incidence of graft extrusion following minimally invasive transforaminal lumbar interbody fusion.

    Science.gov (United States)

    Bakhsheshian, Joshua; Khanna, Ryan; Choy, Winward; Lawton, Cort D; Nixon, Alex T; Wong, Albert P; Koski, Tyler R; Liu, John C; Song, John K; Dahdaleh, Nader S; Smith, Zachary A; Fessler, Richard G

    2016-02-01

    Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) has been scrutinized for having a complex learning curve. Careful assessment of MI-TLIF complications and critical analyses of prevention may aid a safe adoption of this technique. The current report focuses on the incidence of interbody cage extrusions following MI-TLIF in a series of 513 patients. The authors discuss their experience with graft extrusions and provide methods to minimize this complication. This study retrospectively reviewed 513 prospectively followed patients who underwent MI-TLIF over a 10 year period. The inclusion criteria consisted of all patients who underwent one to three level MI-TLIF, from whom the incidence of cage extrusion was analyzed. Cage extrusion was defined as an interbody graft migrating outside the cephalad and caudal vertebral body posterior margin. Cage extrusions were diagnosed by comparing the intraoperative radiographs to the postoperative radiographs. Patients with >10° coronal curves, significant sagittal malalignment, infection, and preoperative instrumentation failure were excluded. Of 513 patients undergoing MI-TLIF, five patients (0.97%) were diagnosed with cage migrations. The mean follow-up duration was 13.6 ± standard deviation of 8.8 months. Complications included asymptomatic cage migration alone (two patients) neurological decline (two patients) and epidural hematoma (one patient). On average, cage migrations cost a university hospital an additional $US17,217 for revision treatment. While the incidence of cage migrations is low (0.97%), it can lead to postoperative complications that require revision surgery and increased hospital costs. The risk for this significant complication can be minimized with proper technique and patient selection. PMID:26578209

  10. Thoracolumbar fracture dislocations treated by posterior reduction interbody fusion and segmental instrumentation

    Directory of Open Access Journals (Sweden)

    Xiao-Bin Wang

    2014-01-01

    Materials and Methods: A retrospective review of 30 patients who had sustained fracture dislocation of the spine and underwent single stage posterior surgery between January 2007 and December 2011 was performed. All the patients underwent single stage posterior pedicle screw fixation, decompression and interbody fusion. Demographic data, medical records and radiographic images were reviewed thoroughly. Results: Ten females and 20 males with a mean age of 39.5 years were included in this study. Based on the AO classification, 13 cases were Type B1, 4 cases were B2, 4 were C1, 6 were C2 and 3 cases were C3. The average time of the surgical procedure was 220 min and the average blood loss was 550 mL. All of the patients were followed up for at least 2 years, with an average of 38 months. The mean preoperative kyphosis was 14.4° and reduced to -1.1° postoperatively. At the final followup, the mean kyphosis was 0.2°. The loss of correction was small (1.3° with no significant difference compared to postoperative kyphotic angle (P = 0.069. Twenty seven patients (90% achieved definitive bone fusion on X-ray or computed tomography imaging within 1 year followup. The other three patients were suspected possible pseudarthrosis. They remained asymptomatic without hardware failure or local pain at the last followup. Conclusion: Single stage posterior reduction using segmental pedicle screw instrumentation, combined with decompression and interbody fusion for the treatment of thoracic or lumbar fracture-dislocations is a safe, less traumatic and reliable technique. This procedure can achieve effective reduction, sagittal angle correction and solid fusion.

  11. Stand-Alone Lateral Interbody Fusion for the Treatment of Low-Grade Degenerative Spondylolisthesis

    Science.gov (United States)

    Marchi, Luis; Abdala, Nitamar; Oliveira, Leonardo; Amaral, Rodrigo; Coutinho, Etevaldo; Pimenta, Luiz

    2012-01-01

    The purpose of this paper was to investigate the stand-alone lateral interbody fusion as a minimally invasive option for the treatment of low-grade degenerative spondylolisthesis with a minimum 24-month followup. Prospective nonrandomized observational single-center study. 52 consecutive patients (67.6 ± 10 y/o; 73.1% female; 27.4 ± 3.4 BMI) with single-level grade I/II single-level degenerative spondylolisthesis without significant spine instability were included. Fusion procedures were performed as retroperitoneal lateral transpsoas interbody fusions without screw supplementation. The procedures were performed in average 73.2 minutes and with less than 50cc blood loss. VAS and Oswestry scores showed lasting improvements in clinical outcomes (60% and 54.5% change, resp.). The vertebral slippage was reduced in 90.4% of cases from mean values of 15.1% preoperatively to 7.4% at 6-week followup (P < 0.001) and was maintained through 24 months (7.1%, P < 0.001). Segmental lordosis (P < 0.001) and disc height (P < 0.001) were improved in postop evaluations. Cage subsidence occurred in 9/52 cases (17%) and 7/52 cases (13%) spine levels needed revision surgery. At the 24-month evaluation, solid fusion was observed in 86.5% of the levels treated. The minimally invasive lateral approach has been shown to be a safe and reproducible technique to treat low-grade degenerative spondylolisthesis. PMID:22545019

  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. Klinische und radiologische Ergebnisse nach monosegmentaler „posterior lumbar interbody fusion“ (PLIF) mit zwei unterschiedlichen Titancages und dorsaler Stabilisierung bei degenerativer Spondylolisthese

    OpenAIRE

    Abbushi, Alexander

    2010-01-01

    This is a retrospective study of 40 patients, who had a monosegmental lumbar degenerative spondylolisthesis treated by monosegmental posterior lumbar interbody fusion (PLIF) using two different types of titan cages and pedicle screw fixation. The objective was to evaluate the radiographic and clinical results of these patients treated with posterior lumbar interbody fusion and pedicle screw fixation either by using the Prospace Titan Cage of Aesculap or the O.I.C Titan Cage of Stryker. ...

  14. 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 ...

  15. 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 ...

  16. Improvement of Segmental Lordosis in Transforaminal Lumbar Interbody Fusion: A Comparison of Two Techniques.

    Science.gov (United States)

    Rice, James W; Sedney, Cara L; Daffner, Scott D; Arner, Justin W; Emery, Sanford E; France, John C

    2016-05-01

    Study Design Retrospective review. Objective The purpose of this study was to determine the radiographic impact of a transforaminal lumbar interbody fusion (TLIF) versus a cantilever TLIF technique on segmental lordosis, segmental coronal alignment, and disk height. Methods A retrospective review was done of all patients undergoing TLIF procedures from 2006 to 2011 by three spine surgeons. Traditional TLIF versus cantilever TLIF results were compared, and radiographic outcomes were assessed. Results One hundred one patients were included in the study. Patients undergoing the cantilever TLIF procedure had a significantly greater change in segmental lordosis and disk height compared with those who underwent the traditional procedure (p > 0.0001). Conclusions The cantilever TLIF technique can lead to greater change in segmental lordosis based upon radiographic outcomes. PMID:27099813

  17. A Randomized Controlled Trial Comparing Transforaminal Lumbar Interbody Fusion and Uninstrumented Posterolateral Fusion in the Degenerative Lumbar Spine.

    Science.gov (United States)

    Jalalpour, Kourosh; Neumann, Pavel; Johansson, Christer; Hedlund, Rune

    2015-08-01

    Study Design Randomized controlled trial. Objective Despite a large number of publications of outcomes after spinal fusion surgery, there is still no consensus on the efficacy of the several different fusion methods. The aim of this study was to determine whether transforaminal lumbar interbody fusion (TLIF) results in an improved clinical outcome compared with uninstrumented posterolateral fusion (PLF) in the surgical treatment for chronic low back pain. Methods This study included 135 patients with degenerative disk disease (n = 96) or postdiskectomy syndrome (n = 39). Inclusion criteria were at least 1 year of back pain with or without leg pain in patients aged 20 to 65 with one- or two-level disease. Exclusion criteria were sequestration of disk hernia, psychosocial instability, isthmic spondylolisthesis, drug abuse, and previous spine surgery other than diskectomy. Pain was assessed by visual analog scale (pain index). Functional disability was quantified by the disability rating index and Oswestry Disability Index. The global outcome was assessed by the patient and classified as much better, better, unchanged, or worse. The patients were randomized to conventional uninstrumented PLF (n = 67) or TLIF (n = 68). PLF was performed in a standardized fashion using autograft. TLIF was performed with pedicle titanium screw fixation and a porous tantalum interbody spacer with interbody and posterolateral autograft. The clinical outcome measurements were obtained preoperatively and at 12 and 24 months postoperatively. The 2-year follow-up rate was 98%. Results The two treatment groups improved significantly from preoperatively to 2 years' follow-up. At final follow-up, the results in the TLIF group were significantly superior to those in the PLF group in pain index (2.0 versus 3.9, p = 0.007) and in disability rating index (22 versus 36, p = 0.003). The Oswestry Disability Index was better in the TLIF group (20 versus 28, p = 0

  18. Treatment of Spinal Tuberculosis by Debridement, Interbody Fusion and Internal Fixation via Posterior Approach Only.

    Science.gov (United States)

    Tang, Ming-xing; Zhang, Hong-qi; Wang, Yu-xiang; Guo, Chao-feng; Liu, Jin-yang

    2016-02-01

    Surgical treatment for spinal tuberculosis includes focal tuberculosis debridement, segmental stability reconstruction, neural decompression and kyphotic deformity correction. For the lesions mainly involved anterior and middle column of the spine, anterior operation of debridement and fusion with internal fixation has been becoming the most frequently used surgical technique for the spinal tuberculosis. However, high risk of structural damage might relate with anterior surgery, such as damage in lungs, heart, kidney, ureter and bowel, and the deformity correction is also limited. Due to the organs are in the front of spine, there are less complications in posterior approach. Spinal pedicle screw passes through the spinal three-column structure, which provides more powerful orthopedic forces compared with the vertebral body screw, and the kyphotic deformity correction effect is better in posterior approach. In this paper, we report a 68-year-old male patient with thoracic tuberculosis who underwent surgical treatment by debridement, interbody fusion and internal fixation via posterior approach only. The patient was placed in prone position under general anesthesia. Posterior midline incision was performed, and the posterior spinal construction was exposed. Then place pedicle screw, and fix one side rod temporarily. Make the side of more bone destruction and larger abscess as lesion debridement side. Resect the unilateral facet joint, and retain contralateral structure integrity. Protect the spinal cord, nerve root. Clear sequestrum, necrotic tissue, abscess of paravertebral and intervertebral space. Specially designed titanium mesh cages or bone blocks were implanted into interbody. Fix both side rods and compress both sides to make the mesh cages and bone blocks tight. Reconstruct posterior column structure with allogeneic bone and autologous bone. Using this technique, the procedures of debridement, spinal cord decompression, deformity correction, bone grafting

  19. Is posterior fusion necessary with laminectomy in the cervical spine?

    OpenAIRE

    McAllister, Beck D.; Rebholz, Brandon J.; Wang, Jeffery C.

    2012-01-01

    Background: Cervical decompressive laminectomy is a common procedure for addressing multilevel cervical spine pathology. The most common reasons for performing simultaneous posterior cervical fusion include the prevention of progressive postlaminectomy kyphotic deformity or other types of instability which can contribute to late neurological deterioration. Methods: The medical literature (Pub Med with MeSH) concerning cervical laminectomy, posterior cervical fusion, and complications of lamin...

  20. A meta-analysis of unilateral versus bilateral pedicle screw fixation in minimally invasive lumbar interbody fusion.

    Directory of Open Access Journals (Sweden)

    Zheng Liu

    Full Text Available STUDY DESIGN: Meta-analysis. BACKGROUND: Bilateral pedicle screw fixation (PS after lumbar interbody fusion is a widely accepted method of managing various spinal diseases. Recently, unilateral PS fixation has been reported as effective as bilateral PS fixation. This meta-analysis aimed to comparatively assess the efficacy and safety of unilateral PS fixation and bilateral PS fixation in the minimally invasive (MIS lumbar interbody fusion for one-level degenerative lumbar spine disease. METHODS: MEDLINE/PubMed, EMBASE, BIOSIS Previews, and Cochrane Library were searched through March 30, 2014. Randomized controlled trials (RCTs and controlled clinical trials (CCTs on unilateral versus bilateral PS fixation in MIS lumbar interbody fusion that met the inclusion criteria and the methodological quality standard were retrieved and reviewed. Data on participant characteristics, interventions, follow-up period, and outcomes were extracted from the included studies and analyzed by Review Manager 5.2. RESULTS: Six studies (5 RCTs and 1 CCT involving 298 patients were selected. There were no significant differences between unilateral and bilateral PS fixation procedures in fusion rate, complications, visual analogue score (VAS for leg pain, VAS for back pain, Oswestry disability index (ODI. Both fixation procedures had similar length of hospital stay (MD = 0.38, 95% CI = -0.83 to 1.58; P = 0.54. In contrast, bilateral PS fixation was associated with significantly more intra-operative blood loss (P = 0.002 and significantly longer operation time (P = 0.02 as compared with unilateral PS fixation. CONCLUSIONS: Unilateral PS fixation appears as effective and safe as bilateral PS fixation in MIS lumbar interbody fusion but requires less operative time and causes less blood loss, thus offering a simple alternative approach for one-level lumbar degenerative disease.

  1. Posterior Decompression, Lumber Interbody Fusion and Internal Fixation in the Treatment of Upper Lumbar Intervertebral Disc Herniation

    Directory of Open Access Journals (Sweden)

    DONG Zhan

    2014-12-01

    Full Text Available Objective: To assess the clinical outcomes of posterior decompression, interbody fusion and internal fixationfor the treatment of the upper lumbar intervertebral disc herniation. Methods: Twelve patients with the upper lumbar intervertebral disc herniation were treated by posterior decompression, interbosy fusion and internal fixation. The time of the operation, the amount of bleeding and the clinical efficacy were evaluated. Results: The time of operation was (143±36 min and the amount of bleeding during operation was (331.5±47.9 mL. There was no spinal cord and injuries, nerve injury, epidural damage and leakage of cerebrospinal fluid. All patients were followed up for 10~19 months with the average being 12.6 months. The functional scoring of Japanese Orthopedic Association (JOA before the operation was (11.4±3.3 scores and final score after follow-up was (22.9±3.1 scores and there were statistical difference (P<0.01. Lumber interbody fusion of all patients completed successfully and the good rate after the operation was 91.7%. Conclusion: Posterior decompression, interbody fusion and internal fixation for the treatment of the upper lumbar intervertebral disc herniation was characterized by full exposure, safety and significant efficacy.

  2. MINIMALLY INVASIVE TRANSFORAMINAL LUMBAR INTERBODY FUSION IN DEGENERATIVE LUMBAR SPINE DISEASE

    Directory of Open Access Journals (Sweden)

    Pankaj

    2015-12-01

    Full Text Available OBJECTIVE To assess the clinical and radiological outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion (MI-TLIF and to analyze the surgical outcome for degenerative lumbar spine disease. METHODS A multicenter retrospective analysis of 20 patients who underwent a MI-TLIF by image guidance from 1 January 2012 to April 2015. The study included 13 males and 7 females (Mean age 53 year. CT scan of operating area was done to evaluate the pedicle screw, cage placement and fusion at 6 months post operatively. Oswestry Disability Index (ODI scores and Visual Analogue Scale (VAS were recorded pre-operatively and at 6-month followup. RESULTS Eighteen (90% patients had evidence of fusion at 6 months post operatively with a mean improvement of 34 on the ODI score. Mean length of hospital stay was 4 days. The mean operative time was 170min. One patient developed transient nerve root pain in the postoperative period which was managed conservatively and one patient developed superficial wound infection. There was no case of CSF leak. CONCLUSION MI-TLIF is a safe and effective surgical procedure for management of degenerative lumbar spine disease.

  3. Application of tridimensional intravertebral bone graft combined with AxiaLIF technique in lumbar interbody fusion

    Directory of Open Access Journals (Sweden)

    Xiangdong Duan

    2009-05-01

    Full Text Available "nLumbar interbody fusion techniques are becoming more and more minimally invasive. AxiaLIF technique can be used in low back pain caused by degenerative disc disease or minor spondylolisthesis, but there are risks for fusion failure. Intravertebral bone graft is performed in painful osteoporotic or posttraumatic vertebral compression fractures (VCFs. Until now, no attempt has been made to apply intravertebral bone graft with AxiaLIF technique."nSo first, we hypothesize a novel method for tridimensional intravertebral bone graft with a special designed bone grafting instrument and describe it vividly. The special instrument would mainly consist of a hollow tube and a rod, the distal parts of them would be shape into 45o slope, so the direction of grafting would be decided by the slope. By rotating the tube we can deliver cancellous bone granules in one plane, but by retreating the tube we can perform tridimensional intravertebral bone graft. Second, intravertebral bone graft is supposed to be performed combined with AxiaLIF technique in order to create biologic vertebral reconstruction and raise fusion rate. We believe this is the first description of such a method, future clinical studies are needed to validate these hypotheses.

  4. TranS1 VEO system: a novel psoas-sparing device for transpsoas lumbar interbody fusion

    OpenAIRE

    Hardenbrook MA; Miller LE; Block JE

    2013-01-01

    Mitchell A Hardenbrook,1,2 Larry E Miller,3,4 Jon E Block4 1Advanced Spine Institute of Greater Boston, North Billerica, MA, 2Department of Orthopedic Surgery, Tufts University School of Medicine, Boston, MA, 3Miller Scientific Consulting Inc, Arden, NC, 4The Jon Block Group, San Francisco, CA, USA Abstract: Minimally invasive approaches for lumbar interbody fusion have been popularized in recent years. The retroperitoneal transpsoas approach to the lumbar spine is a technique that allows dir...

  5. Demineralized Bone Matrix, as a Graft Enhancer of Auto-Local Bone in Posterior Lumbar Interbody Fusion

    OpenAIRE

    Ahn, Dong Ki; Moon, Sang Ho; Kim, Tae Woo; Boo, Kyung Hwan; Hong, Sung Won

    2014-01-01

    Study Design A case controlled study with prospective data collection. Purpose To evaluate the early influence and the final consequence of demineralized bone matrix (DBM) on auto-local bone as a graft enhancer in posterior lumbar interbody fusion (PLIF). Overview of Literature DBM is known as an osteoinductive material; however, it has not been clearly recognized to enhance auto-local bone with a small amount. Methods Patients who had a PLIF were allocated into two groups. Group I (70 cases)...

  6. Modified Posterior Lumbar Interbody Fusion for Radiculopathy Following Healed Vertebral Collapse of the Middle-Lower Lumbar Spine

    OpenAIRE

    Yamashita, Tomoya; Sakaura, Hironobu; Miwa, Toshitada; Ohwada, Tetsuo

    2014-01-01

    Study Design Retrospective study. Objectives Lumbar radiculopathy is rarely observed in patients who have achieved bony healing of vertebral fractures in the middle-lower lumbar spine. The objectives of the study were to clarify the clinical features of such radiculopathy and to evaluate the preliminary outcomes of treatment using a modified posterior lumbar interbody fusion (PLIF) procedure. Methods Fourteen patients with at least 2-year follow-up were enrolled in this study. The radiologic ...

  7. The Effect of the Retroperitoneal Transpsoas Minimally Invasive Lateral Interbody Fusion on Segmental and Regional Lumbar Lordosis

    OpenAIRE

    Le, Tien V.; Vivas, Andrew C.; Elias Dakwar; Ali A Baaj; Uribe, Juan S.

    2012-01-01

    Background. The minimally invasive lateral interbody fusion (MIS LIF) in the lumbar spine can correct coronal Cobb angles, but the effect on sagittal plane correction is unclear. Methods. A retrospective review of thirty-five patients with lumbar degenerative disease who underwent MIS LIF without supplemental posterior instrumentation was undertaken to study the radiographic effect on the restoration of segmental and regional lumbar lordosis using the Cobb angles on pre- and postoperative rad...

  8. Radiographic Results of Single Level Transforaminal Lumbar Interbody Fusion in Degenerative Lumbar Spine Disease: Focusing on Changes of Segmental Lordosis in Fusion Segment

    OpenAIRE

    Kim, Sang-Bum; Jeon, Taek-Soo; Heo, Youn-Moo; Lee, Woo-Suk; Yi, Jin-Woong; Kim, Tae-kyun; Hwang, Cheol-Mog

    2009-01-01

    Background To assess the radiographic results in patients who underwent transforaminal lumbar interbody fusion (TLIF), particularly the changes in segmental lordosis in the fusion segment, whole lumbar lordosis and disc height. Methods Twenty six cases of single-level TLIF in degenerative lumbar diseases were analyzed. The changes in segmental lordosis, whole lumbar lordosis, and disc height were evaluated before surgery, after surgery and at the final follow-up. Results The segmental lordosi...

  9. Surgical outcome of posterior lumbar interbody fusion with pedicle screw fixation for lumbar spondylolisthesis

    International Nuclear Information System (INIS)

    Problems of lumbar spondylolisthesis treatment are many surgical tactics, elderly patient, osteoporosis, complications and recurrence of the symptoms. PLIF (posterior lumbar interbody fusion) and PS (pedicle screw) fixation technique for lumbar spondylolisthesis provide good patient satisfaction. Good outcome has been reported by only laminectomy alone, but patient satisfaction becomes worse year after year. The role of instrumentation for lumbar spondylolisthesis is decompression of the nerve root, correction of lumbar pathologies, bony fusion and early mobilization. We show our surgical technique and long term outcome of PLIF with PS for lumbar spondylolisthesis. Three hundred and fifty cases of lumbar spondylolisthesis were operated on in Department of Neurosurgery, Fujita Health University during the period of from December 1992 to August 2008. Patient background: age 16-84 years old (mean 62.5), Gender: male 153, female 197. Follow-up period 1-180 months (mean 61.2). Degenerative: 255, Isthmic: 63, Dysplastic: 10, Fracture: 5 and scoliosis 16 cases. Surgical procedure was PS with interbody fusion cage: 331, Hybrid cage (titanium cage with hydroxyapatite) 314, PS with Cerabone: 2 and PS with autograft: 17. CT was done to evaluate bony fusion postoperatively. Post operative improvements by JOA (Japan Orthopedic Association) score is 11.4 before surgery, 24.1 (post op. within 2 years), 25.4 (post op. 2-5 years), 25.0 (post op. 5-10 years) and 22.4 (post op. 10-15 years). Significant improvements were observed in %Slip and Slip angle but no remarkable change was observed in lumbar lordotic angle by postoperative X-ray evaluation. No root injury, and systemic complication except 4 cases of cerebrospinal fluid (CSF) leakage during surgery. Two cases were reoperated in whom cage with autograft migration due to pseudoarthrosis. Two cases had to undergo screw and cage system removal due to infection. Two cases of adjacent level stenosis had to undergo operation 10

  10. Minimally invasive presacral approach for revision of an Axial Lumbar Interbody Fusion rod due to fall-related lumbosacral instability: a case report

    Directory of Open Access Journals (Sweden)

    Cohen Anders

    2011-09-01

    Full Text Available Abstract Introduction The purpose of this study was to describe procedural details of a minimally invasive presacral approach for revision of an L5-S1 Axial Lumbar Interbody Fusion rod. Case presentation A 70-year-old Caucasian man presented to our facility with marked thoracolumbar scoliosis, osteoarthritic changes characterized by high-grade osteophytes, and significant intervertebral disc collapse and calcification. Our patient required crutches during ambulation and reported intractable axial and radicular pain. Multi-level reconstruction of L1-4 was accomplished with extreme lateral interbody fusion, although focal lumbosacral symptoms persisted due to disc space collapse at L5-S1. Lumbosacral interbody distraction and stabilization was achieved four weeks later with the Axial Lumbar Interbody Fusion System (TranS1 Inc., Wilmington, NC, USA and rod implantation via an axial presacral approach. Despite symptom resolution following this procedure, our patient suffered a fall six weeks postoperatively with direct sacral impaction resulting in symptom recurrence and loss of L5-S1 distraction. Following seven months of unsuccessful conservative care, a revision of the Axial Lumbar Interbody Fusion rod was performed that utilized the same presacral approach and used a larger diameter implant. Minimal adhesions were encountered upon presacral re-entry. A precise operative trajectory to the base of the previously implanted rod was achieved using fluoroscopic guidance. Surgical removal of the implant was successful with minimal bone resection required. A larger diameter Axial Lumbar Interbody Fusion rod was then implanted and joint distraction was re-established. The radicular symptoms resolved following revision surgery and our patient was ambulating without assistance on post-operative day one. No adverse events were reported. Conclusions The Axial Lumbar Interbody Fusion distraction rod may be revised and replaced with a larger diameter rod using

  11. Lifestyle-Related Diseases Affect Surgical Outcomes after Posterior Lumbar Interbody Fusion.

    Science.gov (United States)

    Sakaura, Hironobu; Miwa, Toshitada; Yamashita, Tomoya; Kuroda, Yusuke; Ohwada, Tetsuo

    2016-02-01

    Study Design Retrospective study. Objective Hyperlipidemia (HL) and hypertension (HT) lead to systemic atherosclerosis. Not only atherosclerosis but also bone fragility and/or low bone mineral density result from diabetes mellitus (DM) and chronic kidney disease (CKD). The purpose of this study was to examine whether these lifestyle-related diseases affected surgical outcomes after posterior lumbar interbody fusion (PLIF). Methods The subjects comprised 122 consecutive patients who underwent single-level PLIF for degenerative lumbar spinal disorders. The clinical results were assessed using the Japanese Orthopaedic Association (JOA) score before surgery and at 2 years postoperatively. The fusion status was graded as union in situ, collapsed union, or nonunion at 2 years after surgery. The abdominal aorta calcification (AAC) score was assessed using preoperative lateral radiographs of the lumbar spine. Results HL did not significantly affect the JOA score recovery rate. On the other hand, HT and CKD (stage 3 to 4) had a significant adverse effect on the recovery rate. The recovery rate was also lower in the DM group than in the non-DM group, but the difference was not significant. The AAC score was negatively correlated with the JOA score recovery rate. The fusion status was not significantly affected by HL, HT, DM, or CKD; however, the AAC score was significantly higher in the collapsed union and nonunion group than in the union in situ group. Conclusions At 2 years after PLIF, the presence of HT, CKD, and AAC was associated with significantly worse clinical outcomes, and advanced AAC significantly affected fusion status. PMID:26835195

  12. Total 3D Airo® Navigation for Minimally Invasive Transforaminal Lumbar Interbody Fusion

    Science.gov (United States)

    Lian, Xiaofeng; Berlin, Connor; Moriguchi, Yu; Zhang, Qiwei; Härtl, Roger

    2016-01-01

    Introduction. A new generation of iCT scanner, Airo®, has been introduced. The purpose of this study is to describe how Airo facilitates minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Method. We used the latest generation of portable iCT in all cases without the assistance of K-wires. We recorded the operation time, number of scans, and pedicle screw accuracy. Results. From January 2015 to December 2015, 33 consecutive patients consisting of 17 men and 16 women underwent single-level or two-level MIS-TLIF operations in our institution. The ages ranged from 23 years to 86 years (mean, 66.6 years). We treated all the cases in MIS fashion. In four cases, a tubular laminectomy at L1/2 was performed at the same time. The average operation time was 192.8 minutes and average time of placement per screw was 2.6 minutes. No additional fluoroscopy was used. Our screw accuracy rate was 98.6%. No complications were encountered. Conclusions. Airo iCT MIS-TLIF can be used for initial planning of the skin incision, precise screw, and cage placement, without the need for fluoroscopy. “Total navigation” (complete intraoperative 3D navigation without fluoroscopy) can be achieved by combining Airo navigation with navigated guide tubes for screw placement. PMID:27529069

  13. Total 3D Airo® Navigation for Minimally Invasive Transforaminal Lumbar Interbody Fusion

    Directory of Open Access Journals (Sweden)

    Xiaofeng Lian

    2016-01-01

    Full Text Available Introduction. A new generation of iCT scanner, Airo®, has been introduced. The purpose of this study is to describe how Airo facilitates minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF. Method. We used the latest generation of portable iCT in all cases without the assistance of K-wires. We recorded the operation time, number of scans, and pedicle screw accuracy. Results. From January 2015 to December 2015, 33 consecutive patients consisting of 17 men and 16 women underwent single-level or two-level MIS-TLIF operations in our institution. The ages ranged from 23 years to 86 years (mean, 66.6 years. We treated all the cases in MIS fashion. In four cases, a tubular laminectomy at L1/2 was performed at the same time. The average operation time was 192.8 minutes and average time of placement per screw was 2.6 minutes. No additional fluoroscopy was used. Our screw accuracy rate was 98.6%. No complications were encountered. Conclusions. Airo iCT MIS-TLIF can be used for initial planning of the skin incision, precise screw, and cage placement, without the need for fluoroscopy. “Total navigation” (complete intraoperative 3D navigation without fluoroscopy can be achieved by combining Airo navigation with navigated guide tubes for screw placement.

  14. Total 3D Airo® Navigation for Minimally Invasive Transforaminal Lumbar Interbody Fusion.

    Science.gov (United States)

    Lian, Xiaofeng; Navarro-Ramirez, Rodrigo; Berlin, Connor; Jada, Ajit; Moriguchi, Yu; Zhang, Qiwei; Härtl, Roger

    2016-01-01

    Introduction. A new generation of iCT scanner, Airo®, has been introduced. The purpose of this study is to describe how Airo facilitates minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Method. We used the latest generation of portable iCT in all cases without the assistance of K-wires. We recorded the operation time, number of scans, and pedicle screw accuracy. Results. From January 2015 to December 2015, 33 consecutive patients consisting of 17 men and 16 women underwent single-level or two-level MIS-TLIF operations in our institution. The ages ranged from 23 years to 86 years (mean, 66.6 years). We treated all the cases in MIS fashion. In four cases, a tubular laminectomy at L1/2 was performed at the same time. The average operation time was 192.8 minutes and average time of placement per screw was 2.6 minutes. No additional fluoroscopy was used. Our screw accuracy rate was 98.6%. No complications were encountered. Conclusions. Airo iCT MIS-TLIF can be used for initial planning of the skin incision, precise screw, and cage placement, without the need for fluoroscopy. "Total navigation" (complete intraoperative 3D navigation without fluoroscopy) can be achieved by combining Airo navigation with navigated guide tubes for screw placement. PMID:27529069

  15. Magnetic resonance imaging analysis of surgical trans-sacral axial L5/S1 interbody fusion

    Institute of Scientific and Technical Information of China (English)

    YAN Ning; HE Shi-sheng; ZHANG Hai-long; GU Guang-fei; LIU Bi-feng; LIU Yan-bin; ZHANG Li-guo; GU Xin; DING Yue; GUO Cheng-bin

    2011-01-01

    Background Trans-sacral axial L5/S1 interbody fusion (AxiaLIF), a novel surgical procedure, recently adopted in clinical practice, has excellent clinical outcomes. However, there is inadequate data on the feasibility of the approach in all adult patients and the optimal surgical approach is currently unclear; therefore, further studies are required. In order to enhance the surgical approach for AxiaLIF, prospective anatomical imaging optimization is necessary. The objective of this study was to investigate the ability of magnetic resonance imaging (MRI) to achieve an optimal procedural setting.Methods The subjects (n=40) underwent lumbosacral MRI examination. The median sagittal MRI images were analyzed and four measurement markers were defined as follows: the center of the L5/S1 disc (A), the anterior margin of the S1/2 disc space (B), the sacrococcygeal junction (C), and the coccygeal tip (D). The measurement markers were connected to each other to produce five lines (AB, AC, AD, BC, and BD), as reference lines for surgical approaches. The distance between each reference line and the anterior and posterior margins of the L5 and S1 vertebral bodies was measured to determine the safety of the respective approaches.Results In all patients, Lines AB and AC satisfied the imaging safety criteria. Line AB would result in a significant deviation from the median and was determined to be unsuitable for AxiaLIF. Line AD satisfied the imaging safety criteria in 39 patients. However, the anal proximity of the puncture point proved to be limiting. For lines BC and BD, the imaging safety criteria were satisfied in 70% and 45% of patients, respectively.Conclusions The AxiaLIF procedure is a safe technique for insertion of fusion implants in all subjects. Line AC is a favorable reference line for surgical approach and safe for all subjects, while line BC is not suitable for all subjects.

  16. Minimally Invasive Extraforaminal Lumbar Interbody Fusion for Revision Surgery: A Technique through Kambin's Triangle

    Science.gov (United States)

    Lee, Jun Gue; Kim, Hyeun Sung

    2015-01-01

    Objective The purpose of this study was to evaluate the clinical outcomes of minimally invasive extraforaminal lumbar interbody fusion (ELIF) for revision surgery. Methods From January 2011 to December 2012, 12 patients who underwent minimally invasive ELIF through the Kambin's triangle for revision surgery were included in this study. All patients underwent the surgical procedure in the following sequence: (1) epidural anesthesia, (2) exposing the Kambin's triangle toward the lateral part of the dura (partial resection of the superior articular process), (3) bilateral cage insertion for reinforcement of stabilization and fusion, and (4) percutaneous transpedicular screwing. Clinical outcomes were assessed using the visual analogue scale (VAS), and Oswestry disability index (ODI). Imaging and clinical findings including surgical techniques, clinical outcomes, and related complications were depicted and analyzed. Results The mean age of the patients (5 men, 7 women) was 60.7±13.4 years, and the mean follow-up period was 27.1±4.9 months. The mean VAS (back and leg) score improved significantly at final follow-up. The mean ODI score decreased as follows: preoperative, 76.78±6.08; 3 months after the surgery, 37.74±6.67; and at final follow-up, 29.91±2.98. Two patients presented with transient nerve root irritation, but there were no cases of incidental dural tear or serious infection. No significant neurological deterioration or major complication was noted in any of the patients. Conclusion Minimally invasive ELIF for revision surgery is an effective surgical option with a low complication rate. PMID:26834815

  17. 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.)

  18. Minimally invasive lumbar interbody fusion via MAST Quadrant retractor versus open surgery: a prospective randomized clinical trial

    Institute of Scientific and Technical Information of China (English)

    WANG Hong-li; L(U) Fei-zhou; JIANG Jian-yuan; MA Xin; XIA Xin-lei; WANG Li-xun

    2011-01-01

    Background In recent years,a variety of minimally invasive lumbar surgery techniques have achieved desirable efficacy,but some dispute remains regarding the advantages over open surgery.This study aimed to compare minimally invasive lumbar interbody fusion via MAST Quadrant retractor with open surgery in terms of perioperative factors,postoperative back muscle function,and 24-month postoperative follow-up results.Methods From September 2006 to June 2008,patients with single-level degenerative lumbar spine disease who were not responsive to conservative treatment were enrolled in this study.Patients were randomized to undergo either minimally invasive surgery (MIS,transforaminal lumbar interbody fusion via MAST Quadrant retractor,41 cases) or open surgery (improved transforaminal lumbar interbody fusion,38 cases).Results The MIS group had longer intraoperative fluoroscopy time than the open surgery group,and the open surgery group had significantly increased postoperative drainage volume and significantly prolonged postoperative recovery time compared with the MIS group (P <0.05 for all).MRI scanning showed that the T2 relaxation time in the multifidus muscle was significantly shorter in the MIS group than in the open surgery group at 3 months after surgery (P <0.01).Surface electromyography of the sacrospinalis muscle showed that the average discharge amplitude and frequency were significantly higher in the MIS group than in the open surgery group (P <0.01).The Oswestry disability index and visual analog scale scores were better at 3,6,12 and 24 months postoperatively than preoperatively in both groups.Both groups of patients met the imaging convergence criteria at the last follow-up.Conclusions MIS can effectively reduce sacrospinalis muscle injury compared with open surgery,which is conducive to early functional recovery.In the short term,MIS is superior to open surgery,but in the long term there is no significant difference between the two procedures.

  19. Evaluation of a novel tool for bone graft delivery in minimally invasive transforaminal lumbar interbody fusion

    Directory of Open Access Journals (Sweden)

    Kleiner JB

    2016-05-01

    Full Text Available Jeffrey B Kleiner, Hannah M Kleiner, E John Grimberg Jr, Stefanie J Throlson The Spine Center of Innovation, The Medical Center of Aurora, Aurora, CO, USA Study design: Disk material removed (DMR during L4-5 and L5-S1 transforaminal lumbar interbody fusion (T-LIF surgery was compared to the corresponding bone graft (BG volumes inserted at the time of fusion. A novel BG delivery tool (BGDT was used to apply the BG. In order to establish the percentage of DMR during T-LIF, it was compared to DMR during anterior diskectomy (AD. This study was performed prospectively. Summary of background data: Minimal information is available as to the volume of DMR during a T-LIF procedure, and the relationship between DMR and BG delivered is unknown. BG insertion has been empiric and technically challenging. Since the volume of BG applied to the prepared disk space likely impacts the probability of arthrodesis, an investigation is justified. Methods: A total of 65 patients with pathology at L4-5 and/or L5-S1 necessitating fusion were treated with a minimally invasive T-LIF procedure. DMR was volumetrically measured during disk space preparation. BG material consisting of local autograft, BG extender, and bone marrow aspirate were mixed to form a slurry. BG slurry was injected into the disk space using a novel BGDT and measured volumetrically. An additional 29 patients who were treated with L5-S1 AD were compared to L5-S1 T-LIF DMR to determine the percent of T-LIF DMR relative to AD. Results: DMR volumes averaged 3.6±2.2 mL. This represented 34% of the disk space relative to AD. The amount of BG delivered to the disk spaces was 9.3±3.2 mL, which is 2.6±2.2 times the amount of DMR. The BGDT allowed uncomplicated filling of the disk space in <1 minute. Conclusion: The volume of DMR during T-LIF allows for a predictable volume of BG delivery. The BGDT allowed complete filling of the entire prepared disk space. The T-LIF diskectomy debrides 34% of the disk

  20. Thrombosis of Left Common Iliac Artery Following Anterior Lumbar Interbody Fusion: Case Report and Review of Literatures

    OpenAIRE

    Kim, Jin-Sung; CHOI, KYUNG-CHUL; Jung, Byungjoo; Lee, Sang-Ho

    2009-01-01

    We report on a case of thrombosis of the left common iliac artery following anterior lumbar interbody fusion (ALIF) of L4-5 in a 79-year-old man with no previous medical problems, including peripheral vascular disease. After completing the ALIF procedure, the surgeon could not feel the pulsation of the left dorsalis pedis artery, and the oxygen saturation (SaO2) had fallen below 90% from pulse oxymetry on the left great toe. Thrombectomy was successfully performed after confirming the thrombu...

  1. Effect of Psychological Status on Outcome of Posterior Lumbar Interbody Fusion Surgery

    Science.gov (United States)

    Lakkol, Sandesh; Budithi, Chakra; Bhatia, Chandra; Krishna, Manoj

    2012-01-01

    Study Design Prospective longitudinal study. Purpose To determine if preoperative psychological status affects outcome in spinal surgery. Overview of Literature Low back pain is known to have a psychosomatic component. Increased bodily awareness (somatization) and depressive symptoms are two factors that may affect outcome. It is possible to measure these components using questionnaires. Methods Patients who underwent posterior interbody fusion (PLIF) surgery were assessed preoperatively and at follow-up using a self-administered questionnaire. The visual analogue scale (VAS) for back and leg pain severity and the Oswestry Disability Index (ODI) were used as outcome measures. The psychological status of patients was classified into one of four groups using the Distress and Risk Assessment Method (DRAM); normal, at-risk, depressed somatic and distressed depressive. Results Preoperative DRAM scores showed 14 had no psychological disturbance (normal), 39 were at-risk, 11 distressed somatic, and 10 distressed depressive. There was no significant difference between the 4 groups in the mean preoperative ODI (analysis of variance, p = 0.426). There was a statistically and clinically significant improvement in the ODI after surgery for all but distressed somatic patients (9.8; range, -5.2 to 24.8; p = 0.177). VAS scores for all groups apart from the distressed somatic showed a statistically and clinically significant improvement. Our results show that preoperative psychological state affects outcome in PLIF surgery. Conclusions Patients who were classified as distressed somatic preoperatively had a less favorable outcome compared to other groups. This group of patients may benefit from formal psychological assessment before undergoing PLIF surgery. PMID:22977697

  2. Comparison of the Dynesys Dynamic Stabilization System and Posterior Lumbar Interbody Fusion for Lumbar Degenerative Disease.

    Directory of Open Access Journals (Sweden)

    Yang Zhang

    Full Text Available There have been few studies comparing the clinical and radiographic outcomes between the Dynesys dynamic stabilization system and posterior lumbar interbody fusion (PLIF. The objective of this study is to compare the clinical and radiographic outcomes of Dynesys and PLIF for lumbar degenerative disease.Of 96 patients with lumbar degenerative disease included in this retrospectively analysis, 46 were treated with the Dynesys system and 50 underwent PLIF from July 2008 to March 2011. Clinical and radiographic outcomes were evaluated. We also evaluated the occurrence of radiographic and symptomatic adjacent segment degeneration (ASD.The mean follow-up time in the Dynesys group was 53.6 ± 5.3 months, while that in the PLIF group was 55.2 ± 6.8 months. At the final follow-up, the Oswestry disability index and visual analogue scale score were significantly improved in both groups. The range of motion (ROM of stabilized segments in Dynesys group decreased from 7.1 ± 2.2° to 4.9 ± 2.2° (P < 0.05, while that of in PLIF group decreased from 7.3 ± 2.3° to 0° (P < 0.05. The ROM of the upper segments increased significantly in both groups at the final follow-up, the ROM was higher in the PLIF group. There were significantly more radiographic ASDs in the PLIF group than in the Dynesys group. The incidence of complications was comparable between groups.Both Dynesys and PLIF can improve the clinical outcomes for lumbar degenerative disease. Compared to PLIF, Dynesys stabilization partially preserves the ROM of the stabilized segments, limits hypermobility in the upper adjacent segment, and may prevent the occurrence of ASD.

  3. Mast Quadrant-assisted Minimally Invasive Modified Transforaminal Lumbar Interbody Fusion: Single Incision Versus Double Incision

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    Xin-Lei Xia

    2015-01-01

    Full Text Available Background: The concept of minimally invasive techniques is to make every effort to reduce tissue damage. Certainly, reducing skin incision is an important part of these techniques. This study aimed to investigate the clinical feasibility of Mast Quadrant-assisted modified transforaminal lumbar interbody fusion (TLIF with a small single posterior median incision. Methods: During the period of March 2011 to March 2012, 34 patients with single-segment degenerative lumbar disease underwent the minimally invasive modified TLIF assisted by Mast Quadrant with a small single posterior median incision (single incision group. The cases in this group were compared to 37 patients with single-segment degenerative lumbar disease in the double incision group. The perioperative conditions of patients in these two groups were statistically analyzed and compared. The Oswestry Disability Index (ODI scores, Visual Analog Scale (VAS scores, and sacrospinalis muscle damage evaluation indicators before operation and 3, 12 months postoperation were compared. Results: A total of 31 and 35 cases in the single incision and double incision groups, respectively, completed at least 12 months of systemic follow-up. The differences in perioperative conditions between the two groups were not statistically significant. The incision length of the single incision group was significantly shorter than that of the double incision group (P < 0.01. The ODI and VAS scores of patients in both groups improved significantly at 3 and 12 months postoperation. However, these two indicators at 3 and 12 months postoperation and the sacrospinalis muscle damage evaluation indicators at 3 months postoperation did not differ significantly between the two groups (P ≥ 0.05. Conclusions: Mast Quadrant-assisted modified TLIF with a small single posterior median incision has excellent clinical feasibility compared to minimally invasive TLIF with a double paramedian incision.

  4. 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

  5. Minimally invasive transforaminal lumbar interbody fusion aided with computer-assisted spinal navigation system combined with electromyography monitoring

    Institute of Scientific and Technical Information of China (English)

    LUO Wei; ZHANG Fan; LIU Tie; DU Xing-li; CHEN An-ming; LI Feng

    2012-01-01

    Background Minimally invasive techniques are gaining wide-spread application in lumbar fusion surgery,because they may have advantage over conventional open surgery in approach-related morbidity.This research was aimed to evaluate the safety and accuracy of the techniques of minimally invasive transforaminal lumbar interbody fusion by using a computer-assisted spinal navigation system combined with electromyography monitoring.Methods Sixteen patients underwent minimally invasive transforaminal lumbar interbody fusion.A computer-assisted spinal navigation system and electromyography were used for guiding pedicle screw placement.The operative duration,blood loss,complications,and fluoroscopic time were recorded.Clinical outcome was assessed by Visual Analog Scale and Oswestry Disability Index.Radiographic images were obtained to evaluate the accuracy of pedicle screw placement and fusion rates.Results The Visual Analog Scale and Oswestry Disability Index scores were vastly improved postoperatively.A total of 64 pedicle screws were implanted and three were regarded as misplacement by post-operative CT scan.Three screw trajectories were adjusted according to intra-operative stimulus-evoked electromyography monitoring.The average fluoroscopy time in each patient was 31.8 seconds,which equals to 7.9 seconds per pedicle screw.No patients had instrument related neurological complications,infection,implant failure or revision.Successful fusion was found in all patients.Conclusions The combination of navigation system and real-time electromyography monitoring can make the minimally invasive operation more safe and accurate while decreasing radiation exposure time of the medical staff and patient and minimizing the chance and the degree of the pedicle screw misplacement.

  6. 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.

  7. Excessive distraction of lumbar disc space induces early degeneration of the adjacent segment after posterior lumbar interbody fusion (PLIF)

    International Nuclear Information System (INIS)

    Posterior lumbar interbody fusion (PLIF) for lumbar spondylolisthesis usually results in an excellent outcome, but the problem of so-called adjacent segment disease (ASD) remains unresolved. ASD at L3/4 was investigated in 85 patients with LA spondylolisthesis treated by L4/5 PLIF with uniform pedicle screws and interbody cages who had been followed up for more than two years (mean, 38.8±17.1 months). The patients were divided into three groups according to the final outcome: a group without ASD (n=58), a group with radiological ASD (n=14), and a group with clinical ASD (n=13). Eleven patients in the third group were reoperated to treat L3/4 lesions. L4-5 disc height distraction by cage insertion in the three groups was 3.1 mm, 4.4 mm, and 6.2 mm, respectively, and the latter two values were significantly higher than the first value. Excessive distraction of the L4/5 disc space proved to be a significant risk factor for radiological and clinical ASD at L3/4. (author)

  8. 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

  9. [Three-dimensional Finite Element Analysis of Biomechanical Effect of Rigid Fixation and Elastic Fixation on Lumbar Interbody Fusion].

    Science.gov (United States)

    Wei, Jiangbo; Song, Yueming; Liu, Limin; Zhou, Chunguan; Yang, Xi

    2015-04-01

    This study was aimed to compare the mechanical characteristics under different physiological load conditions with three-dimensional finite element model of rigid fixation and elastic fixation in the lumbar. We observed the stress distribution characteristics of a sample of healthy male volunteer modeling under vertical, flexion and extension torque situation. The outcomes showed that there existed 4-6 times pressure on the connecting rod of rigid fixation compared with the elastic fixations under different loads, and the stress peak and area of force on elastic fixation were much higher than that of the rigid fixations. The elastic fixation has more biomechanical advantages than rigid fixation in promoting interbody lumbar fusion after surgery. PMID:26211247

  10. Clinico-radiological profile of indirect neural decompression using cage or auto graft as interbody construct in posterior lumbar interbody fusion in spondylolisthesis: Which is better?

    Directory of Open Access Journals (Sweden)

    Q R Abdul

    2011-01-01

    Full Text Available Study design: A prospective clinical study of posterior lumbar interbody fusion in grade I and II degenerative spondylolisthesis was conducted between Mar 2007 and Aug 2008. Purpose: The objective was to assess the clinicoradiological profile of structural v/s nonstructural graft on intervertebral disc height and its consequences on the low back pain (LBP assessed by Visual analog score (VAS score and oswestry disability index (ODI . This study involved 28 patients. Inclusion criteria: Age of 30-70 years, symptomatic patient with disturbed Activities of daily living (ADL, single-level L4/L5 or L5/S1 grade I or grade II degenerative spondylolisthesis. Exclusion criteria: Patients with osteoporosis, recent spondylodiscitis, subchondral sclerosis, visual and cognitive impairment and all other types of spondylolisthesis. All the patients underwent short-segment posterior fixation using CD2 or M8 instrumentation, laminectomy discectomy, reduction and distraction of the involved vertebral space. In 53.5% (n = 15 of the patients, snugly fitted local bone chips were used while in 46.4% (n = 13 of the patients, cage was used. Among the cage group, titanium cage was used in nine (32.1% and PEEK cages were used in four (14.2% patients. In one patient, a unilateral PEEK cage was used. The mean follow-up period was 24 months. Among the 28 patients, 67.8% (n = 19 were females and 32.14% (n = 9 were males. 68.24% (n = 18 had L4/L5 and 35.71% (n = 10 had L5/S1 spondylolisthesis. 39.28% (n = 11 were of grade I and 60.71% (n = 17 were of grade II spondylolisthesis. Conclusions: There was a statistically significant correlation (P < 0.012 and P < 0.027 between the change in disc height achieved and the improvement in VAS score in both the graft group and the cage group. The increment in disc height and VAS score was significantly better in the cage group (2 mm ± SD vis-a-vis 7.2 [88%] than the graft group (1.2 mm ± SD vis-a-vis 5 [62 %].

  11. Minimally Invasive Transforaminal Lumbar Interbody Fusion at L5-S1 through a Unilateral Approach: Technical Feasibility and Outcomes

    Science.gov (United States)

    Choi, Won-Suh; Kim, Jin-Sung; Ryu, Kyeong-Sik; Hur, Jung-Woo; Seong, Ji-Hoon

    2016-01-01

    Background. Minimally invasive spinal transforaminal lumbar interbody fusion (MIS-TLIF) at L5-S1 is technically more demanding than it is at other levels because of the anatomical and biomechanical traits. Objective. To determine the clinical and radiological outcomes of MIS-TLIF for treatment of single-level spinal stenosis low-grade isthmic or degenerative spondylolisthesis at L5-S1. Methods. Radiological data and electronic medical records of patients who underwent MIS-TLIF between May 2012 and December 2014 were reviewed. Fusion rate, cage position, disc height (DH), disc angle (DA), disc slope angle, segmental lordotic angle (SLA), lumbar lordotic angle (LLA), and pelvic parameters were assessed. For functional assessment, the visual analogue scale (VAS), Oswestry disability index (ODI), and patient satisfaction rate (PSR) were utilized. Results. A total of 21 levels in 21 patients were studied. DH, DA, SLA, and LLA had increased from their preoperative measures at the final follow-up. Fusion rate was 86.7% (18/21) at 12 months' follow-up. The most common cage position was anteromedial (15/21). The mean VAS scores for back and leg pain mean ODI scores improved significantly at the final follow-up. PSR was 88%. Cage subsidence was observed in 33.3% (7/21). Conclusions. The clinical and radiologic outcomes after MIS-TLIF at L5-S1 in patients with spinal stenosis or spondylolisthesis are generally favorable. PMID:27433472

  12. Endoscopic minimally invasive transforaminal interbody fusion without general anesthesia: initial clinical experience with 1-year follow-up.

    Science.gov (United States)

    Wang, Michael Y; Grossman, Jay

    2016-02-01

    OBJECTIVE One of the principal goals of minimally invasive surgery has been to speed postoperative recovery. In this case series, the authors used an endoscopic technique for interbody fusion combined with percutaneous screw fixation to obviate the need for general anesthesia. METHODS The first 10 consecutive patients treated with a minimum of 1 year's follow-up were included in this series. The patients were all treated using endoscopic access through Kambin's triangle to allow for neural decompression, discectomy, endplate preparation, and interbody fusion. This was followed by percutaneous pedicle screw and connecting rod placement using liposomal bupivacaine for long-acting analgesia. No narcotics or regional anesthetics were used during surgery. RESULTS All patients underwent the procedure successfully without conversion to open surgery. The patients' average age was 62.2 ± 9.0 years (range 52-78 years). All patients had severe disc height collapse, and 60% had a Grade I spondylolisthesis. The mean operative time was 113.5 ± 6.3 minutes (range 105-120 minutes), and blood loss was 65 ± 38 ml (range 30-190 ml). The mean length of hospital stay was 1.4 ± 1.3 nights. There were no intraoperative or postoperative complications. Comparison of preoperative and final clinical metrics demonstrated that the Oswestry Disability Index improved from 42 ± 11.8 to 13.3 ± 15.1; the 36-Item Short Form Health Survey (SF-36) Physical Component Summary improved from 47.6 ± 3.8 to 49.7 ± 5.4; the SF-36 Mental Component Summary decreased from 47 ± 3.9 to 46.7 ± 3.4; and the EQ-5D improved from 10.7 ± 9.5 to 14.2 ± 1.6. There were no cases of nonunion identified radiographically on follow-up imaging. CONCLUSIONS Endoscopic fusion under conscious sedation may represent a feasible alternative to traditional lumbar spine fusion in select patients. Larger clinical series are necessary to validate that clinical improvements are sustained and that arthrodesis rates are

  13. The impact of sagittal balance on clinical results after posterior interbody fusion for patients with degenerative spondylolisthesis: A Pilot study

    Directory of Open Access Journals (Sweden)

    Chung Sung-Soo

    2011-04-01

    Full Text Available Abstract Background Comparatively little is known about the relation between the sagittal vertical axis and clinical outcome in cases of degenerative lumbar spondylolisthesis. The objective of this study was to determine whether lumbar sagittal balance affects clinical outcomes after posterior interbody fusion. This series suggests that consideration of sagittal balance during posterior interbody fusion for degenerative spondylolisthesis can yield high levels of patient satisfaction and restore spinal balance Methods A retrospective study of clinical outcomes and a radiological review was performed on 18 patients with one or two level degenerative spondylolisthesis. Patients were divided into two groups: the patients without improvement in pelvic tilt, postoperatively (Group A; n = 10 and the patients with improvement in pelvic tilt postoperatively (Group B; n = 8. Pre- and postoperative clinical outcome surveys were administered to determine Visual Analogue Pain Scores (VAS and Oswestry disability index (ODI. In addition, we evaluated full spine radiographic films for pelvic tilt (PT, sacral slope (SS, pelvic incidence (PI, thoracic kyphosis (TK, lumbar lordosis (LL, sacrofemoral distance (SFD, and sacro C7 plumb line distance (SC7D Results All 18 patients underwent surgery principally for the relief of radicular leg pain and back pain. In groups A and B, mean preoperative VAS were 6.85 and 6.81, respectively, and these improved to 3.20 and 1.63 at last follow-up. Mean preoperative ODI were 43.2 and 50.4, respectively, and these improved to 23.6 and 18.9 at last follow-up. In spinopelvic parameters, no significant difference was found between preoperative and follow up variables except PT in Group A. However, significant difference was found between the preoperative and follows up values of PT, SS, TK, LL, and SFD/SC7D in Group B. Between parameters of group A and B, there is borderline significance on preoperative PT, preoperative LL and last

  14. 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...

  15. 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。

  16. TranS1 VEO system: a novel psoas-sparing device for transpsoas lumbar interbody fusion

    Directory of Open Access Journals (Sweden)

    Hardenbrook MA

    2013-06-01

    Full Text Available Mitchell A Hardenbrook,1,2 Larry E Miller,3,4 Jon E Block4 1Advanced Spine Institute of Greater Boston, North Billerica, MA, 2Department of Orthopedic Surgery, Tufts University School of Medicine, Boston, MA, 3Miller Scientific Consulting Inc, Arden, NC, 4The Jon Block Group, San Francisco, CA, USA Abstract: Minimally invasive approaches for lumbar interbody fusion have been popularized in recent years. The retroperitoneal transpsoas approach to the lumbar spine is a technique that allows direct lateral access to the intervertebral disc space while mitigating the complications associated with traditional anterior or posterior approaches. However, a common complication of this procedure is iatrogenic injury to the psoas muscle and surrounding nerves, resulting in postsurgical motor and sensory deficits. The TranS1 VEO system (TranS1 Inc, Raleigh, NC, USA utilizes a novel, minimally invasive transpsoas approach to the lumbar spine that allows direct visualization of the psoas and proximal nerves, potentially minimizing iatrogenic injury risk and resulting clinical morbidity. This paper describes the clinical uses, procedural details, and indications for use of the TranS1 VEO system. Keywords: fusion, lateral, lumbar, minimally invasive, transpsoas, VEO

  17. Structural and mechanical evaluations of a topology optimized titanium interbody fusion cage fabricated by selective laser melting process.

    Science.gov (United States)

    Lin, Chia-Ying; Wirtz, Tobias; LaMarca, Frank; Hollister, Scott J

    2007-11-01

    A topology optimized lumbar interbody fusion cage was made of Ti-Al6-V4 alloy by the rapid prototyping process of selective laser melting (SLM) to reproduce designed microstructure features. Radiographic characterizations and the mechanical properties were investigated to determine how the structural characteristics of the fabricated cage were reproduced from design characteristics using micro-computed tomography scanning. The mechanical modulus of the designed cage was also measured to compare with tantalum, a widely used porous metal. The designed microstructures can be clearly seen in the micrographs of the micro-CT and scanning electron microscopy examinations, showing the SLM process can reproduce intricate microscopic features from the original designs. No imaging artifacts from micro-CT were found. The average compressive modulus of the tested caged was 2.97+/-0.90 GPa, which is comparable with the reported porous tantalum modulus of 3 GPa and falls between that of cortical bone (15 GPa) and trabecular bone (0.1-0.5 GPa). The new porous Ti-6Al-4V optimal-structure cage fabricated by SLM process gave consistent mechanical properties without artifactual distortion in the imaging modalities and thus it can be a promising alternative as a porous implant for spine fusion. PMID:17415762

  18. Retrospective cost analysis of cervical laminectomy and fusion versus cervical laminoplasty in the treatment of cervical spondylotic myelopathy

    OpenAIRE

    Warren, Daniel T.; Ricart-Hoffiz, Pedro A.; Andres, Tate M.; Hoelscher, Christian M.; Protopsaltis, Themistocles S.; Goldstein, Jeffrey A; Bendo, John A.

    2013-01-01

    Background Cervical laminoplasty (CLP) and posterior cervical laminectomy and fusion (CLF) are well-established surgical procedures used in the treatment of cervical spondylotic myelopathy (CSM). In situations of clinical equipoise, an influential factor in procedural decision making could be the economic effect of the chosen procedure. The object of this study is to compare and analyze the total hospital costs and charges pertaining to patients undergoing CLP or CLF for the treatment of CSM....

  19. 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 ...

  20. Percutaneous pedicle screw reduction and axial presacral lumbar interbody fusion for treatment of lumbosacral spondylolisthesis: A case series

    Directory of Open Access Journals (Sweden)

    Miller Larry E

    2011-09-01

    Full Text Available Abstract Introduction Traditional surgical management of lumbosacral spondylolisthesis is technically challenging and is associated with significant complications. The advent of minimally invasive surgical techniques offers patients treatment alternatives with lower operative morbidity risk. The combination of percutaneous pedicle screw reduction and an axial presacral approach for lumbosacral discectomy and fusion offers an alternative procedure for the surgical management of low-grade lumbosacral spondylolisthesis. Case presentation Three patients who had L5-S1 grade 2 spondylolisthesis and who presented with axial pain and lumbar radiculopathy were treated with a minimally invasive surgical technique. The patients-a 51-year-old woman and two men (ages 46 and 50-were Caucasian. Under fluoroscopic guidance, spondylolisthesis was reduced with a percutaneous pedicle screw system, resulting in interspace distraction. Then, an axial presacral approach with the AxiaLIF System (TranS1, Inc., Wilmington, NC, USA was used to perform the discectomy and anterior fixation. Once the axial rod was engaged in the L5 vertebral body, further distraction of the spinal interspace was made possible by partially loosening the pedicle screw caps, advancing the AxiaLIF rod to its final position in the vertebrae, and retightening the screw caps. The operative time ranged from 173 to 323 minutes, and blood loss was minimal (50 mL. Indirect foraminal decompression and adequate fixation were achieved in all cases. All patients were ambulatory after surgery and reported relief from pain and resolution of radicular symptoms. No perioperative complications were reported, and patients were discharged in two to three days. Fusion was demonstrated radiographically in all patients at one-year follow-up. Conclusions Percutaneous pedicle screw reduction combined with axial presacral lumbar interbody fusion offers a promising and minimally invasive alternative for the management

  1. Two-level anterior lumbar interbody fusion with percutaneous pedicle screw fixation. A minimum 3-year follow-up study

    International Nuclear Information System (INIS)

    The clinical and radiological outcomes of two-level anterior lumbar interbody fusion (ALIF) with percutaneous pedicle screw fixation (PSF) were evaluated in 24 consecutive patients who underwent two level ALIF with percutaneous PSF for segmental instability and were followed up for more than 3 years. Clinical outcomes were assessed using a visual analogue scale (VAS) score and the Oswestry Disability Index (ODI). Sagittal alignment, bone union, and adjacent segment degeneration (ASD) were assessed using radiography and magnetic resonance imaging. The mean age of the patients at the time of operation was 56.3 years (range 39-70 years). Minor complications occurred in 2 patients in the perioperative period. At a mean follow-up duration of 39.4 months (range 36-42 months), VAS scores for back pain and leg pain, and ODI score decreased significantly (from 6.5, 6.8, and 46.9% to 3.0, 1.9, and 16.3%, respectively). Clinical success was achieved in 22 of the 24 patients. The mean segmental lordosis, whole lumbar lordosis, and sacral tilt significantly increased after surgery (from 25.1deg, 39.2deg, and 32.6deg to 32.9deg, 44.5deg, and 36.6deg, respectively). Solid fusion was achieved in 21 patients. ASD was found in 8 of the 24 patients. No patient underwent revision surgery due to nonunion or ASD. Two-level ALIF with percutaneous PSF yielded satisfactory clinical and radiological outcomes and could be a useful alternative to posterior fusion surgery. (author)

  2. Distracted cervical spinal fusion for management of caudal cervical spondylomyelopathy in large-breed dogs

    International Nuclear Information System (INIS)

    Using an autogenous bone graft (obtained from the iliac crest), 4-mm cancellous bone screws, and polymethylmethacrylate, a distracted cervical spinal fusion technique was performed on 10 dogs with myelographic evidence of caudal cervical spondylomyelopathy. All dogs had evidence of dynamic soft tissue spinal cord compression, as indicated by flexion, extension, and traction myelographic views. Of the 10 dogs, 4 previously had undergone surgery by use of ventral slot or cervical disk fenestration techniques, and their neurologic status had deteriorated after the original surgery. Preoperative neurologic status of the 10 dogs included nonambulatory tetraparesis (n = 5), severe ataxia with conscious proprioceptive deficits (n = 2), and mild ambulatory ataxia with conscious proprioceptive deficits (n = 3). Five dogs had signs of various degrees of cervical pain. Clinical improvement was observed in 8 of 10 dogs--either improved neurologic status or elimination of cervical pain. Implant loosening developed in 3 dogs; 2 of them were euthanatized because of lack of neurologic improvement. Radiographic evidence of bony cervical fusion was observed during a 9- to 24-week period in 6 of the 8 surviving dogs. The distracted cervical fusion technique appears to be a valid surgical procedure to manage cervical spondylomyelopathy in those dogs in which the lesions are limited to one cervical intervertebral disk space

  3. Clinical study on minimally invasive transforaminal lumbar interbody fusion combined with percutaneous pedicle screw fixation for degenerative lumbar scoliosis

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    Hao WU

    2016-04-01

    Full Text Available Objective To discuss the operative essentials and therapeutic effects of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF combined with percutaneous pedicle screw fixation for degenerative lumbar scoliosis (DLS.  Methods A total of 17 DLS patients without prior spinal diseases were treated by MIS-TLIF and percutaneous pedicle screw fixation from January 2013 to September 2015 in Xuanwu Hospital, Capital Medical University. The operation time, intraoperative blood loss, hospital stay, and postoperative complication were recorded in each patient. Visual Analogue Scale (VAS and Oswestry Disability Index (ODI were used to evaluate postoperative improvement of low back and leg pain, and clinical effects were assessed according to Medical Outcome Study 36-Item Short-Form Health Survey (SF-36. Coronal Cobb angle, sagittal lordosis angle and spinal deviation distances on coronal and sagittal plane were measured before operation, one week, 3 months after operation and in the last follow-up in spinal full-length X-ray examination. Fusion rate was calculated according to X-ray or CT scan, and the degree of decompression was evaluated by MRI.  Results Decompression and fusion levels ranged from T12-S1 vertebrae, and interbody fusion was performed in 17 patients and 56 levels were fused. Average operation time was 200 min (180-300 min, intraoperative blood loss was 320 ml (200-1000 ml and hospital stay was 8.21 d (5-12 d. All patients were followed-up for 12.13 months (5-24 months. Compared with preoperation, VAS (P = 0.000, for all and ODI scores (P = 0.000, for all decreased significantly, SF-36 score increased (P = 0.000, for all, coronal Cobb angle (P = 0.000, for all, sagittal lordosis angle (P = 0.000, for all, coronal and sagittal deviation (P = 0.000, for all decreased significantly one week and 3 months after operation and in the last follow-up. The improvement rate of ODI was (86.51 ± 6.02%, fusion rate of vertebral bodies

  4. Clinical and radiographic outcomes with L4–S1 axial lumbar interbody fusion (AxiaLIF and posterior instrumentation: a multicenter study

    Directory of Open Access Journals (Sweden)

    Tobler WD

    2013-09-01

    Full Text Available William D Tobler,1 Miguel A Melgar,2 Thomas J Raley,3 Neel Anand,4 Larry E Miller,5 Richard J Nasca6 1Department of Neurosurgery, University of Cincinnati College of Medicine, Mayfield Clinic, and The Christ Hospital, Cincinnati, OH, USA; 2Department of Neurosurgery, Tulane University, New Orleans, LA, USA; 3Advanced Spine and Pain, Arlington, VA, USA; 4Spine Trauma, Minimally Invasive Spine Surgery Spine Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA; 5Miller Scientific Consulting, Inc, Arden, NC, USA; 6Orthopaedic and Spine Surgery, Wilmington, NC, USA Introduction: Previous studies have confirmed the benefits and limitations of the presacral retroperitoneal approach for L5–S1 interbody fusion. The purpose of this study was to determine the safety and effectiveness of the minimally invasive axial lumbar interbody approach (AxiaLIF for L4–S1 fusion. Methods: In this retrospective series, 52 patients from four clinical sites underwent L4–S1 interbody fusion with the AxiaLIF two-level system with minimum 2-year clinical and radiographic follow-up (range: 24–51 months. Outcomes included back pain severity (on a 10-point scale, the Oswestry Disability Index (ODI, and Odom's criteria. Flexion and extension radiographs, as well as computed tomography scans, were evaluated to determine fusion status. Longitudinal outcomes were assessed with repeated measures analysis of variance. Results: Mean subject age was 52 ± 11 years and the male:female ratio was 1:1. Patients sustained no intraoperative bowel or vascular injury, deep infection, or neurologic complication. Median procedural blood loss was 220 cc and median length of hospital stay was 3 days. At 2-year follow-up, mean back pain had improved 56%, from 7.7 ± 1.6 at baseline to 3.4 ± 2.7 (P < 0.001. Back pain clinical success (ie, ≥30% improvement from baseline was achieved in 39 (75% patients at 2 years. Mean ODI scores improved 42%, from 60% ± 16% at baseline to 35% ± 27

  5. Neurological Complications after Lateral Transpsoas Approach to Anterior Interbody Fusion with a Novel Flat-Blade Spine-Fixed Retractor

    Science.gov (United States)

    Nunley, Pierce; Sandhu, Faheem; Frank, Kelly; Stone, Marcus

    2016-01-01

    Introduction. The lateral lumbar interbody fusion (LLIF) surgical approach has potential advantages over other approaches but is associated with some unique neurologic risks due to the proximity of the lumbosacral plexus. The present study analyzed complications following LLIF surgical approach using a novel single flat-blade retractor system. Methods. A retrospective data collection of patients receiving LLIF using a novel single flat-blade retractor system at two institutions in the US. Inclusion criteria were all patients receiving an LLIF procedure with the RAVINE® Lateral Access System (K2M, Inc., Leesburg, VA, USA). There was no restriction on preoperative diagnosis or number of levels treated. Approach-related neurologic complications were collected and analyzed postoperatively through a minimum of one year. Results. Analysis included 253 patients with one to four treated lateral levels. Immediate postoperative neurologic complications were present in 11.1% (28/253) of patients. At one-year follow-up the approach-related neurologic complications resolved in all except 5 patients (2.0%). Conclusion. We observed an 11.1% neurologic complication rate in LLIF procedures. There was resolution of symptoms for most patients by 12-month follow-up, with only 2% of patients with residual symptoms. This supports the hypothesis that the vast majority of approach-related neurologic symptoms are transient. PMID:27294140

  6. The Effect of the Retroperitoneal Transpsoas Minimally Invasive Lateral Interbody Fusion on Segmental and Regional Lumbar Lordosis

    Directory of Open Access Journals (Sweden)

    Tien V. Le

    2012-01-01

    Full Text Available Background. The minimally invasive lateral interbody fusion (MIS LIF in the lumbar spine can correct coronal Cobb angles, but the effect on sagittal plane correction is unclear. Methods. A retrospective review of thirty-five patients with lumbar degenerative disease who underwent MIS LIF without supplemental posterior instrumentation was undertaken to study the radiographic effect on the restoration of segmental and regional lumbar lordosis using the Cobb angles on pre- and postoperative radiographs. Mean disc height changes were also measured. Results. The mean follow-up period was 13.3 months. Fifty total levels were fused with a mean of 1.42 levels fused per patient. Mean segmental Cobb angle increased from 11.10° to 13.61° (<0.001 or 22.6%. L2-3 had the greatest proportional increase in segmental lordosis. Mean regional Cobb angle increased from 52.47° to 53.45° (=0.392. Mean disc height increased from 6.50 mm to 10.04 mm (<0.001 or 54.5%. Conclusions. The MIS LIF improves segmental lordosis and disc height in the lumbar spine but not regional lumbar lordosis. Anterior longitudinal ligament sectioning and/or the addition of a more lordotic implant may be necessary in cases where significant increases in regional lumbar lordosis are desired.

  7. 颈椎桥形连接融合器进行双节段以上椎间融合的效果评价%Above two-level segment interbody fusion with double-way connection intervertebral fusion device

    Institute of Scientific and Technical Information of China (English)

    傅宇; 傅云根; 罗嘉全; 曹盛生; 李俊宁; 徐文华

    2013-01-01

    -level cervical interbody fusion. METHODS: Fifty-four patients with above two-level cervical intervertebral disc herination were treated with anterior cervical decompression and fusion. These patients were treated with anterior cervical interbody fusion using double-way connection intervertebral fusion device (n=30) and Cage intervertebral fusion device and anterior plate fixation system (n=24). The clinical results were evaluated with Japanese Orthopedic Association scale scores, and the cervical curvature, intervertebral height and cervical fusion state were tested with X-ray film at 3 and 6 months after interbody fusion. RESULTS AND CONCLUSION: Al patients were fol owed-up for 6 months. The patients in two groups got osseous fusion, and the average fusion time was 5.5 months. Average Japanese Orthopedic Association scale score of double-way connection intervertebral fusion device group was increased from (7.4±0.4) preoperatively to (14.3±0.5) at 3 months and (14.5±0.8) at 6 months postoperatively; and the average Japanese Orthopedic Association scale score of Cage intervertebral fusion device group was increased from (7.6±0.7) preoperatively to (13.9±0.4) at 3 months and (14.0±0.6) at 6 months postoperatively, and the differences were significant. The spinal curvature and intervertebral height were significantly improved after treatment. This procedure can effectively restore cervical lordosis, obviate the complications related to graft harvest and screw-plate fixation, and lead to satisfactory outcomes.

  8. The Outcomes of Surgical Treatment of Recurrent Lumbar Disk Herniation with Discectomy Alone and Discectomy with Posterolateral Interbody Fusion

    Directory of Open Access Journals (Sweden)

    Hossein Nayeb Aghayee

    2014-04-01

    Full Text Available Background: Recurrent lumbar disk herniation (RLDH is one of the major causes of failure of standard discectomy. The optimal treatment method for RLDH is controversial. In the current study, we aimed to compare the clinical and functional outcomes of treating RLDH with discectomy alone and discectomy associated with posterolateral interbody fusion (PLIF.Material and Methods: There were 41 patients with RLHD after primary discectomy in the current retrospective study. Patients were assigned to 2 groups based on the surgical method: discectomy alone (17 patients and discectomy with PLIF (21 patients. At the final visit the following variables were measured and compared between groups: the back and radicular pain intensity using visual analogue scale (VAS, functional outcome using oswestry low back pain disability scale (ODI, return to previous work and complication. Patients were followed for 13.9±2.8 and 15±3 months in discectomy alone and discectomy with PLIF groups, retrospectively.Results: Complete fusion was achieved in 24 patients of PLIF group. The back pain intensity was the same; however the radicular pain intensity was significantly lower in PLIF group (1.5±0.9 V.s 2.3±1; p=0.017. Also, the mean of ODI scale was the same. 82.3% of patients in discectomy group and 87.5% of patients in PLIF group returned to previous work and the difference was not significant. One patient in discectomy group and 2 patients in PLIF group developed temporary neurological deficit which disappeared after 3 months.Conclusions: Although both discectomy alone and discectomy with PLIF were associated with favorable mid-term results in treating patients with RLDH, however, the authors recommend using discectomy with PLIF for lower radicular pain.

  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. Impact on Neurological Recovery of Transforaminal Debridement and Interbody Fusion versus Transpedicular Decompression in Combination with Pedicle Screw Instrumentation for Treating Thoracic and Lumbar Spinal Tuberculosis

    Science.gov (United States)

    Choovongkomol, Kongtush; Piyapromdee, Urawit; Leownorasate, Manoon

    2016-01-01

    Study Design Retrospective study. Purpose To compare the neurological outcome of transforaminal debridement and interbody fusion with transpedicular decompression for treatment of thoracic and lumbar spinal tuberculosis. Overview of Literature Few articles have addressed the impact of neurological recovery in patients with tuberculosis who were treated by two different operative methods via the posterior-only approach. Methods Clinical and radiographic results of one-stage posterior instrumented spinal fusion for treatment of tuberculous spondylodiscitis with neurological deficits were reviewed and analyzed from 2009 to 2013. The extensive (E) group consisted of patients who received transforaminal debridement and interbody fusion, whereas transpedicular decompression was performed on limited (L) group. Rapid recovery was improvement of at least one Frankel grade within 6 weeks after operation. Otherwise, it was slow recovery. Results All 39 patients had improved neurological signs. The median follow-up period was 24 months. Proportionately younger patients (under 65 years of age) received extensive surgery (15 of 18, 83.3% vs. 11 of 21, 52.4%; p=0.04). The mean operative time and blood loss in the group E were higher than in the group L (both pdecompression.

  11. Approach-Related Complications of Anterior Lumbar Interbody Fusion: Results of a Combined Spine and Vascular Surgical Team.

    Science.gov (United States)

    Mobbs, Ralph J; Phan, Kevin; Daly, Daniel; Rao, Prashanth J; Lennox, Andrew

    2016-03-01

    Study Design Retrospective analysis of prospectively collected cohort data. Objective Anterior lumbar interbody fusion (ALIF) is a commonly performed procedure for the treatment of degenerative diseases of the lumbar spine. Detailed and comprehensive descriptions of intra- and postoperative complications of ALIF are surprisingly limited in the literature. In this report, we describe our experience with a team model for ALIF and report all complications occurring in our patient series. Methods Patients were prospectively enrolled between January 2009 and January 2013 by a combined spine surgeon and vascular surgeon team. All patients underwent an open ALIF using an anterior approach to the lumbosacral spine. Results From the 227 ALIF cases, mean operative blood loss was 103 mL, ranging from 30 to 900 mL. Mean operative time was 78 minutes. The average length of stay was 5.2 days. Intraoperative vascular injury requiring primary repair with suturing occurred in 15 patients (6.6%). There were 2 cases of postoperative retroperitoneal hematoma. Three patients (1.3%) had incisional hernia requiring revision surgery; 7 (3.1%) patients had prolonged ileus (>7 days) managed conservatively. Four patients described retrograde ejaculation. Sympathetic dysfunction occurred in 15 (6.6%) patients. There were 5 (2.2%) cases of superficial wound infection treated with oral antibiotics, with no deep wound infections requiring reoperation or intravenous therapy. There were no mortalities in this series. Conclusions ALIF is a safe procedure when performed by a combined vascular surgeon and spine surgeon team with acceptably low complication rates. Our series confirms that the team approach results in short operative times and length of stay, with rapid control of intraoperative vessel injury and low overall blood loss. PMID:26933616

  12. 生物活性颈椎椎间融合器在颈椎融合术中不同固定方式的生物力学研究%Biomechanical study of bioactive cervical fusion cage with different types of fixation in cervical spinal fusion

    Institute of Scientific and Technical Information of China (English)

    胡孔和; 吴强; 段扬; 包拥政; 靳安民; 赵卫东

    2012-01-01

    目的 探讨由羟基磷灰石和左旋聚乳酸复合研制的新型生物活性颈椎椎间融合器在颈椎融合术中不同固定方式的生物力学特性.方法 制备新鲜人颈椎标本6个(尸体均为合法捐赠,由南方医科大学解剖学教研室提供),模拟临床术式行前路C5~6减压椎间分别植入髂骨、生物活性颈椎椎间融合器和生物活性颈椎椎间融合器加钢板内固定,通过脊柱三维运动实验机测量C5~6节段的运动范围.结果 生物活性颈椎椎间融合器加钢板固定后稳定性增加,在各个状态的运动范围均明显小于其他各组(P <0.005).单纯生物活性颈椎椎间融合器组在后伸状态下运动范围(6.25±0.29)度较正常组(5.76±0.40)度增大,稳定性下降,但差异无统计学意义(P>0.05);在除后伸外的其他各种状态下的运动范围均小于髂骨组,较髂骨组稳定,差异有统计学意义(P<0.005).结论 新型生物活性颈椎椎间融合器具有良好的生物力学性能,加钢板内固定后各个方向稳定性好,能重建颈椎稳定性.%Objective To investigate the biomechanical characteristics of different types of fixation with bioactive cervical fusion cage made of hydroxyapatite and poly L-lactic acid in cervical spinal fusion.Methods Iliac crest bone,bioactive cervical fusion cage and bioactive cervical fusion cage with plate fixation were used for anterior interbody implants after anterior discectomy across C5-6 in six fresh human cervical spine specimens respectively,and the range of motion of the cervical vertebrae interbody fusion were measured through the motional stability test.Results After discectomy,Bioactive Cervical Fusion Cage with plate fixation exhibited a significant increase in stability and a decrease of range of motion in angular motion than others in all motional directions ( P < 0.005 ). Bioactive cervical fusion cage exhibited a decrease in stability and an increase of range of motion (6.25

  13. Is the transsacral axial interbody fusion a candidate surgical approach for fusing both L5/S1 and L4/5?

    Institute of Scientific and Technical Information of China (English)

    LIU Bi-feng; ZHANG Li-guo; LIU Yan-bin; YAN Ning; ZHANG Hai-long; GU Xin; DING Yue; GUO Cheng-bin; HE Shi-sheng

    2011-01-01

    Background Previous clinical and basic research of axial lumbar interbody fusion (AxiaLIF) all focused on the L5/S1.However,there is no data on the feasibility of this approach for the fusion of both L4/5 and L5/S1.This study aimed to explore whether transsacral axial interbody fusion is a candidate for the fusion of both L4/5 and L5/S1.Methods The subjects (n=40) underwent lumbosacral magnetic resonance imaging (MRI).The median sagittal MRI images were analyzed and five measurement markers were defined as follows:the center of the L4/5 disc (A),the center of the L5/S1 disc (B),the anterior margin of the S1/2 space (C),the sacrococcygeal junction (D),and the coccygeal tip (E).The measurement markers were connected each other to produce nine lines (AB,AC,AD,AE,BC,BD,BE,CD and CE) as the reference lines for surgical approaches.The distance between each reference line and the anterior and posterior margins of the L4,L5 and S1 vertebral bodies were measured to determine the safety of the respective approaches.Results Twenty subjects were capable of finding one reference line to fuse both L4/5 and L5/S1 via transsacral axial interbody fusion approach.The surgical approach reference line was AE or CE line.In the other 20 subjects,it was failed to find a reference line which met the safety criteria for fusing both L4/5 and L5/S1.Conclusions About half of subjects were capable of finding a suitable AxiaLIF reference line to fuse both L4/5 and L5/S1.In some subjects,it was difficult to find a suitable AxiaLIF reference line to fuse both L4/5 and L5/S1.

  14. 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

  15. Hybrid Biosynthetic Autograft Extender for Use in Posterior Lumbar Interbody Fusion: Safety and Clinical Effectiveness

    OpenAIRE

    Chedid, Mokbel K; Tundo, Kelly M; Block, Jon E; Muir, Jeffrey M

    2015-01-01

    Autologous iliac crest bone graft is the preferred option for spinal fusion, but the morbidity associated with bone harvest and the need for graft augmentation in more demanding cases necessitates combining local bone with bone substitutes. The purpose of this study was to document the clinical effectiveness and safety of a novel hybrid biosynthetic scaffold material consisting of poly(D,L-lactide-co-glycolide) (PLGA, 75:25) combined by lyophilization with unmodified high molecular weight hya...

  16. 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)

  17. 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.

  18. 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.

  19. Diagnostic method for lumbar foraminal stenosis based on the clinical results of transforaminal lumbar interbody fusion (TLIF). Utility of the foraminal stenosis score

    International Nuclear Information System (INIS)

    In this study we analyzed 73 cases treated by transforaminal lumbar interbody fusion (TLIF) for lumbar foraminal stenosis or central canal stenosis and foraminal stenosis, and based on the perioperative findings and outcome of treatment, we considered the diagnostic procedure for lumbar foraminal stenosis in the future. In 25 cases (34.2%) cases there was actually no clear perioperative evidence of foraminal stenosis. We compared the preoperative clinical and imaging findings in the group with perioperative findings and the group without perioperative findings performed a multiple logistic regression analysis to identify factors associated with foraminal stenosis. We also calculated the odds ratio for the perioperative findings and proposed a foraminal stenosis scoring system. (author)

  20. Structural analysis of the intervertebral discs adjacent to an interbody fusion using multibody dynamics and finite element cosimulation

    Energy Technology Data Exchange (ETDEWEB)

    Monteiro, Nuno Miguel Barroso, E-mail: nuno.barroso.monteiro@gmail.com; Silva, Miguel Pedro Tavares da, E-mail: MiguelSilva@ist.utl.pt; Folgado, Joao Orlando Marques Gameiro, E-mail: jfolgado@dem.ist.utl.pt [Technical University of Lisbon, IDMEC/IST-Instituto Superior Tecnico (Portugal); Melancia, Joao Pedro Levy, E-mail: levymelancia@netcabo.pt [University of Lisbon, FML-Faculdade de Medicina de Lisboa (Portugal)

    2011-02-15

    This work describes a methodology for the dynamic and structural analysis of complex (bio)mechanical systems that joins both multibody dynamics and finite element domains, in a synergetic way, through a cosimulation procedure that takes benefit of the advantages of each numerical formulation. To accomplish this goal, a cosimulation module is developed based on the gluing algorithm X-X, which is the key element responsible for the management of the information flux between the two software packages (each using its own mathematical formulation and code). The X-X algorithm uses for each cosimulated structure multiple pairs of reference points whose kinematics are solved by the multibody module and prescribed, as initial data, to the finite element counterpart. The finite element module, by its turn, solves the structural problem imposed by the prescribed kinematics, calculates the resulting generalized loads applied over the reference points and return these loads back to the multibody module that uses them to solve the dynamic problem and to calculate new reference kinematics to prescribe to the finite element module in the next time step. The proposed method is applied to study the cervical spine dynamics in a pathologic situation in which an intersomatic fusion is simulated to confirm its potential advantages. Taking into account the proposed simulation scenario, a cervical spine multibody model that includes the rigid vertebrae, the facet joints' and spinous processes' contacts, ligaments and the finite element models of the intervertebral discs, and their surrogates is developed. The proposed model is simulated for extension in a forward dynamics perspective.

  1. Structural analysis of the intervertebral discs adjacent to an interbody fusion using multibody dynamics and finite element cosimulation

    International Nuclear Information System (INIS)

    This work describes a methodology for the dynamic and structural analysis of complex (bio)mechanical systems that joins both multibody dynamics and finite element domains, in a synergetic way, through a cosimulation procedure that takes benefit of the advantages of each numerical formulation. To accomplish this goal, a cosimulation module is developed based on the gluing algorithm X-X, which is the key element responsible for the management of the information flux between the two software packages (each using its own mathematical formulation and code). The X-X algorithm uses for each cosimulated structure multiple pairs of reference points whose kinematics are solved by the multibody module and prescribed, as initial data, to the finite element counterpart. The finite element module, by its turn, solves the structural problem imposed by the prescribed kinematics, calculates the resulting generalized loads applied over the reference points and return these loads back to the multibody module that uses them to solve the dynamic problem and to calculate new reference kinematics to prescribe to the finite element module in the next time step. The proposed method is applied to study the cervical spine dynamics in a pathologic situation in which an intersomatic fusion is simulated to confirm its potential advantages. Taking into account the proposed simulation scenario, a cervical spine multibody model that includes the rigid vertebrae, the facet joints’ and spinous processes’ contacts, ligaments and the finite element models of the intervertebral discs, and their surrogates is developed. The proposed model is simulated for extension in a forward dynamics perspective.

  2. 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...

  3. Survivorship and clinical outcomes after multi-level anterior lumbar reconstruction with stand-alone anterior lumbar interbody fusion or hybrid construct.

    Science.gov (United States)

    Chen, Benjamin; Akpolat, Yusuf T; Williams, Paul; Bergey, Darren; Cheng, Wayne K

    2016-06-01

    In multilevel disc disease, there is still uncertainty regarding whether multiple total disc replacement is more effective and safer than fusion. Our objective was to measure and compare the clinical outcome of multilevel hybrid constructs with stand-alone anterior lumbar interbody fusion (ALIF) using a retrospective analysis. Sixty-four patients with chronic low back pain determined to be from two or three-level degenerative disc disease were included. Thirty-three patients were treated with hybrid fusion and 31 with ALIF. Several parameters were retrospectively reviewed, including blood loss, operation time, hospital stay, Visual Analog Scale (VAS) score, Oswestry Disability Index (ODI), and survivorship without the need for revision surgery. Telephone follow-ups were conducted to ascertain survivorship, clinical outcomes (VAS, ODI) and patient satisfaction. Operation time was longer in the hybrid group (p=0.021). The hybrid group showed a significant improvement in VAS and ODI with 52.2% and 50.0% improvement versus 28.3% and 25.5% in the ALIF group (pdisability scores. PMID:26896904

  4. Clinical results of cervical laminectomy and fusion for the treatment of cervical spondylotic myelopathy in 58 consecutive patients

    Directory of Open Access Journals (Sweden)

    Victor Chang

    2014-01-01

    Conclusion: Cervical laminectomy and fusion is a safe and efficacious procedure for the treatment of CSM. The clinical outcomes appear to be quite reproducible, and this technique is an important part of a spine surgeon′s armamentarium.

  5. Myasthenia Gravis Presentation After a Cervical Laminectomy With Fusion.

    Science.gov (United States)

    Deters, Darlene; Fowler, Stephanie L; Orozco, Raymundo; Smith, Patrick R; Spurlock, Shelby; Blackmon, Darlene; Thomas, Samantha

    2016-01-01

    Myasthenia gravis is a chronic neuromuscular disorder that causes skeletal muscle weakness. Typically, myasthenia gravis affects the ocular, bulbar, neck, proximal limbs, and respiratory muscles. Although the presentation is typically observed with complaints of vision and bulbar symptoms such as diplopia, dystonia, and dysphagia, this article presents a case study of an elderly man with a history of increasing upper extremity weakness with complaints of worsening hand dexterity and intermittent episodes of expressive aphasia. After cervical laminectomy with fusion, this gentleman was admitted to the medical intensive care unit, in a complete myasthenic crisis. PMID:27258955

  6. 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...

  7. 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...

  8. Associations between craniofacial morphology, head posture, and cervical vertebral body fusions in men with sleep apnea

    DEFF Research Database (Denmark)

    Svanholt, Palle; Petri, Niels; Wildschiødtz, Gordon;

    2009-01-01

    patients were divided into 4 groups according to fusion in the cervical vertebrae: group I, no fusions (42 subjects); group II, fusion of cervical vertebrae 2 and 3 (15 subjects); group III, occipitalization (10 subjects); and group IV, block fusion (11 subjects). Mean differences of craniofacial...... significantly. No significant differences were seen in head posture. CONCLUSIONS: OSA patients with block fusions in the cervical vertebrae and fusion of 2 vertebrae differed significantly in craniofacial profile from other OSA patients.......INTRODUCTION: The aim of this study was to analyze craniofacial profiles and head posture in patients with obstructive sleep apnea (OSA) subgrouped according to cervical column morphology. METHODS: Seventy-four white men aged 27 to 65 years (mean, 49.0 years) diagnosed with OSA in sleep studies by...

  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. Novel pedicle screw and plate system provides superior stability in unilateral fixation for minimally invasive transforaminal lumbar interbody fusion: an in vitro biomechanical study.

    Directory of Open Access Journals (Sweden)

    Jie Li

    Full Text Available This study aims to compare the biomechanical properties of the novel pedicle screw and plate system with the traditional rod system in asymmetrical posterior stabilization for minimally invasive transforaminal lumbar interbody fusion (MI-TLIF. We compared the immediate stabilizing effects of fusion segment and the strain distribution on the vertebral body.Seven fresh calf lumbar spines (L3-L6 were tested. Flexion/extension, lateral bending, and axial rotation were induced by pure moments of ± 5.0 Nm and the range of motion (ROM was recorded. Strain gauges were instrumented at L4 and L5 vertebral body to record the strain distribution under flexion and lateral bending (LB. After intact kinematic analysis, a right sided TLIF was performed at L4-L5. Then each specimen was tested for the following constructs: unilateral pedicle screw and rod (UR; unilateral pedicle screw and plate (UP; UR and transfacet pedicle screw (TFS; UP and TFS; UP and UR.All instrumented constructs significantly reduced ROM in all motion compared with the intact specimen, except the UR construct in axial rotation. Unilateral fixation (UR or UP reduced ROM less compared with the bilateral fixation (UP/UR+TFS, UP+UR. The plate system resulted in more reduction in ROM compared with the rod system, especially in axial rotation. UP construct provided more stability in axial rotation compared with UR construct. The strain distribution on the left and right side of L4 vertebral body was significantly different from UR and UR+TFS construct under flexion motion. The strain distribution on L4 vertebral body was significantly influenced by different fixation constructs.The novel plate could provide sufficient segmental stability in axial rotation. The UR construct exhibits weak stability and asymmetrical strain distribution in fusion segment, while the UP construct is a good alternative choice for unilateral posterior fixation of MI-TLIF.

  11. The significance of removing ruptured intervertebral discs for interbody fusion in treating thoracic or lumbar type B and C spinal injuries through a one-stage posterior approach.

    Directory of Open Access Journals (Sweden)

    Qian-Shi Zhang

    Full Text Available OBJECTIVES: To identify the negative effect on treatment results of reserving damaged intervertebral discs when treating type B and type C spinal fracture-dislocations through a one-stage posterior approach. METHODS: This is a retrospective review of 53 consecutive patients who were treated in our spine surgery center from January 2005 to May 2012 due to severe thoracolumbar spinal fracture-dislocation. The patients in Group A (24 patients underwent long-segment instrumentation laminectomy with pedicle screw-rod fixators for neural decompression. In Group B (29 patients, the patients underwent long-segment instrumentation laminectomy with pedicle screw-rod fixators for neural decompression evacuating of the ruptured disc and inserting of a bone graft into the evacuated disc space for interbody fusion. The mean time between injury and operation was 4.1 days (range 2-15 days. The clinical, radiologic and complication outcomes were analyzed retrospectively. RESULTS: Periodic follow-ups were carried out until an affirmative union or treatment failure took place. A progressive kyphosis angle larger than 10°, loss of disc height, pseudoarthrosis, recurrence of dislocation or subluxation, or instrument failure before fusion were considered treatment failures. Treatment failures were detected in 13 cases in Group A (failure rate was 54.2%. In Group B, there were 28 cases in which definitive bone fusion was demonstrated on CT scans, and CT scans of the other cases demonstrated undefined pseudoarthrosis without hardware failure. There were statistically significant differences between the two groups (p0.05 Fisher's exact test. CONCLUSION: Intervertebral disc damage is a common characteristic in type B and C spinal fracture-dislocation injuries. The damaged intervertebral disc should be removed and substituted with a bone graft because reserving the damaged disc in situ increases the risk of treatment failure.

  12. Laryngeal dislocation after ventral fusion of the cervical spine

    Directory of Open Access Journals (Sweden)

    Jenny Krauel

    2013-01-01

    Full Text Available We report on a 70-year-old patient who underwent ventral fusion of the cervical spine (C3/4 and C4/5 for spinal canal stenosis performed by the neurosurgery department. The patient suffered an exceedingly rare complication of the surgery - laryngeal dislocation. Had the deformed laryngeal structures been overlooked and the patient extubated as usual after surgery, reintubation would have been impossible due to the associated swelling, which might have had disastrous consequences. Leftward dislocation of the larynx became apparent post-operatively, but prior to extubation. Extubation was therefore postponed and a subsequent computed tomography (CT scan revealed entrapment of laryngeal structures within the osteosynthesis. A trial of repositioning using microlaryngoscopy performed by otolaryngology (ears, nose and throat specialists failed, making open surgical revision necessary. At surgery, the entrapped laryngeal tissue was successfully mobilised. Laryngeal oedema developed despite prompt repositioning; thus, necessitating tracheotomy and long-term ventilation. Laryngeal dislocation may be an unusual cause of post-operative neck swelling after anterior cervical spine surgery and should be considered in the differential diagnosis if surgical site haematoma and other causes have been ruled out. Imaging studies including CT of the neck may be needed before extubation to confirm the suspicion and should be promptly obtained to facilitate specific treatment.

  13. Comparison of simple discectomy and instrumented posterior lumbar interbody fusion for treatment of lumbar disc herniation combined with Modic endplate changes

    Institute of Scientific and Technical Information of China (English)

    Cao Peng; Chen Zhe; Zheng Yuehuan; Wang Yuren; Jiang Leisheng; Yang Yaoqi; Zhuang Chengyu

    2014-01-01

    Background The purpose of this retrospective study was to compare the surgical outcomes of simple discectomy and instrumented posterior lumbar interbody fusion (iPLIF) in patients with lumbar disc herniation and Modic endplate changes.Our hypothesis was that iPLIF could provide better outcome for patients with refractory lumbar disc herniation and Modic changes (LDH-MC).Methods Ninety-one patients with single-segment LDH-MC were recruited.All patients experienced low back pain as well as radicular leg pain,and low back pain was more severe than leg pain.Forty-seven patients were treated with discectomy and 44 were treated with iPLIE The outcomes of both low back pain and radicular leg pain using visual analogue scale (VAS) as well as the clinical outcome related to low back pain using Japanese Orthopaedic Association (JOA) score were assessed before and 18 months after surgery,respectively.Results Both low back and leg pain were significantly improved 18 months after simple discectomy and iPLIE Compared to patients undergoing simple discectomy,low back pain was significantly reduced in patients undergoing iPLIE but there was no significant difference in leg pain between two groups.Solid fusion was achieved in all patients who underwent iPLIF.Conclusions In patients with LDH-MC,iPLIF can yield significantly superior outcome on the relief of low back pain compared to simple discectomy.Simple discectomy can relieve radicular leg pain as efficient as iPLIE Accordingly,iPLIF seems to be a reliable treatment for patients with LDH-MC and predominant low back pain.

  14. 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...

  15. 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.

  16. 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.

  17. 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...

  18. 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.

  19. 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.

  20. 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 ...

  1. Clinical results and intramedullary signal changes of posterior decompression with transforaminal interbody fusion for thoracic myelopathy caused by combined ossification of the posterior longitudinal ligament and ligamentum flavum

    Institute of Scientific and Technical Information of China (English)

    WANG Lin-feng; LIU Fa-jing; ZHANG Ying-ze; SHEN Yong; DING Wen-yuan; XU Jia-xin

    2013-01-01

    Background Surgical treatment of thoracic myelopathy caused by ossification of the posterior longitudinal ligament (OPLL) and ossification of the ligamentum flavum (OLF) is technically demanding,and the results tend to be unfavorable.Various operative approaches and treatment strategies have been attempted,and posterior decompression with transforaminal thoracic interbody fusion (PTTIF) may be the optimal method with which the anterior-posterior compression was removed in one step.It is comparatively less traumatic with fewer serious complications.Methods Sixteen patients with thoracic myelopathy due to concurrent OLF and OPLL at the same level underwent PTTIF.We investigated clinical outcomes and neurological improvements.Magnetic resonance imaging (MRI) was performed on all patients preoperatively and postoperatively,and intramedullary signal changes were evaluated.Results The mean operating time was 275 minutes,and the mean operative bleeding amount was 1031 ml.Cerebrospinal fluid leakage occurred in three patients and healed well after repair.Neurological symptom deterioration occurred in one patient,but the patient recovered to nearly the preoperative level after methylprednisolone treatment.The follow-up period ranged from 28 to 47 months.The mean score on the Japanese Orthopedic Association scale improved from 4.3±1.2 preoperatively to 7.3±1.7 at 3 months postoperatively to 8.5±1.5 at the final follow-up (P <0.01),with a recovery rate of (63.6±20.0)%.Postoperative images showed a significant improvement in local kyphosis (P <0.01).Eleven patients (68.8%) showed increased signal intensity (ISI) on preoperative T2-weighted MRI.At the final follow-up,the intramedullary ISI totally recovered in five patients.Neurological improvement was worse in patients with persistent ISI than in the other patients (P <0.05).Conclusions PTTIF is an effective therapeutic option for combined OPLL and OLF and provides satisfactory neurological recovery and

  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. 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. Absorbable self-reinforced polylactide (SR-PLLA) rods vs rigid rods (K-wire) in spinal fusion: an experimental study in rabbits

    OpenAIRE

    Bezer, Murat; Yildirim, Yakup; Erol, Bülent; Güven, Osman

    2004-01-01

    Several clinical and experimental reports have evaluated the spinal application of bioabsorbable material for plating the anterior lumbar and cervical spine, and in anterior and posterior lumbar interbody spinal fusion. Nevertheless, the use of these materials in posterolateral interlaminar fusion has yet to be elucidated in the literature. The effects of bioabsorbable self-reinforced polylactide rod (SR-PLLA) implantation, rigid fixation (K-wire) and non-implantation with posterior interlami...

  5. 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...

  6. Anterior Cervical Spinal Surgery for Multilevel Cervical Myelopathy.

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. FGFR3–TACC3: A novel gene fusion in cervical cancer

    Directory of Open Access Journals (Sweden)

    Benedito A. Carneiro

    2015-08-01

    Full Text Available Cervical cancer epitomizes the success of cancer prevention through the human papillomavirus (HPV vaccine, but significant challenges remain in the treatment of advanced disease. We report the first three cases of cervical carcinoma harboring an FGFR3–TACC3 fusion, which serves as a novel therapeutic target. The fusion, identified by comprehensive genomic profiling, activates the FGFR pathway that has been implicated in HPV-driven carcinogenesis. One of the patients whose tumor contained the FGFR3–TACC3 fusion was treated with an investigational FGFR tyrosine kinase inhibitor. Concomitant molecular alterations involving the PI3K/AKT/mTOR and RAF/MEK pathways were also identified and suggest other treatment strategies that deserve investigation. This case series highlights the role of comprehensive genomic profiling in the identification of new therapeutic targets and in targeted therapy selection for patients with cervical cancer.

  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. TRANSFORAMINAL L U MBAR INTERBODY FUSION IN LOW GRADE COMBINED LYTIC AND DEGENERATIVE SPONDYLOLIDTHESIS : FUNCTIONAL OUTCOME OF 21 CASES

    Directory of Open Access Journals (Sweden)

    Suresh

    2015-10-01

    Full Text Available BACKGROUND: Spondylolisthesis is a heterogenous disorder characterised by subluxation of a vertebral body in sagittal plane occuring frequently at l4 - 5 and l5 - S1commonest being isthmic and degenerative variety. While majority are asymptomatic, a subset do produce pain with neurology. Complete decompression of roots is essential, as is the need for solid stabi lization. Several fusion techniques were reported in literature like PLF, TLIF, PLF, ALIF On theoretical grounds, TLIF has been suggested to be safe and result in an improved outcome compared to other techniques. Data to support this view, are lacking. M ETHODS: A total of 21 patients (age range, 27 - 62 years with adult isthmic and degenerative spondylolisthesis were operated. There were 8 males and 13 females with mean age of 46.8 pre - op and 2 - year follow - up, pain (VAS and functional disability were quan tified by Oswestry Disability Index (ODI.Radiological union assessed with xrays by Brantigen and Steffee criteria. The global outcome was excellent in 90%.and 92% fusion. 2 patients presented motor deficit which did not recover. RESULTS: The follow - up was for 2 years. The mean VAS score for low back pain improved from 7.0 preoperatively to 2.1, as did the mean VAS score for leg pain from 6.7 to 1.4 and the mean ODI from 59.5% to 11.3%. CONCLUSION: TLIF does affect the 2 - year outcome of surgical treatment of spondylolisthesis with decreased back pain and ODI’s, with advantages of minimal thecal retraction, restored segmental lordosis and preserved posterior tension band.

  11. 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

  12. [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

  13. Comparison of the effect of posterior lumbar interbody fusion with pedicle screw fixation and interspinous fixation on the stiffness of adjacent segments

    Institute of Scientific and Technical Information of China (English)

    LI Chun-de; SUN Hao-lin; LU Hong-zhang

    2013-01-01

    Background Adjacent segment degeneration could seriously affect the long-term prognosis of lumbar fusion.Dynamicfixation such as the interspinous fixation,which is characterized by retaining the motion function of the spinal segment,has obtained satisfactory short-term effects in the clinical setting.But there are few reports about the biomechanicalexperiments on whether dynamic fixation could prevent adjacent segment degeneration.Methods The surgical segments of all 23 patients were L4/5.Thirteen patients with disc herniation of L4/5 underwentWallis implantation surgery,and 10 patients with spinal stenosis of L4/5 underwent posterior lumbar interbody fusion(PLIF).L3-S1 segmental stiffness and displacement were measured by a spine stiffness gauge (SSG) device duringsurgery when the vertebral plate was exposed or during spinal decompression or internal fixation.Five fresh,frozencadavers were used in the self control experiment,which was carried out in four steps:exposure of the vertebral plate,decompression of the spinal canal,implantation of a Wallis fixing device,and PLIF of L4/5 after removing the Wallis fixingdevice.Then,L3-S1 segment stiffness was measured by an SSG device.Results The experiments showed that the average stiffness of the L4/5 segment was (37.1±8.9) N/mm after exposure of the vertebral plate,while after spinal decompression,the average stiffness fell to (26.2±7.1) N/mm,decreasing by 25.8% (P <0.05).For the adjacent segments L3/4 and L5/S1,their stiffness showed no significant difference between the L4/5 segment decompression and the exposure of the vertebral plate (P >0.05).After Wallis implantation of L4/5,the stiffness of the cephalic adjacent segment L3/4 was (45.8±10.7) N/mm,which was 20.5% more than that after the exposure of the vertebral plate (P <0.05); after L4/5 PLIF surgery,the stiffness of L3/4 was (35.3±10.7) N/mm and was decreased by 12.4% more than that after the exposure of the vertebral plate (P <0.05).The

  14. Posterior fixation and fusion with atlas pedicle screw system for upper cervical diseases

    Institute of Scientific and Technical Information of China (English)

    LI Lei; ZHOU Feng-hua; WANG Huan; CUI Shao-qian

    2008-01-01

    Objective: To evaluate the feasibility, safety and efficacy of atlas pedicle screws system fixation and fusion for the treatment of upper cervical diseases. Methods: Twenty-three consecutive patients with up-per cervical disorders requiring stabilization, including 19 cases of atlantoaxial dislocation (4 congenital odontoid disconnections, 6 old odontoid fractures, 4 fresh odontoid fractures of Aderson Ⅱ C, 3 ruptures of the C1 transverse ligament, and 2 fractures ofC1), 2 cases ofC2 tumor (instability after the resection of the tumors), and 2 giant neurilemomas of C2-C3(instability after resection of the tumors), were treated by posterior fixation and fusion with the atlas pedicle screw system, in which the screws were inserted through the posterior arch of Cr The operative time, bleeding volume and complications were reported. All patients were immobilized without external fixation or with rigid cervical collars for 1-3 months. All patients were followed up and evaluated with radiographs and CT. Results: In the 23 patients, 46 C1 pedicle screws, 42 C2 pedicle screws and 6 lower cervical lateral mass screws and 2 lower cervical pedicle screws were placed. The mean operative time and bleeding volume was 2.7 hours and 490 ml respectively. No intraoperative complications were directly related to surgical technique. No neurological, vascular or infective complications were encountered. All patients were followed up for 3-36 months (average 15 months). Firm bony fusion was documented in all patients after 3-6 months. One patient with atlas fracture showed anterior occipitocervical fusion. There was no implant failure. Conclusions: Posterior fixation and fusion of the atlas pedicle screw system is feasible and safe for the treatment of upper cervical diseases, and may be applicable to a larger number of patients.

  15. Epidemiologic trends in the utilization, demographics, and cost of bone morphogenetic protein in spinal fusions

    OpenAIRE

    Louie, Philip K.; Hassanzadeh, Hamid; Singh, Kern

    2014-01-01

    Bone morphogenetic protein (BMP) utilization as an adjunct for spinal arthrodesis has gained considerable momentum among spine surgeons. Despite carrying Food and Drug Administration approval for only single level anterior lumbar interbody fusion from L4-S1, the majority of BMP administration is in “off label” settings. Over the last decade, BMP utilization has increased in all facets of spine surgery with the only exception being the anterior cervical spine, in which a downward trend resulte...

  16. Clinical efficacy of three different techniques of fusion in the treatment of cervical spondylotic myelopathy%三种前路手术治疗脊髓型颈椎病临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈占磊; 官众

    2013-01-01

    Objective To observe the clinical effects of cervical spondylotic myelopathy and bone graft fusion by different methods for cervical spondylotic myelopathy.Methods Seventy-one cases of cervical spondylotic myelopathy were treated by cervical anterior decompression and bone graft fusion with three surgical procedures from January 2009 to November 2011.Twenty-four cases were treated by anterior cervical discectomy and bone grafting and fusion (group A),27 cases were treated by cervical anterior decompression bone grafting and internal fixation with steel plate (group B),20 cases were treated by anterior cervical decompression,titanium plate internal fixation(group C),cervical disc prosthesis implantation.X-ray films and regular follow-up were taken after operation to observe the curative effects,the interbody height,the cervical vertebra antecttrvature and the fusion of operative segments.Results According to the results of the follow-up,the fusion rates of A,B,C group were 95.3%,95.4%,97.8%.When the follow-up was over,while there was no such difference in A,B or C group (F =2.32,P > 0.05),while there was no statistical significance in the differences among A,B or C group (F =2.23,P > 0.05).Condusions The key point of the treatment of cervical spondylotic myclopathy lies in thorough decompression and effective bone graft fusion,furthermore,different techniques of fusion affect the curative effects significantly.%目的 观察分析三种颈椎前路手术治疗脊髓型颈椎病(CSM)的临床疗效.方法 将2009年1月至2011年11月青海大学附属医院手术治疗的71例CSM患者分为A、B、C三组.A组24例采用颈椎前路减压植骨钢板内固定术;B组27例采用颈前路减压cage植入植骨术;C组20例采用颈椎间盘切除减压、人工颈椎间盘植入术.术后定期随访及拍摄X线片,观察疗效、椎间高度、颈椎前弯曲度和植骨融合情况.结果 经过随访,A组融合率为95.3%,B组为95.4%,C组为97.8

  17. 可吸收聚合物材料制作椎间融合器的临床应用%Clinical application of bioabsorbable polymer interbody fusion cage

    Institute of Scientific and Technical Information of China (English)

    王乐; 刘少喻

    2013-01-01

    背景:可吸收聚合物材料用于制作椎体间融合器目前是研究的热点,且存在争议。目的:综述可吸收聚合物材料椎间融合器的基础研究及临床应用进展。  方法:以“椎间融合器,可吸收性,动物实验,临床研究; spine,bioabsorbable,intervertebral fusion”为关键词,应用计算机检索维普数据库、万方数据库和PubMed 数据库1989年1月至2012年6月与可吸收聚合物材料椎间融合器相关的文献,总结可吸收聚合物材料椎间融合器基础研究和应用方面的最新进展。  结果与结论:基础研究显示,可吸收聚合物材料椎间融合器可有效促进椎间融合,最主要的缺陷是植入体内产生的迟发型炎症反应和大块侵蚀作用,以及降解与融合速度,机械强度与孔隙率等方面尚待进一步研究。目前,聚乳酸及其衍生的混合共聚物正应用于临床且相关研究正逐步开展。该材料最主要的优势在于其应用于融合器时可针对不同需要灵活改变参数,但融合器周围组织良好的血运和成血管作用十分重要,而且支架孔隙率和其他关键参数可影响融合器的机械强度,要求其在能承受必要压力载荷的同时也可提供足够的空间,满足细胞迁移、血管生成,从而促进骨融合,因此寻找最优化的参数组合在骨组织工程研究领域仍是一项挑战。%BACKGROUND:Bioabsorbable polymer materials used in interbody fusion are currently a hot research, and there is stil no consensus. OBJECTIVE:To summarize the basic research and clinical application of bioabsorbable polymer interbody fusion cages. METHODS:A search of literatures in the database of Wanfang, VIP and PubMed databases from January 1989 to June 2012 was performed with the key words of“intervertebral fusion;bioabsorbable;spine;animal experiment;clinical research”in Chinese and English, respectively. Al the literatures

  18. The Use of Bone Morphogenetic Protein in Pediatric Cervical Spine Fusion Surgery: Case Reports and Review of the Literature

    OpenAIRE

    Molinari, Robert W.; Molinari, Christine

    2015-01-01

    Study Design Case report. Objective There is a paucity of literature describing the use of bone graft substitutes to achieve fusion in the pediatric cervical spine. The outcomes and complications involving the off-label use of bone morphogenetic protein (BMP)-2 in the pediatric cervical spine are not clearly defined. The purpose of this article is to report successful fusion without complications in two pediatric patients who had instrumented occipitocervical fusion using low-dose BMP-2. Meth...

  19. Bioresorbable cage for interbody fusion Progress in research and clinical application%可吸收椎间融合器的理论研究及临床应用

    Institute of Scientific and Technical Information of China (English)

    孙浩林; 李淳德

    2008-01-01

    险带来了相应技术的发展.结论:可吸收椎间融合器的研究和应用仍处于起步阶段,但现有的研究结果已经预示了其进一步研究和临床应用发展前景.%BACKGROUND: The use of interbody cages is rapidly increasing in filed of spinal fusion surgery. The inherent limitations of conventional cages such as cage migration or failure, radiopacity, fusion stress shielding, late-onset inflammation and osteolysis give some impetus for the development of bioresorbable cages. Compared with conventional cages, they show better rigidity and elasticity coefficient, with less interference on the imaging evaluation. OBJECTIVE: To introduce the materials classification and property, animal studies, clinical application, current drawbacks and future directions of bioresorbable fusion cages, and provide objective evidences for the research and clinical application of the cages.RETRIEVAL STRATEGY: The relevant articles published between December 1990 and December 2006 were searched for in Pubmed database by the researchers of this article, with the key words "bioresorbable cages, spine, SCI" in English. A total of 550 articles were selected and reviewed preliminarily by the inclusive standards of: research about materials, animal studies and clinical application of bioresorbable cages. Exclusion criteria: repetitive studies.LITERATURE EVALUATION: The main sources of literatures are researches about materials, animal studies and clinical application of bioresorbable cages. Among the 27 selected articles, 1 is review, while others are clinical or elementary experimental studies. DATA SYNTHESIS: ①Materials: Polylactides becomes the most useful and applied base material for bioresorbable spinal interbody cages; characteristics of bioresorbable materials include crystallinity, average molecular weight, molecular weight distribution (polydispersity), and glass transition temperature. There are also several points to consider in the design of

  20. Combined transforaminal lumbar interbody fusion with posterolateral instrumented fusion for degenerative disc disease can be a safe and effective treatment for lower back pain

    Directory of Open Access Journals (Sweden)

    Ara J Deukmedjian

    2015-01-01

    Full Text Available Background: Lumbar fusion is a proven treatment for chronic lower back pain (LBP in the setting of symptomatic spondylolisthesis and degenerative scoliosis; however, fusion is controversial when the primary diagnosis is degenerative disc disease (DDD. Our objective was to evaluate the safety and effectiveness of lumbar fusion in the treatment of LBP due to DDD. Materials and Methods: Two-hundred and five consecutive patients with single or multi-level DDD underwent lumbar decompression and instrumented fusion for the treatment of chronic LBP between the years of 2008 and 2011. The primary outcome measures in this study were back and leg pain visual analogue scale (VAS, patient reported % resolution of preoperative back pain and leg pain, reoperation rate, perioperative complications, blood loss and hospital length of stay (LOS. Results: The average resolution of preoperative back pain per patient was 84% (n = 205 while the average resolution of preoperative leg pain was 90% (n = 190 while a mean follow-up period of 528 days (1.5 years. Average VAS for combined back and leg pain significantly improved from a preoperative value of 9.0 to a postoperative value of 1.1 (P ≤ 0.0001, a change of 7.9 points for the cohort. The average number of lumbar disc levels fused per patient was 2.3 (range 1-4. Median postoperative LOS in the hospital was 1.2 days. Average blood loss was 108 ml perfused level. Complications occurred in 5% of patients (n = 11 and the rate of reoperation for symptomatic adjacent segment disease was 2% (n = 4. Complications included reoperation at index level for symptomatic pseudoarthrosis with hardware failure (n = 3; surgical site infection (n = 7; repair of cerebrospinal fluid leak (n = 1, and one patient death at home 3 days after discharge. Conclusion: Lumbar fusion for symptomatic DDD can be a safe and effective treatment for medically refractory LBP with or without leg pain.

  1. 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

  2. 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.

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

    Science.gov (United States)

    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

  4. Extreme Lateral Interbody Fusion Procedure

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    Full Text Available ... 00:03:50 FERNANDO VALE, MD: Okay. Well, let me go back a little bit in time. What we' ... are critical. And again, I'm going to go back to the device itself. This is the cage, and there is like a -- it's kind of hard to see, but there are some little bars in there -- let's see if we can get a close-up. ...

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    Full Text Available ... with the questions, these other questions on the web for him. 00:49:58 FERNANDO VALE, MD: ... you can go to the Tampa General Hospital web page, we can get access through physician finder. ...

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    Full Text Available ... could potentially go home within one or two days after surgery. As a matter of fact, we ... or typical open procedure. Now, pedicle screws these days still can be placed through a minimal access ...

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    Full Text Available ... any questions, to please get it on the internet right now, because we are almost done to ... Tampa General Hospital web page, we can get access through physician finder. Dr. Juan Uribe, the surgeon, ...

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    Full Text Available ... much of muscle, minimizing the trauma to the soft tissue. And these are different shots, again, of the ... fusing the spine with minimal trauma to the soft tissue, and that way the patient can recover faster, ...

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    Full Text Available ... C-arm, that is fluoroscopy, to identify the level. In this way, he can mark the skin ... X, we're using radiograph to identify the level, we're looking here at our shot from ...

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    Full Text Available ... step is placing of the guide wire, which uses a monitor. That monitor allows us to record ... show you some of the instruments that we use so that you understand the idea behind this. ...

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    Full Text Available ... takes less time to perform than the traditional open surgery, and patient recovery is noticeably quicker and easier. OR-Live makes it easy for you to learn more. Just click on the "Request Information" button ...

  12. Extreme Lateral Interbody Fusion Procedure

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    Full Text Available ... less time to perform than the traditional open surgery, and patient recovery is noticeably quicker and easier. OR-Live makes ... screws from behind. Well, it's complicated. And both surgeries are complicated, ... pain and prolong the recovery phase. So they're both successful and there ...

  13. Extreme Lateral Interbody Fusion Procedure

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    Full Text Available ... injure them. So now I can have a mapping where the nerves are. Now back to you, ... spondylosis, they can potentially benefit from this surgical intervention. The idea is to remove the disc and ...

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    Full Text Available ... tissue. I also have here a little spine model that I'd like to show to everybody. ... restore the normal height. Again, this is the model that I showed before, and you have to ...

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    Full Text Available ... to perform than the traditional open surgery, and patient recovery is noticeably quicker and easier. OR-Live ... incision. This is in the side of the patient, approximately 4 centimeters. And then I dilated with ...

  16. Extreme Lateral Interbody Fusion Procedure

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    Full Text Available ... space, which is going to be removed. That's what Dr. Juan Uribe was doing. And then we basically place this cage that is replacing the disc. This is your replacement. Now, this is going to fuse. This ...

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    Full Text Available ... the possibility of pain. This is how it should look at the end of the operation. Okay? ... means that that's the annulus, where the disc should be. Now my next step, I'm going ...

  18. Extreme Lateral Interbody Fusion Procedure

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    Full Text Available ... at least two and a half hours, somebody real experienced. It could go up to four hours if somebody -- a more difficult case. And again, you see the devices right here. He's all going through a small opening, ...

  19. Extreme Lateral Interbody Fusion Procedure

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    Full Text Available ... operation, because we can see that it can benefit many patients without causing any major morbidity. And that's the idea behind this. We want people up and around, recover faster. So Dr. Uribe's still working on the discectomy. There are another few things that I'd like to say about this ...

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    Full Text Available ... to learn more. Just click on the "Request Information" button on your webcast screen and open the ... to learn more. Just click on the "Request Information" button on your webcast screen and open the ...

  1. Extreme Lateral Interbody Fusion Procedure

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    Full Text Available ... see, it's made of PEEK, that is a plastic material and has openings that allow for placement ... seen before is made of PEEK, that is plastic, but is real strong plastic, has been tested ...

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    Full Text Available ... and implant insertion. The procedure also takes less time to perform than the traditional open surgery, and ... let me go back a little bit in time. What we're doing today is a procedure ...

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    Full Text Available ... that normal height, try to restore that normal anatomy, and that way open up the nerve, open ... on the cage in between to allow that anatomy to be restored again. And these are all ...

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    Full Text Available ... that is in the short term the biggest cause of pain during the postoperative period. Suction. Okay, ... say -- but when it gets degenerated, that can cause a lot of collapse in that area, it ...

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    Full Text Available ... to informed medical care. Now let's join the doctors. 00:01:17 FERNANDO VALE, MD: Welcome, everybody. ... Hospital web page, we can get access through physician finder. Dr. Juan Uribe, the surgeon, and Dr. ...

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    Full Text Available ... This muscle is really important for us to work around, and we have to go through that ... levels to approach from the lateral approach. It works really well at L4/5, L3/4, L2/ ...

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    Full Text Available ... down to the psoas muscle that is a large muscle that helps stabilize the spine. From there, ... the lumbar spine with the nerve. That's the large muscle that we call the psoas. This muscle ...

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    Full Text Available ... course, everything requires a learning curve. This is something that is done many times, and as you ... of the main indications from this operation. That's something that has to be discussed between the patient ...

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    Full Text Available ... 17 FERNANDO VALE, MD: Welcome, everybody. We are live in Tampa General Hospital in Tampa, Florida, Room 18. Today I'd like to present one of my colleagues, chief of the spine section at the University of South Florida in Tampa, Florida. My name ...

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    Full Text Available ... sequentially, we are removing the disc until we clean and remove the disc as much as we ... those shavers. We shave the disc space, we clean the area so we have bone-to-bone ...

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    Full Text Available ... of muscle, minimizing the trauma to the soft tissue. And these are different shots, again, of the ... the spine with minimal trauma to the soft tissue, and that way the patient can recover faster, ...

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    Full Text Available ... perform the discectomy and place a lot of screws from behind. Well, it's complicated. And both surgeries ... adequate, we can even place a plate and screws from the lateral approach. That also will give ...

  13. Extreme Lateral Interbody Fusion Procedure

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    Full Text Available ... keep going. And then we're going to implant the plate and the screws. And on the table is the cage. Dr. Vale can discuss how the cage looks and the implants on there. 00:52:01 FERNANDO VALE, MD: ...

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    Full Text Available ... General Hospital in Tampa, Florida, Room 18. Today I'd like to present one of my colleagues, ... in Tampa, Florida. My name is Fernando Vale, I will be the narrator of this procedure. I ...

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    Full Text Available ... made of PEEK, that is plastic, but is real strong plastic, has been tested for many years. ... can see before, this is done through a real small incision, and that's another critical part. But ...

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    Full Text Available ... tube has numbers that is telling me how deep is the spine from here. So we set ... dilators are placed and a retractor is placed deep inside in the wound to allow visualization of ...

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    Full Text Available ... you have this many assistants, to make our life a lot easier in surgery. And again, he's ... spine is. It's hard bone, we have to work through this bony surface. As you can see, ...

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    Full Text Available ... perform this operation. Of course, everything requires a learning curve. This is something that is done many ... myself. Seventy-two hours, in my own personal experience, most of these patients want to go home. ...

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    Full Text Available ... using radiograph to identify the level, we're looking here at our shot from the side of ... to fuse the spine. And this is right looking through the front. As you can see, there ...

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    Full Text Available ... 32 FERNANDO VALE, MD: Okay, well the few things that I would like to readdress, number one, it's extremely important that we have good fluoroscopy. I mean, good x-rays. We need ...

  1. Extreme Lateral Interbody Fusion Procedure

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    Full Text Available ... to show you a quick video of the positioning of the patient that will allow you to ... And again, he's still cleaning that space. He's positioning those retractors to make sure that he can ...

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    Full Text Available ... operation. After that -- after that's done, then basically these dilators are placed in a sequential manner, and ... minimizing the trauma to the soft tissue. And these are different shots, again, of the muscle and ...

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    Full Text Available ... of Medicine. He will be joined by Dr. Fernando Vale, vice chief of the Neurosciences Department at ... Now let's join the doctors. 00:01:17 FERNANDO VALE, MD: Welcome, everybody. We are live in ...

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    Full Text Available ... factor, as we believe that as the recovery phase moves along, you'll feel much better. Again, ... potentially bring more pain and prolong the recovery phase. So they're both successful and there is ...

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    Full Text Available ... OR-Live makes it easy for you to learn more. Just click on the "Request Information" button ... perform this operation. Of course, everything requires a learning curve. This is something that is done many ...

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    Full Text Available ... minimize muscle destruction. We go from the side, split the muscle apart, and get access to the ... we have the flank on the side, we split the skin and the fascia and get down ...

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    Full Text Available ... the disc space before he gets to the process of inserting the cage. And I would like ... URIBE, MD: Okay, now I'm in the process of finishing the procedure. I'm just putting ...

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    Full Text Available ... these instruments to be able to perform the surgery. We're not hurting anybody. This is the way that it works in the spine. You have to get access there, you've got to work against bone, which is extremely hard. So it's normal ...

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    Full Text Available ... to be stable. Another question is: can it be rejected? Well, we've never seen it. This cage that ... about rejection from a device like this. It's well-incorporated in the body, especially in the spine. More questions: can it be done at age 70 and older? Absolutely. It's ...

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    Full Text Available ... like, if we have time, to show an animation so people can understand how this procedure is ... different shots, again, of the muscle and the animation. This is just -- you can see the machine ...

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    Full Text Available ... General Hospital in Tampa, Florida. You're just a few moments away from seeing a live minimally-disruptive procedure for spine surgery called ... the event. The minimally invasive XLIF procedure takes a unique approach with a side entry. This allows ...

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    Full Text Available ... is the assistant professor of neurosurgery at the University of South Florida College of Medicine. He will ... colleagues, chief of the spine section at the University of South Florida in Tampa, Florida. My name ...

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    Full Text Available ... webcast screen and open the door to informed medical care. Now let's join the doctors. 00:01: ... webcast screen and open the door to informed medical care. 00:59:48 [ end of webcast

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    Full Text Available ... to an open operation? Well, they're all open. We make openings. To get access to the spine, you have to make an ... of surgery. There is a role for the open operation and there seems to be another role for the minimal access operation like this. Now, as we learn more, ...

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    Full Text Available ... me my knife again. I'm going to increase a little bit more the opening. And cup. ... as planned. We believe that this hopefully will help this gentleman to recover from his spine disease. ...

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    Full Text Available ... psoas muscle that is a large muscle that helps stabilize the spine. From there, we just get ... as planned. We believe that this hopefully will help this gentleman to recover from his spine disease. ...

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    Full Text Available ... severe facet disease. These are all stages of arthritis. And it will happen to anybody. It will ... suffering from severe lumbar spondylosis. Again, spondylosis means arthritis, which results in pain, nerve damage, and all ...

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    Full Text Available ... you have this many assistants, to make our life a lot easier in surgery. And again, he's ... within 24, 48, at the latest 72 hours. After that, I probably would like to get him ...

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    Full Text Available ... dilated with sequential tubings down into the psoas muscle. And now we're going to stimulate in ... side. And that way we try to minimize muscle destruction. We go from the side, split the ...

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    Full Text Available ... perform this operation. Of course, everything requires a learning curve. This is something that is done many ... cameras don't have -- we cannot get them deep enough to look at the disc space, but ...

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    Full Text Available ... any questions, to please get it on the internet right now, because we are almost done to ... to learn more. Just click on the "Request Information" button on your webcast screen and open the ...

  2. Extreme Lateral Interbody Fusion Procedure

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    Full Text Available ... by Dr. Fernando Vale, vice chief of the Neurosciences Department at Tampa General Hospital. Dr. Vale will ... treasure box. I would like to thank the anesthesia and the people from Tampa General Hospital for ...

  3. Extreme Lateral Interbody Fusion Procedure

    Medline Plus

    Full Text Available ... So the opening that I have on the working channel is approximately two centimeters by one and a half centimeters that you can see, so we were to use more channel, but everything that we do is just to minimize the postoperative pain and the muscle injury that is in the short term the biggest ...

  4. Extreme Lateral Interbody Fusion Procedure

    Medline Plus

    Full Text Available ... Vale. 00:03:50 FERNANDO VALE, MD: Okay. Well, let me go back a little bit in ... procedure. 00:08:32: FERNANDO VALE, MD: Okay, well, basically this is retroperitoneal approach, and I would ...

  5. Extreme Lateral Interbody Fusion Procedure

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    Full Text Available ... perform this operation. Of course, everything requires a learning curve. This is something that is done many ... us to hammer to get access to the problem. What he's doing at this stage is basically ...

  6. Extreme Lateral Interbody Fusion Procedure

    Medline Plus

    Full Text Available ... perform this operation. Of course, everything requires a learning curve. This is something that is done many ... 00:52:01 FERNANDO VALE, MD: Okay. well, basic-- we can go back to, again, this is ...

  7. Extreme Lateral Interbody Fusion Procedure

    Medline Plus

    Full Text Available ... the muscles. We're just clearing the muscle fibers. So we leave some time for the muscles ... can see, that dilator is spreading the muscle fibers apart. We're not cutting any muscle fiber, ...

  8. Extreme Lateral Interbody Fusion Procedure

    Medline Plus

    Full Text Available ... PEEK, that is plastic, but is real strong plastic, has been tested for many years. We have -- as far as I know, I've never heard a case about rejection from a device like this. It's well-incorporated in the body, especially in the spine. More questions: can it ...

  9. Extreme Lateral Interbody Fusion Procedure

    Medline Plus

    Full Text Available ... and he's using the C-arm, that is fluoroscopy, to identify the level. In this way, he ... VALE, MD: So we like to see the fluoroscopy, the x-ray that shows the retractor. 00: ...

  10. Extreme Lateral Interbody Fusion Procedure

    Medline Plus

    Full Text Available ... is noticeably quicker and easier. OR-Live makes it easy for you to learn more. Just click ... m rotating my instrument and as I rotate it, numbers are changing. Now we can see on ...

  11. Extreme Lateral Interbody Fusion Procedure

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    Full Text Available ... procedure. Dr. Uribe is the assistant professor of neurosurgery at the University of South Florida College of ... at the University of South Florida, Department of Neurosurgery, acting chief of the spine section. Dr. Juan ...

  12. Extreme Lateral Interbody Fusion Procedure

    Science.gov (United States)

    ... procedure. Dr. Uribe is the assistant professor of neurosurgery at the University of South Florida College of ... at the University of South Florida, Department of Neurosurgery, acting chief of the spine section. Dr. Juan ...

  13. Extreme Lateral Interbody Fusion Procedure

    Medline Plus

    Full Text Available ... from this operation. It's minimal access. Some people call it minimally invasive. The idea is to minimize ... the idea behind this. This is what we call our transpsoas approach. Basically we have the flank ...

  14. 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

    OpenAIRE

    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...

  15. Introduction and evaluation of an anterior interbody fusion model on rabbits%一种兔腰椎间融合模型的建立及效果评价

    Institute of Scientific and Technical Information of China (English)

    汤嘉军; 杨宇超; 陈国荣; 张忠民

    2015-01-01

    目的:利用兔腰椎骨性结构测量数据建立一种稳定的腰椎椎体间植骨融合模型,为组织工程学研究提供标准化的模型参考。方法选用健康新西兰大白兔(2~2.5 kg)44只,随机分为A、B、C、D四组,A组(n=10)用于解剖进行腰椎椎体测量,B组(n=12)行L4/5椎体间椎骨融合术加内固定;C组(n=12只)行L4/5椎体间植骨融合术未进行内固定,D组(n=10)行单纯显露加横突破坏。B、C、D 3组造模后4周行X线检查,术后12周取标本进行大体观察、Micro-CT、生物力学及组织学切片检查。结果 B组仅出现1例因固定螺钉进入椎管导致脊髓损伤造成双下肢瘫痪。手触法检测B组融合率为100%(12/12),C组融合率为75%(9/12),D组标本未见椎间盘损伤及间隙破坏。影像学B组植入骨块位置明显优于C组,融合评分明显高于C组(P<0.05)。组织学提示B、C两组椎体间融合部位均可见新生软骨,C组中可见植骨块脱出后形成软组织空腔。生物力学显示B组最大载荷显著高于C组(P<0.05)。结论在兔腰椎解剖基础上进行兔腰椎间植骨融合模型制作是安全、可靠的。内固定装置可以为椎间植骨块提供稳定的融合空间,防止植骨块脱离融合位置,有助于提高该模型的融合效率。%Objective In order to provide a standardized model for tissue engineering research,we took measurement of lumbar bodies on rabbits to establish a stable interbody fusion model. Methods Forty-four healthy adult New Zealand white rabbits (2~2.5 kg) were randomly divided into an anatomical analysis group (group A, n=10), an interbody fusion with fixation group (group B, n=12), an interbody fusion with no fixation group(group C, n=12) and a blank control group (group D, n=10). Animals in group B、C、D underwent x-ray examination at 4 weeks after operation. At 12 weeks all rabbits were euthanasized, the fusion segments were

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

    Directory of Open Access Journals (Sweden)

    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.

  17. A computed tomography morphometric study of occipital bone and C2 pedicle anatomy for occipital-cervical fusion

    OpenAIRE

    Nicolas K.K. King; Tiruchelvarayan Rajendra; Ivan Ng; Wai Hoe Ng

    2014-01-01

    Background: Occipital-cervical fusion (OCF) has been used to treat instability of the occipito-cervical junction and to provide biomechanical stability after decompressive surgery. The specific areas that require detailed morphologic knowledge to prevent technical failures are the thickness of the occipital bone and diameter of the C2 pedicle, as the occipital midline bone and the C2 pedicle have structurally the strongest bone to provide the biomechanical purchase for cranio-cervical instrum...

  18. 单侧椎间融合内固定治疗腰椎间盘突出症的手术效果%Surgical Effect of Unilateral Pedicle Screw Fixation and Lumbar Interbody Fusion in the Treatment of Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    李开雄; 邵玉凯; 郑晓刚; 郭金元; 肖卫; 欧艳春

    2016-01-01

    目的 分析椎间盘突出症椎间融合后单侧内固定的手术效果 .方法 随机选取2007年8月—2014年12月收治的腰椎间盘突出症患者68例,均给予椎间植骨融合术治疗,随机分为单侧内固定治疗的观察组(34例)和双侧内固定治疗的对照组(34例),观察与对比两组患者手术治疗情况. 结果 与对照组比较,观察组患者的手术时间、术中出血量 、术后引流量均低于对照组,差异有统计学意义(P<0.05);术后二组患者的椎间隙曲度、融合率以及JOA评分、MACMAB疗效评定的差异均无统计学意义. 结论 研究表明,单侧椎间融合内固定治疗手术创伤小,可取得与双侧手术相当的近远期疗效.%Objective To analyze the surgical effect of unilateral pedicle screw fixation and lumbar interbody fusion in the treatment of lumbar disc herniation. Methods 68 patients with lumbar disc herniation admitted from August 2007 to De-cember 2014 were randomly divided into the observation group and the control group with 34 cases in each. The observation group were treated by the unilateral pedicle screw fixation and lumbar interbody fusion, while the control group were treated by bilateral pedicle screw fixation and lumbar interbody fusion. And the surgical treatment effect of the two groups was ob-served and compared. Results Compared to the control group, the observation group had shorter operative time, less intra-operative blood loss and less postoperative drainage, the differences were statistically significant (P<0.05). The differences in intervertebral curvature, fusion rate, JOA score and result of MACMAB between the groups after surgery were not statistical-ly significant. Conclusion The study shows that for the treatment of lumbar disc herniation, unilateral pedicle screw fixation and lumbar interbody fusion have smaller trauma, but can obtain the same short-term and long-term effects as bilateral pedicle screw fixation and lumbar interbody fusion.

  19. Solid radiographic fusion with a nonconstrained device 5 years after cervical arthroplasty.

    Science.gov (United States)

    Heary, Robert F; Goldstein, Ira M; Getto, Katarzyna M; Agarwal, Nitin

    2014-12-01

    Cervical disc arthroplasty (CDA) has been gaining popularity as a surgical alternative to anterior cervical discectomy and fusion. Spontaneous fusion following a CDA is uncommon. A few anecdotal reports of heterotrophic ossification around the implant sites have been noted for the BRYAN, ProDisc-C, Mobi-C, PRESTIGE, and PCM devices. All CDA fusions reported to date have been in devices that are semiconstrained. The authors reported the case of a 56-year-old man who presented with left C-7 radiculopathy and neck pain for 10 weeks after an assault injury. There was evidence of disc herniation at the C6-7 level. He was otherwise healthy with functional scores on the visual analog scale (VAS, 4.2); neck disability index (NDI, 16); and the 36-item short form health survey (SF-36; physical component summary [PSC] score 43 and mental component summary [MCS] score 47). The patient underwent total disc replacement in which the DISCOVER Artificial Cervical Disc (DePuy Spine, Inc.) was used. The patient was seen at regular follow-up visits up to 60 months. At his 60-month follow-up visit, he had complete radiographic fusion at the C6-7 level with bridging trabecular bone and no motion at the index site on dynamic imaging. He was pain free, with a VAS score of 0, NDI score of 0, and SF-36 PCS and MCS scores of 61 and 55, respectively. Conclusions This is the first case report that identifies the phenomenon of fusion around a nonconstrained cervical prosthesis. Despite this unwanted radiographic outcome, the patient's clinical outcome was excellent. PMID:25303618

  20. Design of Lamifuse : a randomised, multi-centre controlled trial comparing laminectomy without or with dorsal fusion for cervical myeloradiculopathy

    NARCIS (Netherlands)

    Bartels, R.H.M.A.; Verbeek, A.L.M.; Grotenhuis, J.A.

    2007-01-01

    BACKGROUND: laminectomy is a valuable surgical treatment for some patients with a cervical radiculomyelopathy due to cervical spinal stenosis. More recently attention has been given to motion of the spinal cord over spondylotic spurs as a cause of myelopathic changes. Immobilisation by fusion could

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

    Science.gov (United States)

    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

  2. Laminoplasty instead of laminectomy as a decompression method in posterior instrumented fusion for degenerative cervical kyphosis with stenosis

    OpenAIRE

    Yeh, Kuang-Ting; Lee, Ru-Ping; Chen, Ing-Ho; Yu, Tzai-Chiu; Liu, Kuan-Lin; Peng, Cheng-Huan; Wang, Jen-Hung; Wu, Wen-Tien

    2015-01-01

    Background Posterior laminectomy with instrumented fusion is a standard procedure for treating degenerative cervical kyphosis with stenosis (DCKS). Two major disadvantages of the surgery are adhesion of the dural membrane with significant disfiguring of cervical spine and a small fusion bed around the lateral mass. One of the advantages of laminoplasty over laminectomy is the protection of the dural membrane from adhesion through preservation of posterior bony elements. This study presents th...

  3. Time-sequential changes of differentially expressed miRNAs during the process of anterior lumbar interbody fusion using equine bone protein extract, rhBMP-2 and autograft

    Science.gov (United States)

    Chen, Da-Fu; Zhou, Zhi-Yu; Dai, Xue-Jun; Gao, Man-Man; Huang, Bao-Ding; Liang, Tang-Zhao; Shi, Rui; Zou, Li-Jin; Li, Hai-Sheng; Bünger, Cody; Tian, Wei; Zou, Xue-Nong

    2014-03-01

    The precise mechanism of bone regeneration in different bone graft substitutes has been well studied in recent researches. However, miRNAs regulation of the bone formation has been always mysterious. We developed the anterior lumbar interbody fusion (ALIF) model in pigs using equine bone protein extract (BPE), recombinant human bone morphogenetic protein-2 (rhBMP-2) on an absorbable collagen sponge (ACS), and autograft as bone graft substitute, respectively. The miRNA and gene expression profiles of different bone graft materials were examined using microarray technology and data analysis, including self-organizing maps, KEGG pathway and Biological process GO analyses. We then jointly analyzed miRNA and mRNA profiles of the bone fusion tissue at different time points respectively. Results showed that miRNAs, including let-7, miR-129, miR-21, miR-133, miR-140, miR-146, miR-184, and miR-224, were involved in the regulation of the immune and inflammation response, which provided suitable inflammatory microenvironment for bone formation. At late stage, several miRNAs directly regulate SMAD4, Estrogen receptor 1 and 5-hydroxytryptamine (serotonin) receptor 2C for bone formation. It can be concluded that miRNAs play important roles in balancing the inflammation and bone formation.

  4. 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.)

  5. 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...

  6. Clinical outcomes of two types of cages used in transforaminal lumbar interbody fusion for the treatment of degenerative lumbar diseases: n-HA/PA66 cages versus PEEK cages.

    Science.gov (United States)

    Deng, Qian-Xing; Ou, Yun-Sheng; Zhu, Yong; Zhao, Zeng-Hui; Liu, Bo; Huang, Qiu; Du, Xing; Jiang, Dian-Ming

    2016-06-01

    This study reports the clinical effects of nano-hydroxyapatite/polyamide66 cages (n-HA/PA66 cages) and compares the clinical outcomes between n-HA/PA66 and polyetheretherketone cages (PEEK cages) for application in transforaminal lumbar interbody fusion (TLIF). A retrospective and case-control study involving 124 patients using n-HA/PA66 cages and 142 patients using PEEK cages was conducted. All patients underwent TLIF and had an average of 2-years of follow-up. The Oswestry Disability Index and Visual Analog Scale were selected to assess the pain of low back and leg, as well as neurological status. The intervertebral space height and segmental angle were also measured to estimate the radiological changes. At the 1-year and final follow-ups, the fusion and subsidence rates were evaluated. There was no significant difference between the two groups regarding clinical and radiological results. At the final follow-up, the bony fusion rate was 92.45 and 91.57 % for the n-HA/PA66 and PEEK groups, respectively, and the subsidence rate was 7.55 and 8.99 %, respectively. The study indicated that both n-HA/PA66 and PEEK cages could promote effective clinical and radiographic outcomes when used to treat degenerative lumbar diseases. The high fusion and low subsidence rates revealed that n-HA/PA66 cages could be an alternative ideal choice as the same to PEEK cages for lumbar reconstruction after TLIF. PMID:27091044

  7. The Use of Bone Morphogenetic Protein in Pediatric Cervical Spine Fusion Surgery: Case Reports and Review of the Literature.

    Science.gov (United States)

    Molinari, Robert W; Molinari, Christine

    2016-02-01

    Study Design Case report. Objective There is a paucity of literature describing the use of bone graft substitutes to achieve fusion in the pediatric cervical spine. The outcomes and complications involving the off-label use of bone morphogenetic protein (BMP)-2 in the pediatric cervical spine are not clearly defined. The purpose of this article is to report successful fusion without complications in two pediatric patients who had instrumented occipitocervical fusion using low-dose BMP-2. Methods A retrospective review of the medical records was performed, and the patients were followed for 5 years. Two patients under 10 years of age with upper cervical instability were treated with occipitocervical instrumented fusion using rigid occipitocervical fixation techniques along with conventionally available low-dose BMP-2. A Medline and PubMed literature search was conducted using the terms "bone morphogenetic protein," "BMP," "rh-BMP2," "bone graft substitutes," and "pediatric cervical spine." Results Solid occipitocervical fusion was achieved in both pediatric patients. There were no reported perioperative or follow-up complications. At 5-year follow-up, radiographs in both patients showed successful occipital cervical fusion without evidence of instrumentation failure or changes in the occipitocervical alignment. To date, there are few published reports on this topic. Complications and the appropriate dosage application in the pediatric posterior cervical spine remain unknown. Conclusions We describe two pediatric patients with upper cervical instability who achieved successful occipital cervical fusion without complication using off-label BMP-2. This report underscores the potential for BMP-2 to achieve successful arthrodesis of the posterior occipitocervical junction in pediatric patients. Use should be judicious as complications and long-term outcomes of pediatric BMP-2 use remain undefined in the existing literature. PMID:26835215

  8. 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...

  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. Langerhans cell histiocytosis causing cervical myelopathy in a child.

    Science.gov (United States)

    Jang, Kun Soo; Jung, Youn Young; Kim, Seok Won

    2010-06-01

    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 corpectemy and fusion. A 5-year-old boy presented with 3 weeks of severe neck pain and limited neck movement accompanying right arm motor weakness. CT scans revealed destruction of C7 body and magnetic resonance imaging showed a tumoral process at C7 with cord compression. Interbody fusion using cervical mesh 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 right arm. 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:20617093

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Laminoplasty versus laminectomy and fusion for multilevel cervical compressive myelopathy: A meta-analysis.

    Science.gov (United States)

    Liu, Feng-Yu; Yang, Si-Dong; Huo, Li-Shuang; Wang, Tao; Yang, Da-Long; Ding, Wen-Yuan

    2016-06-01

    This is a meta-analysis to compare the results between laminoplasty and laminectomy followed by fusion for the patients with multilevel cervical compressive myelopathy. An extensive search of literature was performed in MEDLINE, Embase, the Cochrane library, CNKI, and WANFANG. The following outcome measures were extracted: the Japanese Orthopaedic Association (JOA) scores, cervical curvature index (CCI), visual analog scale (VAS), cervical lordosis (C2-7), complications, blood loss, and operation time. Data analysis was conducted with RevMan 5.3 and STATA 12.0. A total of 23 studies comprising 774 and 743 patients treated with laminoplasty and laminectomy followed by fusion, respectively, were included in the final analysis. The pooled analysis showed that there was no significant difference in preoperative JOA scores [P = 0.89], postoperative JOA scores [P = 0.13], JOA scores improvement rate [P = 0.27], preoperative CCI [P = 0.15], postoperative CCI [P = 0.14], preoperative VAS [P = 0.41], postoperative VAS [P = 0.52], preoperative cervical lordosis (C2-7) [P = 0.46], postoperative cervical lordosis (C2-7) [P = 0.67], total complications [P = 0.07], axial pain [P = 0.94], and blood loss [P = 0.51]. However, there were significant difference in operation time (WMD = -19.57 [-32.11, -7.02], P = 0.002) and C5 palsy (OR = 0.26 [0.15, 0.44], P lordosis (C2-7), axial pain, total complications, and blood loss, but shorter operation time and fewer C5 palsy. PMID:27281067

  13. Analytical comparison study of the clinical and radiological outcome of spine fixation using posterolateral, posterior lumber interbody and transforaminal lumber interbody spinal fixation techniques to treat lumber spine degenerative disc disease

    OpenAIRE

    Al Barbarawi, Moh’d M; Audat, Ziad M; Mohammed Z. Allouh

    2015-01-01

    Background Degenerative disc disease is a common cause of chronic and disabling back pain that requires surgical intervention, posterolateral and posterior instrumental fixation (PLF), posterior lumber interbody fusion (PLIF) and transforaminal lumber interbody fusion (TLIF) are the techniques used to deal with such a problem. Objective To compare the clinical and radiological outcome of the variable surgical techniques used to deal with Lumber degenerative disc disease and to recommend the t...

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Design of Lamifuse: a randomised, multi-centre controlled trial comparing laminectomy without or with dorsal fusion for cervical myeloradiculopathy

    Directory of Open Access Journals (Sweden)

    Grotenhuis J André

    2007-11-01

    Full Text Available Abstract Background laminectomy is a valuable surgical treatment for some patients with a cervical radiculomyelopathy due to cervical spinal stenosis. More recently attention has been given to motion of the spinal cord over spondylotic spurs as a cause of myelopathic changes. Immobilisation by fusion could have a positive effect on the recovery of myelopathic signs or changes. This has never been investigated in a prospective, randomised trial. Lamifuse is an acronyme for laminectomy and fusion. Methods/Design Lamifuse is a multicentre, randomised controlled trial comparing laminectomy with and without fusion in patients with a symptomatic cervical canal stenosis. The study population will be enrolled from patients that are 60 years or older with myelopathic signs and/or symptoms due to a cervical canal stenosis. A kyphotis shape of the cervical spine is an exclusion criterium. Each treatment arm needs 30 patients. Discussion This study will contribute to the discussion whether additional fusion after a cervical laminectomy results in a better clinical outcome. ISRCT number ISRCTN72800446

  16. Correlations of Cervical Sagittal Alignment before and after Occipitocervical Fusion.

    Science.gov (United States)

    Matsubayashi, Yoshitaka; Shimizu, Takachika; Chikuda, Hirotaka; Takeshita, Katsushi; Oshima, Yasushi; Tanaka, Sakae

    2016-06-01

    Study Design Retrospective radiographic study. Objective To investigate changes and correlations of cervical sagittal alignment including T1 slope before and after occipitocervical corrective surgery. We also investigated the relevance for preoperative planning. Methods We conducted a retrospective radiographic analysis of 27 patients who underwent surgery for occipitocervical deformity. There were 7 men and 20 women with a mean age of 56.0 years. Mean follow-up was 68.0 months (range 24 to 120). The radiographic parameters measured before surgery and at final follow-up included McGregor slope, T1 slope, occipito (O)-C2 angle, O-C7 angle, and C2-C7 angle. Pearson correlation coefficient was used to examine the correlation between the radiographic parameters. Results There was a stronger positive correlation between the T1 slope and the O-C7 angle both preoperatively and postoperatively (r = 0.72 and r = 0.83, respectively) than between the T1 slope and the C2-C7 angle (r = 0.60 and r = 0.76, respectively). The O-C2 angle and C2-C7 angle had inverse correlations to each other both pre- and postoperatively (r =  - 0.50 and -0.45). McGregor slope and T1 slope did not significantly change postoperatively at final follow-up. Increase in O-C2 angle after surgery (mean change, 10.7 degrees) inversely correlated with decrease in postoperative C2-C7 angle (mean change, 12.2 degrees). As result of these complementary changes, O-C7 angle did not statistically change. Conclusions Our results suggest that the O-C7 angle is regulated by T1 slope and the corresponding O-C7 angle is divided into the O-C2 and C2-C7 angles, which have inverse correlation to each other and then maintain McGregor slope (horizontal gaze). PMID:27190739

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

    Directory of Open Access Journals (Sweden)

    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.

  18. 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

  19. Transdural retrieval of a retropulsed lumbar interbody cage: Technical case report.

    Science.gov (United States)

    Zaidi, Hasan Aqdas; Shah, Ashish; Kakarla, Udaya Kumar

    2016-01-01

    The purpose of this case report was to describe a novel method to retrieve a herniated lumbar interbody cage. Transforaminal lumbar interbody fusion (TLIF) is an increasingly popular method of spinal fixation and fusion. Unexpected retropulsion of an interbody is a rare event that can result in intractable pain or motor compromise necessitating surgical retrieval of the interbody. Both anterior and posterior approaches to removing migrated cages may be associated with significant surgical morbidity and mortality. A 60-year-old woman underwent an L4-S1 TLIF coupled with pedicle screw fixation at a previous hospital 5 years prior to admission. She noted sudden-onset bilateral lower extremity weakness and right-sided foot drop. Magnetic resonance imaging and radiographs were notable for purely centrally herniated interbody. A posterior, midline transdural approach was used to retrieve the interbody. Situated in between nerve rootlets to the ventral canal, this virgin corridor allowed us to easily visualize and protect neurological structures while safely retrieving the interbody. The patient experienced an immediate improvement in symptoms and was discharged on postoperative day 3. At 12-month follow-up, she had no evidence of cerebrospinal fluid (CSF) leak and had returned to normal activities of daily living. While the risk of CSF leak may be higher with a transdural approach, we maintain that avoiding unnecessary retraction of the nerve roots may outweigh this risk. To our knowledge, this is the first case report of a transdural approach for the retrieval of a retropulsed lumbar interbody cage. PMID:26889290

  20. Commentary on article: Laminoplasty versus laminectomy and fusion for multilevel cervical myelopathy: A meta-analysis of clinical and radiological outcomes by Chang-Hyun Lee et al

    OpenAIRE

    Nancy E Epstein

    2015-01-01

    Background: This is a commentary on the article laminoplasty versus laminectomy and fusion (LF) for multilevel cervical myelopathy: A meta-analysis of clinical and radiological outcomes by Chang-Hyun Lee et al. Here, the authors utilized seven studies to compare the efficacy of cervical expansive laminoplasty (EL) versus laminectomy and fusion (LF) to address three or more level multilevel cervical spondylotic myelopathy (CSM). Both procedures led to similar degrees of neurological recovery a...

  1. 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...

  2. Ureteral injury after posterior lumbar discectomy with interbody screw fixation

    OpenAIRE

    Pillai, Sunil Bhaskara; Hegde, Padmaraj; Venkatesh, Giridhar; Iyyan, Bhalaguru

    2013-01-01

    We report a case of iatrogenic ureteral injury secondary to L5 laminectomy and microdiscectomy with L5–S1 bone graft with posterior lumbar interbodyfusion using presacral cancellous screw fixation, managed by initial ureteral stent placement and subsequent Boari bladder flap repair. A 33-year-old woman underwent L5 laminectomy and microdiscectomy with L5–S1 bone graft with posterior lumbar interbody fusion using presacral cancellous screw fixation. On postoperative day 10, she developed lower...

  3. 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.

  4. 颈椎有限元模型的应用进展%Application progress of finite element model in cervical spine

    Institute of Scientific and Technical Information of China (English)

    周毅强; 张建新; 林蔚莘

    2014-01-01

    有限元分析法(FEA)是一种在生物力学领域广泛应用的研究方法.近年来,颈椎有限元模型已被广泛应用于研究颈椎损伤、颈椎退变及模拟各种颈椎手术,已日趋完善.回顾了颈椎有限元模型的发展,介绍了颈椎有限元建模与分析在颈椎损伤、人工椎间盘置换、椎间植骨融合、颈椎退变及颈椎失稳等方面的应用进展,展望了未来的发展趋势.%Finite element analysis (FEA) is broadly used in biomechanics.Being widely used in clinical studies on cervical spine injury,cervical degeneration and stimulating a variety of cervical spine surgeries,cervical finite element model is becoming more and more accurate in recent years.This paper aims to review the development of cervical finite element model,to introduce the application progress of the modeling and analysis in cervical spine injury,cervical disc arthroplasty,cervical interbody fusion,cervical degeneration and cervical instability,and to prospect the foreground of cervical finite element model in future.

  5. 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

  6. 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.

  7. 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.

  8. 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

  9. MR and CT image fusion of the cervical spine: a noninvasive alternative to CT-myelography

    Science.gov (United States)

    Hu, Yangqiu; Mirza, Sohail K.; Jarvik, Jeffrey G.; Heagerty, Patrick J.; Haynor, David R.

    2005-04-01

    CT-Myelography (CTM) is routinely used for planning surgery for degenerative disease of the spine, but its invasive nature, significant potential morbidity, and high costs make a noninvasive substitute desirable. We report our work on evaluating CT and MR image fusion as an alternative to CTM. Because the spine is only piecewise rigid, a multi-rigid approach to the registration of spinal CT and MR images was developed (SPIE 2004), in which the spine on CT images is first segmented into separate vertebrae, each of which is then rigidly registered with the corresponding vertebra on MR images. The results are then blended to obtain fusion images. Since they contain information from both modalities, we hypothesized that fusion images would be equivalent to CTM. To test this we selected 34 patients who had undergone MRI and CTM for degenerative disease of the cervical spine, and used the multi-rigid approach to produce fused images. A clinical vignette for each patient was created and presented along with either CT/MR fusion images or CTM images. A group of spine surgeons are asked to formulate detailed surgical plans based on each set of images, and the surgical plans are compared. A similar study assessing diagnostic agreement is being performed with neuroradiologists, who also assess the accuracy of registration. Our work to date has demonstrated the feasibility of segmentation and multi-rigid fusion in clinical cases and the acceptability of the questionnaire to physicians. Preliminary analysis of one surgeon's and one neuroradiologist"s evaluation has been performed.

  10. 上颈椎融合对颈椎活动度的影响%The impact of the upper cervical spine fusion on cervical range of motion

    Institute of Scientific and Technical Information of China (English)

    袁伟; 朱悦; 崔璀

    2012-01-01

    目的 探讨上颈椎融合对颈椎活动功能的影响,并评估颈椎活动度测量仪(cervical range of motion device,CROM)的可靠性.方法 我科于2010年7月至2011年10月对收治的14例上颈椎疾病患者使用CROM仪测量,其中5例为颈枕融合,2例寰枢椎融合,7例采用Halo架非融合治疗后2个月及6个月左右颈椎前屈、后伸、左右侧弯、左右旋转主动活动度,并与15例健康志愿者颈椎活动度进行比较,分析术后颈椎活动度丢失情况;使用CROM仪重复测量健康志愿者颈椎活动度并采用组间相关系数(intraclass correlation coefficients,ICC)来评价CROM仪的测量者内可靠性.结果 术后6个月随访时颈椎活动度六个方向中的三个方向:颈椎前屈、左旋转及右旋转,融合组与非融合组相比有显著降低(P<0.05),与正常组相比则在六个方向均有显著性差异(P<0.05).融合组中颈枕融合较寰枢椎融合在颈椎前屈、左右旋转活动上有显著性降低(P<0.05),术后第6个月随访各组颈椎活动度较3个月随访时均有一定程度的增加.CROM仪测量颈椎六个方向的活动度测量者内ICC均在0.91以上,有较高的可靠性.结论 上颈椎融合使颈椎活动范围显著性减小,对颈椎前屈、旋转功能影响最大.此外,CROM仪是一种可靠的颈椎活动度测量工具.%Objective To investigate the impact of the upper cervical spine fusion on cervical range of motion (CROM) and to evaluate the reliability of the CROM device. Methods From July 2010 to October 2011, 14 patients with upper cervical disease were adopted by our department and treated with cervical spine fusion or non-fusion, among whom there were 5 cases of cervicooccipital fusion, 2 cases of atlantoaxial fusion and 7 cases of Halo-vest treatment. The cervical flexion, backward extension, left and right lateral bending and rotation of all patients were measured by the CROM device about 2 months and 6 months after surgery

  11. 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。

  12. Treatment of the upper cervical instability 18 cases with occipital-cervical fusion surgery%枕颈融合术治疗上颈椎不稳18例

    Institute of Scientific and Technical Information of China (English)

    宋楹卓; 杜俊杰; 罗卓荆; 梁伟; 张建

    2012-01-01

    Objective To study the effect of occipital-cervical fusion in the treatment of upper cervical instability. Methods 18 cases of patients with upper cervical instability in our department were used occipital-cervical fusion surgery, and spinal cord function was assessed by the JOA score. Results 18 cases were followed up 3 months to 2 years after surgery, all the patients showed complete fusion, the upper cervical were stability, JOA score improved rate was 67.0%. Conclusion The occipital-cervical fusion surgery is effective to treat the upper cervical instability and spinal cord compression.%目的 研究枕颈融合手术治疗上颈椎不稳的疗效.方法 对我科上颈椎不稳患者18例行枕颈融合内固定手术,按JOA评分进行脊髓功能评定.结果 术后3个月~2年随访,全部病例上颈椎稳定性良好,植骨全部愈合,JOA评分平均改善率为67.0%.结论 枕颈融合术治疗上颈椎不稳、脊髓受压有确切治疗效果.

  13. Preliminary documentation of the comparable efficacy of vitoss versus NanOss bioactive as bone graft expanders for posterior cervical fusion

    OpenAIRE

    Nancy E Epstein

    2015-01-01

    Background: Laminectomies with posterior cervical instrumented fusions often utilize bone graft expanders to supplement cervical lamina/iliac crest autograft/bone marrow aspirate (BMA). Here we compared posterior fusion rates utilizing two graft expanders; Vitoss (Orthovita, Malvern, PA, USA) vs. NanOss Bioactive (Regeneration Technologies Corporation [RTI: Alachua, FL, USA]). Methods: Two successive prospective cohorts of patients underwent 1-3 level laminectomies with 5-9 level posterio...

  14. Complications and clinical outcomes of minimally invasive transforaminal lumbar interbody fusion for the treatment of one- or two-level degenerative disc diseases of the lumbar spine in patients older than 65 years

    Institute of Scientific and Technical Information of China (English)

    WU Wen-jian; LIANG Yu; ZHANG Xin-kai; CAO Peng; ZHENG Tao

    2012-01-01

    Background Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has been successfully used to treat degenerative diseases of the lumbar spine.There are few reports comparing the complications and clinical outcomes in older patients who have undergone one- or two-level MIS-TLIF with those of younger patients.The aim of this study was to investigate the clinical outcomes of MIS-TLIF in the treatment of degenerative disc disease of lumbar spine of the patients older than 65 years,with an emphasis on perioperative complications compared to the younger patients.Methods One hundred and fifty-one consecutive cases of one- or two-level degenerative disc disease of lumbar spine treated with MIS-TLIF were reviewed for the radiological and clinical outcomes.They were divided into elderly group (age ≥65 years old) and younger group (age <65 years old),and were followed for at least 6 months.Radiographs were obtained before and after surgery,3 months postoperatively,and at the final follow-up to determine the presence of fusion,hardware-related problems.The clinical outcomes were evaluated using the Oswestry Disability Index (ODI)before and after surgery,and at the final follow-up.The visual analogue scale (VAS) score of back and leg pain were evaluated as well.The intra-operative data and peri-operative complications were recorded.Results The mean age of these patients at operation was (57.7±14.2) years (range 26-82 years).Of 151 patients,62were 65 years or older.The elderly patients had more comorbidities and more porportion of lumbar canal stenosis.The overall fusion rate was 88.4% at the final follow-up,with no significant difference between younger and elderly patients.The ODI,the VAS of back pain and radicular pain of both young and elderly group were significantly improved aftersurgery and at the final follow-up,without significant difference between two groups.There were 16 complications with an incidence of 10.6%,including 7 major complications

  15. 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

  16. Extreme lateral transforaminal lumbar interbody fusion (E-TLIF) designed via digital technology%数字化设计微创极外侧经椎间孔腰椎椎体间融合术

    Institute of Scientific and Technical Information of China (English)

    杨明杰; 李立钧; 祝建光; 潘杰; 谭军

    2011-01-01

    目的 通过数字技术设计一种新的手术方式——微创极外侧经椎间孔腰椎椎体间融合术(extreme lateral transforaminal lumbar interbody fusion,E-TLIF),并探讨其治疗退变性腰椎疾患的可行性.方法 通过对志愿者(男,26岁,健康,体重67 kg,身高172 cm)腰椎行CT扫描及Mimics三维重建,研究椎间孔区域骨性结构和神经根走行,探讨腰椎椎间孔区域的解剖学特点.在Mimics软件中模拟E-TLIF手术操作,切除上关节突而保留下关节突,并植入椎弓根螺钉和椎体间融合器.最后通过尸体模拟手术证实E-TLIF的可行性.结果 正中线旁开9 cm的纵行手术切口,45°斜向椎体的手术通道可以充分暴露病椎的椎间孔区域.通过E-TLIF手术途径可充分地显露目标椎间盘和神经根以及后方的上、下关节突和关节囊,操作简便直观.E-TLIF手术可以实现单纯切除上关节突,而保留下关节突,通过扩大的椎间孔牵开神经根后可以显露并切除椎间盘,并能完成椎间融合器的植入.结论 (1)通过Mimics可以精确地进行手术设计,模拟手术操作.成本低,可操作性强,对真实手术有较好的指导作用.(2)E-TLIF手术仅切除上关节突而保留了下关节突,在达到与传统手术同样的减压、固定、融合效果的同时,更完整保留了脊柱后方的张力带结构,加强术后即刻稳定性,并促进患者更快恢复,是一种创伤更小、安全、有效的腰椎椎体间融合术式.%Objective To design a new operation approach:extreme lateral transforaminal lumbar interbody fusion (E-TLIF) via digital technology and to discuss its feasibility in treatment of degenerative lumbar diseases.Methods CT scan image data of lumbar vertebra were obtained from volunteer (a healthy male of 26 years old,67 kg in weight and 172 cm in height).Mimics was used to read and reconstruct the data into 3D images.We observe the anatomical bone structures of intervertebral foramen and nerve

  17. Leakage of cerebrospinal fluid and secondary intracranial infection induced by Cloward technique of cervical discectomy and fusion: presentation and treatment

    Institute of Scientific and Technical Information of China (English)

    GUO Hong-bin; YANG Shu-xu; WANG Yi-rong

    2008-01-01

    @@ Cloward technique of cervical discectomy and fusion is a long and complex surgical proce dure and instrumentation, by which compli-cated infection is rare in an era of routine prophylactic antimicrobial agent, especially in procedures by anterior approach. A study in the journal of Spine suggested that the incidence of unintentional laceration of the dura mater during spinal surgery might be as high as 14%.

  18. Lumbar interbody expanding cage. A preliminary study on an animal model.

    Science.gov (United States)

    Manunta, M L; Careddu, G M; Masala, G; Columbano, N; Doria, C; Crissantu, L; Sanna Passino, E

    2008-01-01

    Interbody fusion devices are used in human medicine for treating degenerative diseases of the spine. Currently, there is not a universally accepted assessment tool for determining fusion, and the definitive criteria for diagnosing a successful interbody fusion remain controversial. The aim of this study was to describe microscopic and helical computed tomography (CT) imaging in the assessment of lumbar interbody fusion using cylindrical threaded titanium expanding cage in sheep. One cylindrical threaded expanding titanium cage (Proconcept--SA, Orange, France) was inserted through a transperitoneal approach after radical discectomy and packed with cancellous bone autograft in five adult sheep. The subjects were euthanatized after three, six, 12, 18 and 24 months. CT images revealed lumbar fusion at 12 months post operation, whereas microscopic evaluations indicated the presence of lumbar fusion at 18 months. CT and histological grades were the same in 65% of the cases observed. There were not a significant difference between CT, histological and micro radiographic grades. Helical CT scanning can be considered to be a suitable method for the monitoring of lumbar fusion as it enables observation of the deposition of bony bridging within the cage. PMID:18704248

  19. 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

  20. 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.

  1. Preliminary documentation of the comparable efficacy of vitoss versus NanOss bioactive as bone graft expanders for posterior cervical fusion

    Directory of Open Access Journals (Sweden)

    Nancy E Epstein

    2015-01-01

    Conclusion: In this preliminary study combining cervical laminectomy/fusions, the time to fusion (5.65 vs. 5.35 months, pseudarthrosis (2.7% vs. 0%, and infection rates (2.7% vs. 0% were nearly comparable sequentially utilizing Vitoss (72 patients vs. NanOss (20 patients as bone graft expanders.

  2. Comparison of 2 Zero-Profile Implants in the Treatment of Single-Level Cervical Spondylotic Myelopathy: A Preliminary Clinical Study of Cervical Disc Arthroplasty versus Fusion

    Science.gov (United States)

    Yang, Li-Li; Liu, Zu-De; Yuan, Wen

    2016-01-01

    Objectives Cervical disc arthroplasty (CDA) with Discover prosthesis or anterior cervical discectomy and fusion (ACDF) with Zero-P cage has been widely used in the treatment of cervical spondylotic myelopathy (CSM). However, little is known about the comparison of the 2 zero-profile implants in the treatment of single-level CSM. The aim was to compare the clinical outcomes and radiographic parameters of CDA with Discover prosthesis and ACDF with Zero-P cage for the treatment of single-level CSM. Methods A total of 128 consecutive patients who underwent 1-level CDA with Discover prosthesis or ACDF with Zero-P cage for single-level CSM between September 2009 and December 2012 were included in this study. Clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) score and Neck Disability Index (NDI). For radiographic assessment, the overall sagittal alignment (OSA), functional spinal unit (FSU) angle, and range of motion (ROM) at the index and adjacent levels were measured before and after surgery. Additionally, the complications were also recorded. Results Both treatments significantly improved all clinical parameters (P 0.05). Besides, no significant differences existed in dysphagia, subsidence, or adjacent disc degeneration between the 2 groups (P > 0.05). However, significant differences occurred in prosthesis migration in CDA group. Conclusions The results of this study showed that clinical outcomes and radiographic parameters were satisfactory and comparable with the 2 techniques. However, more attention to prosthesis migration of artificial cervical disc should be paid in the postoperative early-term follow-up. PMID:27441736

  3. 单侧椎弓根螺钉内固定联合单枚融合器治疗极外侧腰椎间盘突出症%Unilateral pedicle screw fixation combined with single cage interbody fusion for far lateral lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    王佳; 周耀; 李伟; 杨方

    2013-01-01

    Objective To evaluate the surgical results of treating far lateral lumbar disc herniations by lumbar inter-body fusion with unilateral pedicle screw fixation and single cage. Methods 26 cases of far lateral lumbar disc herniations were received the treatment of lumbar interbody fusion with unilateral pedicle screw fixation and single cage via a posterior approach. X-ray or CT examinations were taken in the regular follow-up to observe the fusion rates and complications, and the outcome of the surgery was assessed by Japanese Orthopaedic Association ( JOA ) low back pain scores. Results There were no wound infection or nerve complications after operation. All patients were followed up for 18 ~27 months. The fusion rate was 96. 2%( 25/26 ). The average JOA scores of preoperation and final followed-up were 12. 43 2. 16 and 24. 53 2. 97 respectively, which showed significant difference ( P <0. 05 ) between the two observations. The mean improvement rate was 81. 6% , and 19 cases got excellent results,5 good and 2 fair. The excellent and good rate was 92. 3%( 24/26 ). Conclusions Lumbar interbody fusion with unilateral pedicle screw fixation combined with single cage can provide simple procedure, little trauma, reliable fixation, high fusion rate, and satisfactory clinical results.%目的 评估单侧椎弓根螺钉内固定联合单枚融合器治疗极外侧腰椎间盘突出症的疗效.方法 对26例极外侧腰椎间盘突出症患者经腰椎后路行单侧椎弓根螺钉内固定联合单枚cage的融合手术.术后定期复查X线片或CT片,观察融合率及并发症情况;采用JOA腰腿痛评分法评估疗效.结果 术后均无伤口感染、神经损伤.患者均获随访,时间18~27个月.临床融合率96.2%(25/26).JOA评分:术前为12.43分±2.16分,末次随访时为24.53分±2.97分,差异有统计学意义(P<0.05),平均改善率为81.6%.疗效评定:优19例,良5例,中2例,优良率92.3%(24/26).结论 单侧椎弓根螺钉内固定联合单

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

    Directory of Open Access Journals (Sweden)

    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.

  5. 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

  6. 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

  7. Clinical study on lumbar spondylolisthesis treated by minimally invasive transforaminal lumbar interbody fusion%微创经椎间孔腰椎体间融合术治疗腰椎滑脱症的临床研究

    Institute of Scientific and Technical Information of China (English)

    王建; 黄博; 周跃; 张正丰; 李长青; 任先军; 初同伟; 王卫东; 郑文杰; 潘勇

    2011-01-01

    目的 回顾性分析和比较微创经椎间孔腰椎间融合术(MIS-TLIF)和开放经椎间孔腰椎间融合术(OTLIF)治疗腰椎滑脱症的临床结果.方法 自2006年6月至2010年5月,371例Ⅰ°或Ⅱ°腰椎滑脱症患者接受TLIF和腰椎弓根螺钉固定治疗并获得随访,男性134例,女性237例;年龄37~85岁,平均50.4岁.采用可扩张通道下单节段TLIF和经皮椎弓根螺钉内固定治疗患者172例(MIS-TLIF组),传统开放TLIF和椎弓根螺钉内固定方法治疗患者199例(OTLIF组).分析两组手术时间、术中术后出血、放射线暴露时间和并发症等方面的差异.采用视觉模拟评分( VAS)和Oswestry功能障碍指数(ODI)评分评估临床结果,行腰椎动力位X线片和薄层CT扫描重建检查评价椎间融合情况.结果 371例患者均获得随访,随访时间12~ 58个月,平均32.7个月.术前两组性别、年龄、滑脱类型和融合节段差异无统计学意义.术中出血MIS-TLIF组平均为(310±75)ml,OTLIF组(623±156)ml,MIS-TLIF组显著优于OTLIF组(t=2.836,P<0.01).术后出血MIS-TLIF组平均为(38±13)ml,OTLIF组(184±72)ml,MIS-TLIF组显著优于OTLIF组(=3.274,P<0.01).与OTLIF组放射暴露时间(20±10)s比较,MIS-TLIF组放射暴露时间(51±19)s更长(t=2.738,P<0.01).两组在手术时间、腰痛VAS评分、ODI评分和并发症发生方面差异均无统计学意义.结论 针对Ⅱ°以下腰椎滑脱症,MIS-TLIF安全有效,相对而言,与开放固定比较具有出血少及组织损伤轻优点.%Objectives To retrospectively analyze the treatment of lumbar spondylolisthesis using minimally invasive and open transforaminal lumbar interbody fusion (TLIF),and compare the clinical results of two techniques.Methods From June 2006 to May 2010,371 patients with lumbar spondylolisthesis grade 1 and 2 were treated with TLIF,pedicle screw fixation and followed up.The mean age was 50.4 years (range,37-85 years).There were 172 patients who underwent minimally

  8. Laminoplasty versus laminectomy and fusion for multilevel cervical myelopathy: a meta-analysis of clinical and radiological outcomes.

    Science.gov (United States)

    Lee, Chang-Hyun; Lee, Jaebong; Kang, James D; Hyun, Seung-Jae; Kim, Ki-Jeong; Jahng, Tae-Ahn; Kim, Hyun-Jib

    2015-06-01

    OBJECT Posterior cervical surgery, expansive laminoplasty (EL) or laminectomy followed by fusion (LF), is usually performed in patients with multilevel (≥ 3) cervical spondylotic myelopathy (CSM). However, the superiority of either of these techniques is still open to debate. The aim of this study was to compare clinical outcomes and postoperative kyphosis in patients undergoing EL versus LF by performing a meta-analysis. METHODS Included in the meta-analysis were all studies of EL versus LF in adults with multilevel CSM in MEDLINE (PubMed), EMBASE, and the Cochrane library. A random-effects model was applied to pool data using the mean difference (MD) for continuous outcomes, such as the Japanese Orthopaedic Association (JOA) grade, the cervical curvature index (CCI), and the visual analog scale (VAS) score for neck pain. RESULTS Seven studies comprising 302 and 290 patients treated with EL and LF, respectively, were included in the final analyses. Both treatment groups showed slight cervical lordosis and moderate neck pain in the baseline state. Both groups were similarly improved in JOA grade (MD 0.09, 95% CI -0.37 to 0.54, p = 0.07) and neck pain VAS score (MD -0.33, 95% CI -1.50 to 0.84, p = 0.58). Both groups evenly lost cervical lordosis. In the LF group lordosis seemed to be preserved in long-term follow-up studies, although the difference between the 2 treatment groups was not statistically significant. CONCLUSIONS Both EL and LF lead to clinical improvement and loss of lordosis evenly. There is no evidence to support EL over LF in the treatment of multilevel CSM. Any superiority between EL and LF remains in question, although the LF group shows favorable long-term results. PMID:25815808

  9. A computed tomography morphometric study of occipital bone and C2 pedicle anatomy for occipital-cervical fusion

    Directory of Open Access Journals (Sweden)

    Nicolas K.K. King

    2014-01-01

    Full Text Available Background: Occipital-cervical fusion (OCF has been used to treat instability of the occipito-cervical junction and to provide biomechanical stability after decompressive surgery. The specific areas that require detailed morphologic knowledge to prevent technical failures are the thickness of the occipital bone and diameter of the C2 pedicle, as the occipital midline bone and the C2 pedicle have structurally the strongest bone to provide the biomechanical purchase for cranio-cervical instrumentation. The aim of this study was to perform a quantitative morphometric analysis using computed tomography (CT to determine the variability of the occipital bone thickness and C2 pedicle thickness to optimize screw placement for OCF in a South East Asian population. Methods: Thirty patients undergoing cranio-cervical junction instrumentation during the period 2008-2010 were included. The thickness of  the occipital bone and the length and diameter of the C2 pedicle were measured based on CT. Results: The thickest point on the occipital bone was in the midline with a maximum thickness below the external occipital protuberance of 16.2 mm (±3.0 mm, which was thicker than in the Western population. The average C2 pedicle diameter was 5.3 mm (±2.0 mm. This was smaller than Western population pedicle diameters. The average length of the both pedicles to the midpoint of the C2 vertebral body was 23.5 mm (±3.3 mm on the left and ±2.3 mm on the right. Conclusions: The results of this first study in the South East Asian population should help guide and improve the safety in occipito-cervical region instrumentation. Thus reducing the risk of technical failures and neuro-vascular injury.

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

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    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...

  11. 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

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    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.

  12. 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...

  13. Comparison of clinical efficacy of minimally invasive versus open transforaminal lumbar interbody fusion with unilat-eral pedicle screw fixation for lumbar disc herniation%单侧微创与开放经椎间孔腰椎椎体间融合内固定治疗腰椎椎间盘突出症的临床疗效比较

    Institute of Scientific and Technical Information of China (English)

    井贵龙; 袁峰; 郭开今; 孙玛骥

    2014-01-01

    Objective To compare the clinical effect of minimally invasive versus open transforaminal lumbar interbody fusion with unilateral pedicle screw fixation for lumbar disc herniation.Methods The data of 54 patients with lumbar disc herniation who were a-dopted from October 2009 to October 2012 were retrospectively analyzed.There were 32 males and 22 females, and the mean age was 42. 7 years (rang, 32-60 years).The level of surgery was L4/L5 in 34 patients,L5/S1 in 20 patients.All patients were divided into 2 groups according to the surgical methods, including 30 patients undergoing open transforaminal lumbar interbody fusion (OTLIF) and 24 patients undergoing minimally invasive transforaminal lumbar interbody fusion(MiTLIF).The operation time, intraoperative and postoperative blood loss, length of hospital-stay, intraoperative and postoperative complications were recorded .Intervertebral fusion rates 1 year after the operation were observed by radiographic data.Japanese Orthopaedic Association (JOA) scores were used for assessment.Results All patients were followed up for a mean period of 21.4 months (range, 12-36 months).In the MiTLIF group, the intraoperative andpostoperative blood loss was (40.2±15.6) mL, the length of hospital-stay was (6.2 ±2.4) d.Two weeks after the operation, the JOAscore was 18.7±1.9.In the OTLIF group, the intraoperative and postoperative blood loss was (203.6 ±52.8) mL, the length of hospital-stay was (10.8±4.2) d.Two weeks after the operation, the JOA score was 15.1 ±1.4.The difference between the 2 groups werestatistically significant (P 0.05). Conclusion The MiTLIF has the advantages of less blood loss, shorter hospitalization time and rapid postoperative recovery in thetreatment of lumbar disc herniation with unilateral pedicle screw fixation.%目的:比较微创经椎间孔融合内固定与传统开放经椎间孔融合内固定术治疗腰椎椎间盘突出症的临床疗效。方法2009年10月~2012年10月,对54例腰

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

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    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

  15. Biomechanische Untersuchung eines biodegradierbaren Cages zur interkorporellen Spondylodese der Halswirbelsäule.

    OpenAIRE

    Gumnior, Sarah Nicole Stephanie

    2010-01-01

    Biomechanical evaluation of a biodegradable cage for interbody fusion at the cervical spine Biomechanical evaluation of a biodegradable cage for interbody fusion in the cervical spine. A in vivo animal study in a sheep model.   Abstract Background Anterior interbody fusion using an intervertebral spacer is a widely accepted surgical treatment for patients with degenerative and traumatic cervical spinal-c...

  16. Cervical disc herniation presenting with neck pain and contralateral symptoms: a case report

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    Yeung Jacky T

    2012-06-01

    Full Text Available Abstract Introduction Cervical disc herniation often results in neck and arm pain in patients as a result of direct impingement of nerve roots and associated inflammatory processes. The clinical presentation usually corresponds with the side of herniation and ipsilateral symptoms predominate the clinical picture. Case presentation A 35-year-old Caucasian man presented to our facility with neck pain and left-sided upper and lower extremity pain. A magnetic resonance imaging scan revealed a right paramedian herniated disc at the C5 to C6 level. All other cervical levels were normal without central canal stenosis or neural foraminal stenosis. Results from magnetic reasonance imaging scans of the brain and lumbar spine were negative. An anterior cervical discectomy was performed at the C5 to C6 level, and an inter-body graft and plate were placed. Our patient had complete resolution of his neck and left arm pain. Conclusions Anterior discectomy and fusion of the cervical spine resulted in complete resolution of our patient’s neck and left arm symptoms and improvement of his contralateral left leg pain. Cervical disc herniation may present with contralateral symptoms that are different from the current perception of this disease.

  17. 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.

  18. 经椎间孔椎体间融合术治疗复发性腰椎椎间盘突出症的疗效分析%Transforaminal lumbar interbody fusion for treatment of recurrent lumbar disc herniation: an analysis of therapeutic Effect

    Institute of Scientific and Technical Information of China (English)

    张剑刚; 丁文元; 申勇; 徐佳欣; 安志辉; 杨少坤

    2011-01-01

    Objective To assess the therapeutic effect of transforaminal lumbar interbody fusion ( TLIF ) in treatment of recurrent lumbar disc herniation. Methods From February 2008 to June 2010, 27 patients ( average age 52. 4, ranging 28 ~ 64 years old ) with recurrent lumbar disc herniation, who had been treated by TLIF, were collected in the present study. Japanese Orthopaedic Association ( JOA )score system and Nakai standards were used to evaluate the clinical results. Suk criterion was used to evaluate bone graft fusion. Results All the patients were followed up for 8-36 months ( a mean of 23 months ). According to JOA score system, excellent outcomes were obtained in 20 cases and good in 7, with the average improvement rate being 88. 5%. According to Nakai standard, excellent outcomes were obtained in 18 cases, good in 6 cases, and fair in 3 cases, with the excellent and good rate being 88. 9%. Bone grafts in all patients were fused according to Suk criterion. Conclusion TLIF is an effective procedure for treatment of recurrent lumbar disc herniation; it can obtain satisfactory clinical results.%目的 探讨经椎间孔椎体间融合术(transforaminal lumbar interbody fusion,TLIF)治疗复发性腰椎椎间盘突出症(recurrent lumbar disc herniation,RLDH)的疗效.方法 2008年2月~2010年6月应用TLIF技术再手术治疗的RLDH患者27例,年龄为28~64岁,平均52.4岁.采用日本骨科学会(Japanese Orthopaedic Association,JOA)评分系统、Nakai标准评价治疗效果,Suk方法评价植骨融合情况.结果 患者均获得随访,随访时间为8~36个月(平均23个月).术后根据JOA评分,优20例,良7例,平均改善率88.5%;根据Nakai评分标准,优18例,良6例,可3例,优良率88.9%;根据Suk标准患者椎间植骨均获得骨性融合.结论 TLIF是治疗RLDH的有效术式,可以获得满意临床效果.

  19. 下颈椎骨折脱位修复方法的选择:植骨融合及颈椎稳定性分析%Restoration of fracture and dislocation of lower cervical spine:bone graft fusion and cervical stability

    Institute of Scientific and Technical Information of China (English)

    王建元; 邓强; 盛伟斌; 陆永江

    2015-01-01

    of grade A were not recovered, one case of grade B was not recovered, 1-2 degree of neurological function recovery was achieved in the remaining cases by Frankel system. X-ray finding showed the good recovery of cervical vertebrae sequence after operation. Fusion was achieved in al cases within 12 months (mean 8.5 months) except non-fusion in one case and delayed fusion in two cases. There was no pseudarthrosis or nonunion occurred. The interbody height, physiological curvature and cervical stability maintained wel. The SLIC system, with a combination of sub-axial injury classification system, the type of fracture, spinal cord compression, and cervical spine injury degree should be considered before surgery. Reasonable selection of surgical approach can reconstruct spinal stability and achieve anatomical reduction and complete decompression, which is conducive to the recovery of neurological function.%背景:下颈椎骨折脱位的治疗难点是如何改善患者的神经功能,选择手术入路应既有利于复位及脊髓的减压,又能够保证坚强固定,植骨融合。目前对下颈椎骨折脱位的术式选择仍存在较大分歧。  目的:探讨下颈椎骨折脱位的修复方式选择及其对植骨融合、颈椎稳定性的影响。  方法:收集新疆医科大学第一附属医院2009年1月至2013年9月收治的下颈椎骨折脱位患者126例,按照Frankel分级标准进行分级:A级7例,B级48例,C级54例,D级17例。术前进行下颈椎损伤分类评分,其中4分15例,5分23例,6分25例,7分22例,8分18例,9分16例,10分6例。结合患者受伤机制、形态特点、脊髓受压部位及损伤程度等因素进行分析,选择修复方案,其中前路组91例采用单纯前路手术治疗(单间隙或椎体次全切除减压、椎间植骨钛板内固定);后路组6例行后路减压、复位、内固定;前后联合组29例采用前后联合入路。随访患者神经功能改

  20. 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.

  1. High-risk HPV E5-induced cell fusion: a critical initiating event in the early stage of HPV-associated cervical cancer

    Directory of Open Access Journals (Sweden)

    Gao Peng

    2010-09-01

    Full Text Available Abstract Background Cervical cancer is strongly associated with high-risk human papillomavirus (HPV and viral oncoproteins E5, E6 and E7 can transform cells by various mechanisms. It is proposed that oncogenic virus-induced cell fusion may contribute to oncogenesis if p53 or apoptosis is perturbed simultaneously. Recently, HPV-16 E5 was found to be necessary and sufficient for the formation of tetraploid cells, which are frequently found in precancerous cervical lesions and its formation is strongly associated with HPV state. Presentation of the hypothesis We propose that high-risk HPV E5-induced cell fusion is a critical initiating event in the early stage of HPV-associated cervical cancer. Testing the hypothesis Our hypothesis can be tested by comparing the likelihood for colony formation or tumorigenic ability in nude mice between normal HaCaT cells expressing all three oncogenic proteins and E5-induced bi-nucleated HaCaT cells expressing E6 and E7. Moreover, investigating premature chromosome condensation (PCC in HPV-positive and negative precancerous cervical cells is another way to assess this hypothesis. Implication of the hypothesis This viewpoint would change our understanding of the mechanisms by which HPV induces cervical cancer. According to this hypothesis, blocking E5-induced cell fusion is a promising way to prevent the progression of cervical cancer. Additionally, establishment of a role of cell fusion in cervical carcinogenesis is of reference value for understanding the pathogenesis of other virus-associated cancers.

  2. The relationship between discography pressure and outcome of anterior lumbar interbody fusion for discogenic low back pain%椎间盘造影压力与椎间盘源性腰痛手术疗效的关系

    Institute of Scientific and Technical Information of China (English)

    张继东; 夏群; 胡永成; 苗军; 徐宝山

    2009-01-01

    目的 探讨椎间蕊造影压力与腰椎间盘源件疼痛手术疗效的关系.方法 2004年4月至2006年6月,65例慢性腰痛患者经压力控制性椎间盘造影确诊为椎间盘源性腰痛.其中22例经保守治疗无效者接受前路腰椎椎间融合术,年龄25~67岁,平均43.6岁.L4-5例,L5S112例,L4-5和L5S1双间隙2例.记录椎间盘造影诱发疼痛时的压力,将患者分为椎间盘造影压力≤300 kPa(低压组)10例,300~500 kPa(高压组)12例.椎间cage融合术22例24个椎间盘.术后3~7 d下地活动.腰围固定3个月.根据术前、术后VAS评分和ODI评分比较高压组和低压组手术疗效.结果 所有患者随访6~26个月,平均18个月.手术时间70~120 min,平均90 min;出血量100~400 ml,平均220 ml.低压组与高压组术前VAS评分和ODI评分、椎间隙高度、手术时间、出血量差异无统计学意义.术后腰及下肢痛症状明显缓解,均恢复正常生活或工作.椎间隙高度从术前平均9.5 mm增加至13.5 mm.术后6个月低压组VAS、ODI改善率分别为82.4%、90.1%,高压组为71.7%、80.6%.随访时未发现肠梗阻、逆行射精和假体位置移动.结论 压力控制性椎间盘造影能够提高椎间盘源性腰痛的诊断准确性,低压力椎间盘造影阳性者手术疗效更好.%Objective To explore the relationship between discography pressure and outcome of an-terior lumbar interbody fusion (ALIF) for discogenic low back pain. Methods From April 2004 to June 2006, 65 patients with chronic low back pain were identified as diseogenic origin by pressure controlled discography, 22 cases of which received ALIF after failed conservative treatment for at least 6 months. The surgically treated patients aged 43.6 on the average (range, 25-67). The treated discs located: 8 in L4-5, 12 in L5S1, 2 in both L4-5 and L5S1. 22 cases received ALIF in 24 levels via retroperitoneal approach. The pressure as soon as accordant initially induced pain was recorded during

  3. 单节段双节段颈椎融合术后颈椎活动度的观察%Motion changes of cervical range after one or two-level cervical spine fusion

    Institute of Scientific and Technical Information of China (English)

    赵信; 徐宏光; 郑权; 方振; 赵泉来; 王弘; 刘平

    2015-01-01

    目的:探讨单节段及双节段颈椎融合手术对颈椎活动度的影响。方法:选取2010年6月~2012年6月在皖南医学院附属弋矶山医院脊柱外科行颈椎前路减压融合术的43例颈椎病患者,其中单节段融合29例,双节段融合14例。根据症状及X线片评价手术的有效率及融合节段的融合率。使用颈椎活动度测量仪( cervical range of motion device ,CROM)测量患者术前及术后随访24个月时颈椎前屈、后伸、左右侧弯、左右旋转6个方向的活动度。结果:从患者主诉分析,所有患者临床症状均得到缓解,通过X线评价融合节段融合率为100%。与术前相比单节段融合术后患者颈椎左右侧弯方向活动度无明显差异(P>0.05),而在前屈、后伸及左右旋转方向的活动度均较术前明显减低(P<0.05)。行双节段融合手术后患者颈椎在6个方向的活动度较术前均明显减低( P<0.05)。对两种不同融合术后患者颈椎活动度的差异进行统计学分析后发现双节段融合患者术后颈椎活动度在6个方向均较单节段融合患者降低( P<0.05)。结论:颈椎融合手术能够降低患者颈椎的活动度,与单节段融合相比双节段融合术后颈椎活动度的降低更为明显。%Objective:To observe the impact of one or two-level and double-level cervical spine fusion on the rang of cervical motion .Methods:Forty-three patients undergone cervical spine fusion in our department between June of 2010 and 2012 were included,among whom 29 received single-level fusion,and 14,two-level fusion.The curative effects and fusion rate of spine were evaluated by presented symptoms and X-ray findings.The cervical flexion,backward extension,left and right lateral bending,left and right rotation of the cervical vertebrae were measured by the cervical range of motion device(CROM) in all patients before operation and post-operative 24-month follow

  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. Clinical Application Of Locking Cervical lntervertebral Fusion Cage In Unisegmental Intervertebral Disk Hernia Of Cervical Vertebrae%锁定式颈椎融合器治疗单节段颈椎问盘突出症

    Institute of Scientific and Technical Information of China (English)

    范磊; 何斌; 邵增务; 王云华

    2011-01-01

    目的 探讨应用颈椎前路减压结合锁定式颈椎融合器治疗单节段颈椎间盘突出症的临床疗效.方法 21例单节段颈椎间盘突出症应用颈椎前路减压加锁定式颈椎融合器植骨融合术治疗,并对其疗效进行评价.结果 所有病例随访12~24个月,平均17.6个月.6个月后椎体间均达到骨性融合,无并发症出现,脊髓功能状态评分术后1个月及术后6个月优良率分别达66.67%、85.71%.结论 应用颈椎前路减压结合锁定式颈椎融合器治疗单节段颈椎间盘突出症疗效肯定.%Objective To evaluate the clinic curative effect of anterior cervical decompression and implantation of cervical intervertebral fusion cage in the treatment of unisegmental intervertebral disk hernia of cervical vertebrae. Methods 21 cases of unisegmental intervertebral disk hernia of cervical vertebrae were treated with anterior cervical decompression and implantation of locking cervical Intervertebral fusion cage and the curative effect was evaluated. Results All cases were followed up for 12~24 months (17. 6 months in average). All patients gained osseous fusion 6 monthes after the operation and there was no complication. According to the functional status score of spinal cord. The fineness rate was 66. 67% 1 month after the operation and 85. 71% 6 monthes after the operation. Conclusion The curative effect of the treatment of unisegmental intervertebral disk hernia of cervical vertebrae anterior cervical decompression and implantation of locking cervical Intervertebral fusion cage was affirmative.

  6. 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

  7. Spine interbody implants: material selection and modification, functionalization and bioactivation of surfaces to improve osseointegration.

    Science.gov (United States)

    Rao, Prashanth J; Pelletier, Matthew H; Walsh, William R; Mobbs, Ralph J

    2014-05-01

    The clinical outcome of lumbar spinal fusion is correlated with achievement of bony fusion. Improving interbody implant bone on-growth and in-growth may enhance fusion, limiting pseudoarthrosis, stress shielding, subsidence and implant failure. Polyetheretherketone (PEEK) and titanium (Ti) are commonly selected for interbody spacer construction. Although these materials have desirable biocompatibility and mechanical properties, they require further modification to support osseointegration. Reports of extensive research on this topic are available in biomaterial-centric published reports; however, there are few clinical studies concerning surface modification of interbody spinal implants. The current article focuses on surface modifications aimed at fostering osseointegration from a clinician's point of view. Surface modification of Ti by creating rougher surfaces, modifying its surface topography (macro and nano), physical and chemical treatment and creating a porous material with high interconnectivity can improve its osseointegrative potential and bioactivity. Coating the surface with osteoconductive materials like hydroxyapatite (HA) can improve osseointegration. Because PEEK spacers are relatively inert, creating a composite by adding Ti or osteoconductive materials like HA can improve osseointegration. In addition, PEEK may be coated with Ti, effectively bio-activating the coating. PMID:24890288

  8. L4、5侧路单枚cage椎间融合术式的生物力学及临床研究%Biomechanical and Clinical Study of L4.5 Lateral Lumbar Interbody Fusion Using Single Anatomical Threaded Cage

    Institute of Scientific and Technical Information of China (English)

    郑忠; 翁绳健; 吴立忠; 李炜明; 陈国龄

    2011-01-01

    Objective To evaluate the relative stability of L4.5 lateral lumbar interbodyfusion using single anatomical threaded cage.Methods Twelve calf spine models and dimensional element models of lateral and posterior approach were established.Pure moment and forces were applied to the top of spinal eolumn. The motion range of all the specimens was measured during the experiment. The improvement rate of lumbar pain in 33 patients who took operation from Dec. 2003 to Dec. 2006 was evaluated. Results The stability in lateral group was superior to posterior group. The effective rate of operation was 100%. The improvement rate of lumbar pain was 93.94%.The patients's satisfactory rate was 100%.Conclusion Interbody fusion of L4.5 through lateral approach using single anatomical threaded cage without internal fixation is a mini-invasive operation process. It can provide instant posterior biomechanical stiffness. It is an effective operation process of interbody fusion in lumbar.%目的 评价L4、5侧路单枚椎间融合器融合术式的稳定性及力学合理性.方法 建立L4、5侧路与后路单枚椎间融合器融合术式的三维有限元模型及小牛脊柱模型,测定二者的位移变化.临床随访2003年12月~2006年12月行侧路单枚椎间融合器融合术式33例,评价腰痛改善率.结果 实验显示侧路模型的稳定性优于后路模型.临床研究显示手术有效率100%,腰痛改善率93.94%,患者满意率100%.结论 侧路植入单枚椎间融合器融合术式是一种微创的术式,不使用椎弓根固定系统而又能够提供足够的术后即刻生物力学刚度,是一种合理有效的腰椎椎间融合术式.

  9. ACDR 和 ACDF 治疗单节段颈椎间盘突出症的对比分析%Comparative analysis of ACDR and ACDF in the treatment of single segmental cervical intervertebral disc herniation

    Institute of Scientific and Technical Information of China (English)

    黄长安; 李军; 袁文旗; 周立

    2015-01-01

    目的:对比分析颈椎前路椎间盘切除植骨融合术( ACDF)和颈椎人工椎间盘置换术( ACDR)%Objective To compare the effect of anterior cervical discectomy and interbody fusion(ACDF) and artificial cervical disc replacement(ACDR) in the treatment of single segmental cervical disc herniation.Methods A total of 81 patients with single segmental cervical disc herniation were collected in our hospital from January 2010 to June 2014, in which 40 patients received ACDF surgery(fusion group) and other 41 patients underwent ACDR sur-gery(permutation group).The changes of activity were compared between the two groups before and the last follow-up after the surgery.Results There were significant differences in the changes of activity between the two groups at the last time of follow-up after the surgery(P <0.01).For each group, the activity improved at the end of the follow-up compared with that before the surgery(P <0.01).Conclusion Both ACDR and ACDF are effective in the treatment of single segmental cervical disc herniation, which improves the activity of cervical disc herniation.ACDR also makes the surgery adjacent segments of the compensatory activity increased, and therefore may prevent adjacent segment de-generation.

  10. Avaliação clínica radiológica da artrodese lombar transforaminal aberta versus minimamente invasiva Evaluación clínica radiológica de la artrodesis lumbar transforaminal abierta versus mínimamente invasiva Clinical and radiological evaluation of open transforaminal lumbar interbody fusion versus minimally invasive

    Directory of Open Access Journals (Sweden)

    Cristiano Magalhães Menezes

    2009-09-01

    Full Text Available OBJETIVO: a proposta deste trabalho é comparar os resultados clínicos e radiológicos dos pacientes submetidos à artrodese transforaminal aberta e minimamente invasiva. MÉTODOS: quarenta e cinco pacientes foram submetidos à artrodese lombar transforaminal pelo Grupo de Cirurgia Espinhal do Hospital Lifecenter/Ortopédico de Belo Horizonte, no período de Dezembro de 2005 a Maio de 2007, sendo 15 no grupo de artrodese aberta e 30 pacientes do grupo de artrodese minimamente invasiva (MIS. As indicações para a artrodese intersomática foram: doença degenerativa do disco, associada ou não a hérnia de disco ou estenose do canal; espondilolistese de baixo grau espondilolítica ou degenerativa; e síndrome pós-laminectomia/discectomia. As variáveis analisadas foram: tempo de cirurgia, tempo de internação hospitalar, necessidade de hemotransfusão, escala analógica visual de dor (VAS lombar e dos membros inferiores, Oswestry, índice de consolidação da artrodese e retorno ao trabalho. RESULTADOS: o seguimento mínimo foi de 24 meses. Havia oito homens e sete mulheres no Grupo Aberto e 17 homens e 13 mulheres no Grupo MIS. O tempo cirúrgico médio foi de 222 minutos e 221 minutos, respectivamente. Houve melhora significativa da VAS e Oswestry no pós-operatório em ambos os grupos. O tempo de internação hospitalar variou de 3,3 dias para o Grupo Aberto e 1,8 dias para o Grupo MIS. O índice de fusão obtido foi de 93,3% em ambos os grupos. Houve necessidade de hemotransfusão em três pacientes no Grupo Aberto (20% e nenhum caso MIS. CONCLUSÕES: a transforaminal lumbar interbody fusion (TLIF minimamente invasiva apresenta resultados similares em longo prazo quando comparado à TLIF aberta, com os benefícios adicionais de menor morbidade pós-operatória, menor período de internação e reabilitação precoce.OBJETIVO: la propuesta de este trabajo es comparar los resultados clínicos y radiológicos de los pacientes sometidos a la

  11. Combination therapy of transforaminal lumbar interbody fusion and Wiltse pedicle screw fixation approach in the treatment of the lumbar disc protrusion%经椎间孔椎间融合术联合Wiltse入路椎弓根固定治疗腰椎间盘突出症

    Institute of Scientific and Technical Information of China (English)

    隋海涛; 冯涛; 李亮; 于学忠

    2013-01-01

    [Objective] To compare the clinical effects of transforaminal lumbar interbody fusion with Wiltse pedicle screw fixation approach combined (TLIF,group A) and posterior lumbar interbody fusion (PLIF,group B).[Methods] From March 2008 to September 2012,186 patients on treatment for lumbar disc were divided into two groups:there were 104 patients in group A,48 males and 56 females,aged between 43 to 65,55 on average and 82 patients in group B,39 males and 43 females,aged between 45 to 67,57 on average.The bleeding volume,average time of operation,the rate of complications,fusion rate,the intervertebral space and the improvements in symptoms were compared and statistical analyzed.Visual analogue pain score (VAS) of low back pain and leg pain as well as the Oswestry disability index (ODI) were used in preoperative assessment and postoperative follow-up for symptoms evaluation.[Results] There were no statistical differences in the age,sex,intervertebral space,VAS score and ODI score before operation.The follow-up times without statistical difference were 26 months on average in group A and 23 months in group B.No significant differences were found between the two groups in last VAS scores of leg pain,ODI scores,fusion rate and intervertebral space (P > O.05).But group A had significant (P < 0.01) advantages of the bleeding volume,average time of operation,the rate of complications and the last VAS scores of low back pain.Significant improvements (P < 0.01) of intervertebral space,VAS scores and ODI scores after operation were ensured in both groups by the last follow-ups.[Conclusion] The efficacy of TLIF and PLIF are both satisfactory,but TLIF is better for less trauma,fewer complications and lower residual low back pain rate after operation.%[目的]比较经椎间孔腰椎椎间融合术(transforaminal lumbar interbody fusion,TLIF,A组)联合Wiltse入路椎弓根固定与传统经后路腰椎椎间融合术(posterior lumbar interbody fusion,PLIF,B组)治疗腰

  12. 单侧椎弓根螺钉固定经椎间孔腰椎体间融合治疗腰椎间盘突出症疗效分析%The effect analysis of transforamen lumbar interbody fusion in treatment of lumbar intervertebral disk herniation with unilateral pedicle screw fixation

    Institute of Scientific and Technical Information of China (English)

    李光富; 刘文斌; 罗政; 周焱涛

    2015-01-01

    Objective To explore the effect of transforamen lumbar interbody fusion in treatment of lumbar intervertebral disk herniation with unilateral pedicle screw fixation. Methods Retrospectivly studied the clinical data of 36 patients with lumbar intervertebral disk herniation who were treated through transforamen lumbar interbody fusion with unilateral pedicle screw from January 2011 to October 2012. There were 22 male and 14 female patients, aged form 44 to 68 years old with mean age of 56. The lesion positions included 8 patients in L3/4, 17 patients in L4/5, and 11 patients in L5/S1. The data of operation time, intraoperative bleeding volume, and postoperative drainage volume were collected. Therapeutic effect were evaluated by visual analogue score (VAS), lumbar vertebral score of Japanese Orthopedic Association (JOA) score, and Oswestry dysfunction index (ODI). Results Operation time was 65-100 min with mean time of 85 min. Intraoperative bleeding volume was 100-250 ml with mean volume of 135 ml. Postoperative drainage volume was 100-200 ml with mean volume of 150 ml. Followed up for 12-36 months with mean time of 20 months. No loosening, breakage of screws or displacement of interbody fusion cages were found in the follow up period. The rate of anastomosis was 100%(36/36). The VAS was (7.9 ± 1.2) scores before operation and (1.1±0.3) scores at the end of follow up period, there was significant difference( P<0.05). The JOA score was (10.2±2.6) scores before operation and (23.2±4.3) scores at the end of follow up period, there was significant difference (P<0.05). The ODI was (43.3±6.2) scores before operation and (15.2±4.3) scores at the end of follow up period, there was significant difference ( P<0.05). Conclusion The effect of transforamen lumbar interbody fusion with unilateral pedicle screw fixation is proper for the patients who are suffering from lumbar intervertebral disk herniation, which has advantages of less invasion, less bleeding, better

  13. Multilevel decompressive laminectomy and transpedicular instrumented fusion for cervical spondylotic radiculopathy and myelopathy: A minimum follow-up of 3 years

    Directory of Open Access Journals (Sweden)

    Kadir Kotil

    2011-01-01

    Full Text Available Objective: Cervical laminectomies with transpedicular insertion technique is known to be a biomechanically stronger method in cervical pathologies. However, its frequency of use is low in the routine practice, as the pedicle is thin and risk of neurovascular damage is high. In this study, we emphasize the results of cervical laminectomies with transpedicular fixation using fluoroscopy in degenerative cervical spine disorder. Materials and Methods: Postoperative malposition of the transpedicular screws of the 70 pedicles of the 10 patients we operated due to degenerative stenosis in the cervical region, were investigated. Fixation was performed between C3 and C7, and we used resected lamina bone chips for fusion. Clinical indicators included age, gender, neurologic status, surgical indication, and number of levels stabilized. Dominant vertebral artery of all the patients was evaluated with Doppler ultrasonography. Preoperative and postoperative Nurick grade of each patient was documented. Results: No patients experienced neurovascular injury as a result of pedicle screw placement. Two patients had screw malposition, which did not require reoperation due to minor breaking. Most patients had 32-mm screws placed. Postoperative computed tomography scanning showed no compromise of the foramen transversarium. A total of 70 pedicle screws were placed. Good bony fusion was observed in all patients. At follow-up, 9/10 (90% patients had improved in their Nurick grades. The cases were followed-up for an average of 35.7 months (30-37 months. Conclusions: Use of the cervical pedicular fixation (CPF provides a very strong three-column stabilization but also carries vascular injury without nerve damage. Laminectomies technique may reduce the risk of malposition due to visualization of the spinal canal. CPF can be performed in a one-stage posterior procedure. This technique yielded good fusion rate without complications and can be considered as a good

  14. 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

  15. 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

  16. 选择性椎间融合与椎弓根螺钉置入修复退变性腰椎侧凸:脊柱稳定性评价%Selective interbody fusion combined with pedicle screw fixation for degenerative lumbar scoliosis:spinal stability

    Institute of Scientific and Technical Information of China (English)

    尹承慧; 符臣学; 叶永平; 徐皓

    2015-01-01

    fusion should be conducted. This can achieve nerve decompression, spinal stability, and is relatively minimaly invasive. OBJECTIVE:To explore the efficacy of selective interbody fusion, limited neural decompression combined with pedicle screw system fixation for degenerative lumbar scoliosis. METHODS:Clinical characteristics of 53 patients with degenerative lumbar scoliosis were retrospectively analyzed, and the indication and contraindication were investigated. Selective interbody fusion, and limited neural decompression combined with pedicle screw system fixation were performed in the patients. Treatment effect and complication were analyzed. During folow-up, Suk standard was utilized to judge bone graft fusion. Before treatment and during final folow-up, lower back pain score system recommended by the Japanese Orthopaedic Association was used for assessment, and the excelent and good rate of curative effects was calculated. Cobb’s angle on the sagittal and coronal positions was compared and analyzed before and after treatment. RESULTS AND CONCLUSION:The patients were folowed up for 12 to 36 months. According to low back pain score of Japanese Orthopaedic Association Scores, the excelent and good rate of curative effect was 89% during the last folow-up. According to Suk standard, the fusion rate of vertebra was 94%. The last X-ray films revealed that Cobb’s angle was averagely (4.3±2.3)° (0°-13.5°) on the coronal plane after treatment, and the correction rate of scoliosis was 56%. The Cobb’s angle was averagely (45.1±12.5)° (10.4°-65.3°) after treatment, and the correction rate of lordosis was 36%. Complications after repair consisted of cerebrospinal fluid leakage in two cases, nerve injury in two cases, instrumental failure in one case, and pulmonary infection in one case, and symptomatic deep venous thrombosis in three cases. These findings suggest that selective interbody fusion, and limited neural decompression combined with pedicle screw system

  17. 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.

  18. Occipital Neuralgia after Occipital Cervical Fusion to Treat an Unstable Jefferson Fracture

    OpenAIRE

    Kong, Seong Ju; Park, Jin Hoon; Roh, Sung Woo

    2012-01-01

    In this report we describe a patient with an unstable Jefferson fracture who was treated by occipitocervical fusion and later reported sustained postoperative occipital neuralgia. A 70-year-old male was admitted to our center with a Jefferson fracture induced by a car accident. Preoperative lateral X-ray revealed an atlanto-dens interval of 4.8mm and a C1 canal anterior-posterior diameter of 19.94mm. We performed fusion surgery from the occiput to C5 without decompression of C1. The patient r...

  19. 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

  20. 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...

  1. Commentary on article: Laminoplasty versus laminectomy and fusion for multilevel cervical myelopathy: A meta-analysis of clinical and radiological outcomes by Chang-Hyun Lee et al

    Directory of Open Access Journals (Sweden)

    Nancy E Epstein

    2015-01-01

    Full Text Available Background: This is a commentary on the article laminoplasty versus laminectomy and fusion (LF for multilevel cervical myelopathy: A meta-analysis of clinical and radiological outcomes by Chang-Hyun Lee et al. Here, the authors utilized seven studies to compare the efficacy of cervical expansive laminoplasty (EL versus laminectomy and fusion (LF to address three or more level multilevel cervical spondylotic myelopathy (CSM. Both procedures led to similar degrees of neurological recovery and short-term loss of lordosis, but found that LF led to more favorable long-term results. Methods: For patients with three or more level CSM, laminectomy followed by an instrumented fusion (LF has major advantages; open bilateral decompression of the nerve roots, while minimizing the risk of inadvertent injury to the cord, and the fusion′s maintenance of lordosis. Results: Some would argue that inadvertent cord/root injury is greater utilizing any of the EL techniques; e.g., unilateral, bilateral, or spinous process splitting techniques. In short, why risk cord/root injury by manipulating the compressive posterior/posterolateral elements, which are already threatening neural function. Conclusion: Although the results of EL versus LF appeared comparable in the short-term in these seven articles, LF resulted in better long-term outcomes. Some would also argue that LF, utilizing an open approach offers safer bilateral neural exposure and decompression.

  2. 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....

  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

    resembling natural bone. METHODS: 19 patients who underwent cervical spine fusion were retrospective

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

    Directory of Open Access Journals (Sweden)

    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.

  5. 单侧椎弓根钉固定结合单枚融合器治疗腰椎不稳症%Treatment of lumbar instability with transforaminal lumbar interbody fusion (with single cage) combined with uni-lateral pedicle screw fixation

    Institute of Scientific and Technical Information of China (English)

    华永均; 王人彦; 郭志辉; 朱利民; 陆建阳

    2014-01-01

    Objective:To explore the clinical effect of transforaminal lumbar interbody fusion (with single cage) combined with unilateral pedicle screw fixation in treating lumbar instability. Methods:The clinical data of 50 patients with lumbar in-stability were retrospectively analyzed. They underwent treatment and obtained following up more than 8 months from 2009 to 2012. All patients complicated with refractory or recurrent lower back pain ,and unilateral primarily or unilateral lower limb ra-diation pain,X ray and CT films showed lumbar instability. The patients were respectively treated with transforaminal lumbar interbody fusion (with single cage) combined with unilateral or bilateral pedicle screw fixation. According to different fixation methods,they divided into unilateral fixation group and bilateral fixation group. There were 20 patients with 22 intervertebral spaces in unilateral fixation group,8 males and 12 females,aged from 26 to 66 years old,2 cases with isthmic spondylolisthesis of degreeⅠ,8 cases with degenerative spondylolisthesis,10 cases with lumbar disc herniation;fusion location with L3,4 was in 1 case,L4,5 was in 12 cases,L5S1 was in 9 cases. There were 30 patients with 30 intervertebral spaces in bilateral fixation group,14 males and 16 females,aged from 41 to 62 years old,4 cases with isthmic spondylolisthesis of degree Ⅰ,14 cases with degenerative spondylolisthesis,12 cases with lumbar disc herniation;fusion location with L3,4 was in 3 cases,L4,5 was in 15 case,L5S1 was in 12 cases. Operation time,intraoperative blood loss,postoperative drainage,complications were analyzed and intervertebral height,lordosis angle changes,fusion rate and clinical effect were compared between two groups. Results:All incisions obtained primary healing,lower limb radiation pain and low back pain disappeared basically,no infection,endo-rachis injury was found. Foot drop occurred in one case of bilateral fixation group and no iatrogenic neurological symptom was

  6. 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

    OpenAIRE

    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...

  7. 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。

  8. 椎间打压植骨联合棘突椎板复合体回植内固定治疗退变性腰椎不稳症%LUMBAR INTERBODY FUSION IMPACTED BONE GRAFTS COMBINED WITH REGRAFTING IN SITU WITH SPINOUS PROCESS AND VERTEBRAL PLATE COMPLEX AND PEDICLE SCREW FIXATION FOR LUMBAR DEGENERATIVE INSTABILITY

    Institute of Scientific and Technical Information of China (English)

    张超远; 孟祥翔; 秦晓彬; 付玉娟; 付鹏军

    2012-01-01

    Objective To evaluate the effectiveness of lumbar interbody fusion impacted bone grafts combined with regrafting in situ with spinous process and vertebral plate complex and pedicle screw fixation for lumbar degenerative instability. Methods Between January 1998 and October 2010, 48 patients with lumbar degenerative instability were treated by posterior decompression, lumbar interbody fusion impacted bone grafts combined with regrafting in situ with spinous process and vertebral plate complex and pedicle screw fixation. There were 26 males and 22 females, aged 52-76 years (mean, 62.4 years). The disease duration was 7 months to 25 years (mean, 6.5 years). One segmental instability was located at L3,4 in 1 case, at L4,5 in 10 cases, and at L5, S1 in 11 cases; multi-segmental instability was located at L3,4, L4,5, and L5, S1 in 5 cases, at L2,3 and L3,4 in 2 cases, at L3,4 and L4,5 in 10 cases, and at L4,5 and L5, S1 in 9 cases. Of 48 patients, 32 complicated by lumbar disc herniation, 46 by lumbar spinal stenosis, and 16 by degenerative scoliosis. The clinical results were evaluated by the Japanese Orthopaedic Association (JOA) score, recovery rate, disc height, and lumbar lordosis angles. Results The incisions obtained healing by first intention after operation. No nerve injury, rod or screw breakage, and infection occurred during and after operation. All 48 patients were followed up 1 to 6 years. The fusion time was 12-18 weeks (mean, 16.2 weeks). Vertebra slipping or degenerative scoliosis was corrected, and spinal column series became normal. At preoperation, 6 months after operation, and last follow-up, the disc heights were (5.2 ± 2.3), (11.9 ± 2.0), and (11.6 + 2.1) mm, respectively; the JOA scores were 3.2 + 2.1, 12.8 ± 1.6, and 13.6 + 1.2, respectively; and the lumbar lordosis angles were (-20.5 ± 10.5), (30.5 ± 8.5), and (31.2 + 5.6)°, respectively. The JOA scores, disc heights, and lumbar lordosis angles were significantly improved at 6 months after

  9. Axial Neck Pain after Cervical Laminectomy with Instrumented Fusion%颈椎椎板切除融合术后轴性疼痛

    Institute of Scientific and Technical Information of China (English)

    韩雨; 张永刚; 张雪松; 陆宁; 毛克亚; 崔庚; 王征

    2011-01-01

    目的:目前已证实颈椎椎板切除融合术是治疗多阶段的脊髓型颈椎病和后纵韧带骨化病的一种安全和有效的方法.然而,颈椎椎板切除融合术后经常发生颈部轴性疼痛.本研究的目的是观察C7棘突保留与否与颈椎椎板切除融合术后轴性疼痛的关系.方法:对2006年1月~2008年12月在我院行颈椎椎板切除融合术的67个病人进行回顾性分析.将这67个病人之中保留了C7棘突的29名病人称为A组,未保留C7棘突的38名病人称为B组,对两组病人的轴性症状、颈椎曲度和颈椎曲度指数(cervi cal curbatureindex,CCI)进行评估和比较.结果:在A组中有51.7%的病人发生了早期的轴性症状,10.3%的病人发生了晚期的轴性症状,B组分别为60.5%和42.1%.B组中42.1%的病人和A组中10.3%的病人在手术后晚期有轴性症状,A组的轴性疼痛发生率低于B组,有统计学意义(p=0.001).结论:保留C7棘突可以降低颈椎椎板切除融合术后轴性症状的发生率.%Objective: It has been demonstrated that cervical laminectomy with instrumented fusion is an effective and safe method of treating multi-level cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament.However, axial neck pain is frequently encountered after cervical laminectomy with instrumented fusion.The aim of the present study was to determine clinical significance of the C7 spinous process on axial neck pain after cervical laminectomy with instrumented fusion.Methods: A total of 67 consecutive patients that underwent cervical laminectomy with instrumented fusion between Janurary 2006 and December 2008 were reviewed.The authors evaluated and compared axial neck pain 、 lordotic angle and cervical curbature index (CCI) in patients that underwent C7 spinous process preserving surgery (groupA n = 29) and in patients in which the C7 spinons process was sacrificed (groupB, n = 38).Results: Early axial pain occurred in 51.7% of

  10. Freeze-dried and irradiated tricortical cancellous bovine grafts - a new product for the fusion to the inter somatic cervical

    International Nuclear Information System (INIS)

    Full text: This paper present a new implantable product with the help of bovine bone tissue, in phase of clinical rehearsal, for the ORTOP Tissue Bank. The intersomatic cervical vertebra r fusion requires the interference of a bone implant. The best results are obtained due to the implant antOlogo, but it forces to a second intervention, to the increase of the surgical time, to a bigger infection risk and bigger annoyances for the patients. On the other hand, it not always has allografts front tissue Banking. The difficulties, to obtain allografts in our country, in which Priones does not exist (Illness of the crazy cows), made us think of the possibility of using to bone xenograft, recognized by its antiguenique, osteo conductive and osteo inductive qualities. Bovine bone tissues coming from the branch isqiopuviana of the pelvis of young animals, with certifies of health were used. Grafts of 10 and 12 millimeters of diameter and 4, 5 and 6 mm of thickness were manufactured and then subjected to chemical process of Desproteinizacion and Deslipidacion; later on freezer-drying and then irradiates with Cobalt to 60 at dose of 25 KGy; following strict quality controls during the whole process. The xenografts is presented with double sterile cover, containing three rings whose dimensions are plowed in a visible way in the packaging. The xenografts is accompanied by instructions for its employment and the address of the Tissue Bank to inform eventual adverse reactions. Although it involved a short term of follow up, eight months, not adverse reaction was present

  11. 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

  12. Evaluation of the 96/4 PLDLLA polymer resorbable lumbar interbody cage in a long term animal model.

    Science.gov (United States)

    Lazennec, Jean Y; Madi, Abdallah; Rousseau, Marc A; Roger, Bernard; Saillant, Gérard

    2006-10-01

    Arthrodesis using interbody cages has demonstrated high fusion rates. However, permanent cages are exposed to stress-shielding, corrosion, and may require explanation when necessary. Polylactic acid (PLA) bioresorbable cages are developed for avoiding these problems, but significant tissue reaction has been reported with 70/30 PLDLLA in some preclinical animal studies. The objective was to evaluate 96/4 PLDLLA cages in a sheep model over 3 years. Sixteen sheeps underwent one level anterior lumbar interbody fusion using 96/4 PLDLLA cages, filled and surrounded with cancellous bone graft from the iliac crest. Six groups of three animals were killed after 3, 6, 9, 12, 24, and 36 months. Harvested lumbar spine had radiographic, MRI, and CT evaluation and histological analysis. Histological results: cage swelling and slight signs of fragmentation associated to fibrocartilaginous tissue apposition at 3 months; bone remodeling around the cage with direct apposition of the mineralization front at 6 months; active cage degradation and complete fusion around the cage at 9 months; cage fragmentation and partial replacement by bone tissue at 12 months; bone bridges in and around the cage at 24 months; full resorption and intervertebral fusion at 36 months. Radiological results: partial arthrodesis at 3 months; definite peripheral arthrodesis at 6 months; similar aspect at 9 months; significant cage resorption at 12 months; definite inner and outer fusion at 24 months; complete cage resorption and calcification at the location of the cage at 36 months confirmed histological observations. Radiographic, CT scan, MRI, and histological data were consistent for showing progressive resorption of 96/4 PLDLLA, interbody fusion, and bone remodeling, with no significant signs of local intolerance reaction. These results are promising and suggest further development of 96/4 PLDLLA cages. PMID:16736199

  13. 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.

  14. 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...

  15. 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

    Directory of Open Access Journals (Sweden)

    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

  16. 后路减压经椎间孔椎间融合术治疗钙化型高位腰椎间盘突出症的临床研究%Study of Transforaminal Lumbar Interbody Fusion in Patients with Calcified Upper Lumbar Intervertebral Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    易泽洪; 肖波; 杨国奇; 刘光勇; 刘建伟; 蔡杰勇; 黄亮; 马俊; 权正学

    2014-01-01

    目的:探讨后路减压经椎间孔椎间融合术( transforminal lumbar interbody fusion,TLIP)治疗钙化型高位腰椎间盘突出症的临床疗效。方法2008年1月至2011年12月采用全椎板切除TLIP技术治疗的钙化型高位腰椎间盘突出症患者19例。男10例,女9例;年龄23~58岁,平均41.2岁。其中L1/24例,L2/38例,L3/47例。合并T12/L1突出1例,其余均为单间隙椎间盘突出。术前、末次随访时进行疼痛视觉模拟评分( VAS)、Oswestry功能障碍指数( ODI)评分,根据Otani方法评定疗效。结果所有病例获得随访,随访时间3~24个月,平均12个月。术中3例硬脊膜损伤,术后脑脊液漏,经加压包扎处理后痊愈,1例出现对侧神经牵拉症状,经对症处理后缓解。1例术后症状无恢复。术前VAS评分与ODI评分分别为(8.1±1.4)分、(57.79±1.90)%,末次随访 VAS 评分与 ODI 评分分别为(2.2±1.0)分、(20.53±0.3)%。均较术前有统计学差异(P0. 05). According to Otani’s criteria,the results were excellent in 9 ca-ses,good in 6 cases,improved in 3 cases,fair in 1 case,and poor in 1 case with an excellent and good rate of 78. 9%. Conclusion Posterior decompression TLIP is effective in the treatment of patients with calcified upper lumbar intervertebral disc herniation.

  17. 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 ...

  18. Stability and interbody fusion of augmented pedicle screws with bone cement for lumbar spondylolisthesis accompanied with osteoporosis%骨水泥螺钉强化固定伴骨质疏松腰椎滑脱症的稳定性及椎间融合

    Institute of Scientific and Technical Information of China (English)

    姚珍松; 丁金勇; 唐永超; 陈康; 江晓兵; 梁德; 晋大祥; 庄洪; 张顺聪; 杨志东

    2016-01-01

    polymethylmethacrylate for lumbar spondylolisthesis accompanied with osteoporosis. METHODS: From June 2009 to June 2011, 27 patients suffering from lumbar spondylolisthesis accompanied with osteoporosis were included in this retrospective study. These patients received augmented pedicle screw with polymethylmethacrylate. The levels of disability and pain were evaluated by Oswestry Disability Index and visual analog scale. The internal fixation and fusion were evaluated by radiological findings. Al complications were recorded. RESULTS AND CONCLUSION: Al cases were fol owed up for 15-37 months. Oswestry Disability Index and visual analog scale scores were significantly better in final fol ow-up than that pre-treatment (P < 0.05). Imaging results revealed that bone cement tightly connected to bone interface. The position of screw and bone cement was good. Symptomatic bone cement leakage was not found. No fixation failure was detected during final fol ow-up. Al patients achieved interbody fusion. These results suggested that polymethylmethacrylate bone cement could increase the gripping force of the pedicle screw in osteoporotic vertebral body. It is safe and effective to treat spondylolisthesis accompanied with osteoporosis with augmented pedicle screws. Satisfactory fixation stability and interbody fusion can be obtained.

  19. Comparison of clinical efficacies of single segment transforaminal lumbar interbody fusion with cage versus autogenous morselized bone for degenerative lumbar spinal stenosis: a prospective randomized controlled study%椎间融合器植入与单纯自体颗粒骨植骨治疗退变性腰椎管狭窄症的比较

    Institute of Scientific and Technical Information of China (English)

    刘培盛; 刘小臻; 乔雪静; 都文楠; 罗大伟; 郑修军

    2014-01-01

    Objective To compare the clinical efficacies of single segment transforaminal lumbar interbody fusion (TLIF) with cage versus autogenous morselized bone for degenerative lumbar spinal stenosis.Methods A total of 87 patients undergoing single segment TLIF were randomly divided into 2 groups.A cage was implanted into intervertebral space in group A patients while autogenous morselized bone in group B patients.Operative duration,blood loss,length of stay and cost of hospitalization of two groups were recorded.They were followed up at 1 week,12,24 months post-operation.Oswestry disability index (ODI),visual analogue scale (VAS) fusion rates,intervertebral space and foramen height restoration,lumbar lordosis and postoperative complications were compared between two groups.Results No significant inter-group difference existed in operative duration,blood loss or length of stay.However,the average hospitalization cost in group A were 18% higher than that of group B (P < 0.05).Both groups achieved excellent clinical outcomes within 2 years.ODI,VAS score improvement rates and postoperative complication rates were not statistically different.Lumbar fusion rate was 86.7% in group A versus 85.7% in group B after 2 years.And there was no significant difference (P > 0.05).The heights of intervertebral space and foramen in group A achieved a better recovery than those of group B.Both groups had similar improvements of lumbar lordosis.Conclusion For degenerative lumbar spinal stenosis,usage of interbody cage is more effective in terms of recovery of intervertebral space and foraminal height compared with usage of bone graft.However it brings no better clinical efficacy while the usage of autogenous morselized bone is more cost-effective.Two grafting methods yield similar overall clinical outcomes.%目的 比较单节段经椎间孔腰椎椎间融合术(TLIF)手术中椎间融合器植入或单纯自体颗粒骨植骨两种融合方式治疗退变性腰椎管

  20. 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.

  1. Fusion

    CERN Document Server

    Mahaffey, James A

    2012-01-01

    As energy problems of the world grow, work toward fusion power continues at a greater pace than ever before. The topic of fusion is one that is often met with the most recognition and interest in the nuclear power arena. Written in clear and jargon-free prose, Fusion explores the big bang of creation to the blackout death of worn-out stars. A brief history of fusion research, beginning with the first tentative theories in the early 20th century, is also discussed, as well as the race for fusion power. This brand-new, full-color resource examines the various programs currently being funded or p

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

    Directory of Open Access Journals (Sweden)

    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. 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

  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. 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

  6. Comparing precision of distortion-compensated and stereophotogrammetric Roentgen analysis when monitoring fusion in the cervical spine

    OpenAIRE

    Leivseth, Gunnar; Kolstad, Frode; Nygaard, Øystein P; Zoega, Björn; Frobin, W; Brinckmann, P.

    2005-01-01

    Two methods to measure sagittal plane segmental motion in the cervical spine are compared. Translational and rotational motion was measured in nine cervical motion segments of nine patients by distortion-compensated (DCRA) as well as by stereophotogrammetric Roentgen analysis (RSA). To compare measurement precision of the new DCRA protocol with the established RSA technique under realistic clinical conditions and to discuss advantages and disadvantages of both methods in clinical studies. RSA...

  7. 腰椎融合术对脊柱-骨盆矢状面平衡及疗效的临床观察%Clinical observation and efficacy on lumbar interbody fusion for spine pelvic sagittal balance

    Institute of Scientific and Technical Information of China (English)

    罗江洪; 李伟; 陆庭盛

    2015-01-01

    Objective To analyze the clinical therapeutic effect of lumbar fusion in the treatment of lumbar degenerative diseases in the spine pelvic sagittal balance. Methods From June 2009 to June 2012,the clinical data of 92 cases with lumbar degenerative diseases ac-cepted lumbar spinal fusion operation in our hospital was collected. The contrast lumbar lordosis ( LL) ,lumbar sagittal vertical axis ( SVA) , pelvic incidence angle ( PI) ,sacral inclination angle ( SS) ,pelvic tilt angle ( PT) and other numerical parameters,using the Oswestry disabil-ity index ( ODI) ,visual analogue scale ( VAS) and the Japan Society of Department of orthopedics ( JOA) score were followed up two years after operation,and the postoperative effect was evaluated. Results The spinal pelvic parameters SVA,LL,SS and PT after surgery were changed obviously,and the difference was statistically significant(P<0. 05). The postoperative follow-up of VAS,ODI and JOA score were better than that of preoperation,the difference was significant(P<0. 05). Conclusion Lumbar fusion operation can restore lumbar lordosis, to maintain the spine pelvic sagittal balance and improve the effect of operation,and have positive significance to improve the postoperative symptoms.%目的:探讨腰椎退变性疾病采用腰椎融合术治疗对脊柱-骨盆矢状面平衡及临床疗效分析。方法收集2009年6月至2012年6月我院骨科接受腰椎内固定融合手术的92例腰椎退行性疾病患者的临床资料,术后2年内随访患者,对比腰椎前凸角( LL)、腰椎矢状垂直轴( SVA)、骨盆入射角( PI)、骶骨倾斜角( SS)、骨盆倾斜角( PT)等参数数值,采用Oswestry功能障碍指数( ODI)、视觉模拟评分法( VAS)及日本骨科学会( JOA)评分,评估术后疗效。结果脊柱骨盆参数SVA、LL、SS及PT手术后均较术前有明显改变,且差异有统计学意义(P<0.05),术后随访VAS、ODI及JOA 评分,均较术前有明显改善,治疗

  8. Off-label innovation: characterization through a case study of rhBMP-2 for spinal fusion.

    Science.gov (United States)

    Schnurman, Zane; Smith, Michael L; Kondziolka, Douglas

    2016-09-01

    OBJECTIVE Off-label therapies are widely used in clinical practice by spinal surgeons. Some patients and practitioners have advocated for increased regulation of their use, and payers have increasingly questioned reimbursment for off-label therapies. In this study, the authors applied a model that quantifies publication data to analyze the developmental process from initial on-label use to off-label innovation, using as an example recombinant human bone morphogenetic protein 2 (rhBMP-2) because of its wide off-label use. METHODS As a case study of off-label innovation, the developmental patterns of rhBMP-2 from FDA-approved use for anterior lumbar interbody fusion to several of its off-label uses, including posterolateral lumbar fusion, anterior cervical discectomy and fusion, and posterior lumbar interbody fusion/transforaminal lumbar interbody fusion, were evaluated using the "progressive scholarly acceptance" (PSA) model. In this model, PSA is used as an end point indicating acceptance of a therapy or procedure by the relevant scientific community and is reached when the total number of peer-reviewed studies devoted to refinement or improvement of a therapy surpasses the total number assessing initial efficacy. Report characteristics, including the number of patients studied and study design, were assessed in addition to the time to and pattern of community acceptance, and results compared with previous developmental study findings. Disclosures and reported conflicts of interest for all articles were reviewed, and these data were also used in the analysis. RESULTS Publication data indicated that the acceptance of rhBMP-2 off-label therapies occurred more rapidly and with less evidence than previously studied on-label therapies. Additionally, the community appeared to respond more robustly (by rapidly changing publication patterns) to reports of adverse events than to new questions of efficacy. CONCLUSIONS The development of off-label therapies, including the

  9. 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...

  10. Extinction of the HPV18 upstream regulatory region in cervical carcinoma cells after fusion with non-tumorigenic human keratinocytes under non-selective conditions.

    Science.gov (United States)

    Rösl, F; Achtstätter, T; Bauknecht, T; Hutter, K J; Futterman, G; zur Hausen, H

    1991-01-01

    'Universal fuser' clones of a human papillomavirus type 16 positive cervical carcinoma cell line (SiHa) were established to study the effect of a non-tumorigenic fusion partner on the regulation of a stably integrated chloramphenicol acetyltransferase (CAT) gene controlled by the HPV18 upstream regulatory region under non-selective conditions. The CAT expressing cells were fused with both non-tumorigenic, spontaneously immortalized human keratinocytes (HaCaT) and non-modified SiHa cells. The resulting hybrids were characterized by restriction enzyme fragment length polymorphism analysis and flow cytometry. While the non-selectable, HPV18-driven indicator gene is constitutively expressed in SiHa cells, the CAT activity is extinguished in SiHa x HaCaT cells, but still present in SiHa x SiHa hybrids. Examination of the cytokeratin expression pattern reveals that the keratinocyte phenotype seems not only to be dominant in terms of the extinction of the HPV18 regulatory region but also by the conservation of most of the differentiation markers of the non-tumorigenic fusion partner. Cycloheximide treatment and intracellular competition experiments using the transient COS7 fusion-amplification technique are accompanied by the reactivation of the marker gene in previously CAT- SiHa x HaCaT hybrids. These data strongly suggest that trans-acting negative regulatory factors derived from the non-malignant human keratinocytes are responsible for the extinction phenomenon. Images PMID:1709093

  11. Clinical effects of minimally invasive transforaminal lumbar interbody fusion for obese ;patients with lumbar disc herniation in peri operation period%微创经椎间孔腰椎椎间融合术治疗腰椎间盘突出肥胖患者围手术期疗效评价

    Institute of Scientific and Technical Information of China (English)

    张权; 毛克亚; 王博; 顾挺帅; 熊森; 张雅宾; 韩振川; 王义国; 肖波

    2015-01-01

    of minimally invasive transforaminal lumbar interbody fusion (MIS‐TLIF) for the obese patients with lumbar disc herniation in peri operation period .Methods The retrospective analysis of 56 obese patients with lumbar disc herniation from January 2013 to June 2014 ,body mass index (BMI) of all patients was higher than 30 kg/m2 .There were 32 cases in MIS‐TLIF group and 24 cases in open transforaminal lumbar interbody fusion (Open‐TLIF) group . The average operation time ,intraoperative blood loss ,length of incision ,ambulation time ,hospitalization time ,blood indexes ,complication rate were compared between two groups . Japanese Orthopedic Association (JOA) score ,visual analogue scale (VAS) ,and Oswestry Dability Index (ODI) were assessed .Results The average operation time ,intraoperative blood loss ,length of incision ,ambulation time , hospitalization time ,complication rate were 200 .00 ± 43 .05 min ,420 .56 ± 86 .42 mL ,8 .00 ± 4 .01 cm ,100 .80 ± 53 .04 h ,9 .30 ± 3 .40 d and 8 .33% in Open‐TLIF group ,respectively .They were 120 .00 ± 28 .26 min ,110 .83 ± 50 .51 mL ,5 .00 ± 2 .52 d ,24 .37 ± 8 .50 h ,2 .50 ± 0 .18 cm and 6 .25% in MIS‐TLIF group ,respectively .There were significant differences between two groups (P 0 .05) .WBC , ESR and CRP in MIS‐TLIF group were significantly lower than those in Open‐TLIF group at 3 , 5 days postoperatively (P<0 .05) .JOA scores ,VAS scores and ODI in MIS‐TLIF group were better than those in Open‐TLIF group at 5 days postoperatively (P<0 .05) .The complication rate in MIS‐TLIF group was significantly lower than that in Open‐TLIF group (P<0 .05) .Conclusion MIS‐TLIF for the obese patients with lumbar disc herniation could have the advantages of less bleeding ,fewer complication rate ,shorter hospitalization time and quick recovery . It is the future trend of treatment for the obese patients with lumbar disc herniation .

  12. Clinical significance of MRI/{sup 18}F-FDG PET fusion imaging of the spinal cord in patients with cervical compressive myelopathy

    Energy Technology Data Exchange (ETDEWEB)

    Uchida, Kenzo; Nakajima, Hideaki; Watanabe, Shuji; Yoshida, Ai; Baba, Hisatoshi [University of Fukui, Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, Eiheiji, Fukui (Japan); Okazawa, Hidehiko [University of Fukui, Department of Biomedical Imaging Research Center, Eiheiji, Fukui (Japan); Kimura, Hirohiko [University of Fukui, Departments of Radiology, Faculty of Medical Sciences, Eiheiji, Fukui (Japan); Kudo, Takashi [Nagasaki University, Department of Radioisotope Medicine, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki (Japan)

    2012-10-15

    {sup 18}F-FDG PET is used to investigate the metabolic activity of neural tissue. MRI is used to visualize morphological changes, but the relationship between intramedullary signal changes and clinical outcome remains controversial. The present study was designed to evaluate the use of 3-D MRI/{sup 18}F-FDG PET fusion imaging for defining intramedullary signal changes on MRI scans and local glucose metabolic rate measured on {sup 18}F-FDG PET scans in relation to clinical outcome and prognosis. We studied 24 patients undergoing decompressive surgery for cervical compressive myelopathy. All patients underwent 3-D MRI and {sup 18}F-FDG PET before surgery. Quantitative analysis of intramedullary signal changes on MRI scans included calculation of the signal intensity ratio (SIR) as the ratio between the increased lesional signal intensity and the signal intensity at the level of the C7/T1 disc. Using an Advantage workstation, the same slices of cervical 3-D MRI and {sup 18}F-FDG PET images were fused. On the fused images, the maximal count of the lesion was adopted as the standardized uptake value (SUV{sub max}). In a similar manner to SIR, the SUV ratio (SUVR) was also calculated. Neurological assessment was conducted using the Japanese Orthopedic Association (JOA) scoring system for cervical myelopathy. The SIR on T1-weighted (T1-W) images, but not SIR on T2-W images, was significantly correlated with preoperative JOA score and postoperative neurological improvement. Lesion SUV{sub max} was significantly correlated with SIR on T1-W images, but not with SIR on T2-W images, and also with postoperative neurological outcome. The SUVR correlated better than SIR on T1-W images and lesion SUV{sub max} with neurological improvement. Longer symptom duration was correlated negatively with SIR on T1-W images, positively with SIR on T2-W images, and negatively with SUV{sub max}. Our results suggest that low-intensity signal on T1-W images, but not on T2-W images, is correlated

  13. Clinical significance of MRI/18F-FDG PET fusion imaging of the spinal cord in patients with cervical compressive myelopathy

    International Nuclear Information System (INIS)

    18F-FDG PET is used to investigate the metabolic activity of neural tissue. MRI is used to visualize morphological changes, but the relationship between intramedullary signal changes and clinical outcome remains controversial. The present study was designed to evaluate the use of 3-D MRI/18F-FDG PET fusion imaging for defining intramedullary signal changes on MRI scans and local glucose metabolic rate measured on 18F-FDG PET scans in relation to clinical outcome and prognosis. We studied 24 patients undergoing decompressive surgery for cervical compressive myelopathy. All patients underwent 3-D MRI and 18F-FDG PET before surgery. Quantitative analysis of intramedullary signal changes on MRI scans included calculation of the signal intensity ratio (SIR) as the ratio between the increased lesional signal intensity and the signal intensity at the level of the C7/T1 disc. Using an Advantage workstation, the same slices of cervical 3-D MRI and 18F-FDG PET images were fused. On the fused images, the maximal count of the lesion was adopted as the standardized uptake value (SUVmax). In a similar manner to SIR, the SUV ratio (SUVR) was also calculated. Neurological assessment was conducted using the Japanese Orthopedic Association (JOA) scoring system for cervical myelopathy. The SIR on T1-weighted (T1-W) images, but not SIR on T2-W images, was significantly correlated with preoperative JOA score and postoperative neurological improvement. Lesion SUVmax was significantly correlated with SIR on T1-W images, but not with SIR on T2-W images, and also with postoperative neurological outcome. The SUVR correlated better than SIR on T1-W images and lesion SUVmax with neurological improvement. Longer symptom duration was correlated negatively with SIR on T1-W images, positively with SIR on T2-W images, and negatively with SUVmax. Our results suggest that low-intensity signal on T1-W images, but not on T2-W images, is correlated with a poor postoperative neurological outcome. SUVmax

  14. Spine surgery - discharge

    Science.gov (United States)

    ... Vertebral interbody fusion - discharge; Posterior spinal fusion - discharge; Arthrodesis - discharge; Anterior spinal fusion - discharge; Spine surgery - spinal fusion - discharge Images Spinal surgery -- cervical - series References Agrawal BM, Zeidman SM, Rhines L, ...

  15. 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.

  16. MICROSURGICAL LANDMARKS IN MINIMALLY INVASIVE TRANSFORAMINAL LUMBAR INTERBODY FUSION

    Directory of Open Access Journals (Sweden)

    Javier Quillo-Olvera

    2015-12-01

    Full Text Available Microsurgical landmarks of the facet joint complex were defined to provide guidance and security within the tubular retractor during transforaminal surgery. A retrospective observational study was performed in segments L4-L5 by the left side approach. Microsurgical relevant photos, anatomical models and drawing were used to expose the suggested landmarks. The MI-TLIF technique has advantages compared with conventional open TLIF technique, however minimally invasive technique implies lack of security for the surgeon due to the lack of defined microanatomical landmarks compared to open spine surgery, and disorientation within the tubular retractor, the reason why to have precise microsurgical references and its recognition within the surgical field provide speed and safety when performing minimally invasive technique.

  17. Clinical effect of minimally invasive transforaminal lumbar interbody fusion combined with unilateral pedicle fixation on elderly lumbar degenerative diseases%微创经椎间孔椎间融合术并单侧椎弓根固定治疗老年人腰椎退变性疾病的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    张建乔; 曾忠友; 叶招明; 宋永兴; 韩建福; 籍剑飞

    2015-01-01

    Objective To analyze the clinical effect of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) in combination with unilateral pedicle fixation on lumbar degenerative diseases in the elderly.Methods From June 2011 and June 2013,51 elderly patients with lumbar degenerative diseases who underwent MI-TLIF in combination with unilateral pedicle fixation,including 39 males and 12 females,aged from 60 to 72 years (average 65 years old),were included in this study.All the 51 cases had mono segmental lesion,including 11 cases with the lesion in L3.4,22 cases with the lesion in L4.5,and 18 cases with the lesion in L5-S1.The operation time,blood loss,postoperative drainage and complications were recorded.Postoperative outpatient follow-ups were conducted once every 2-3 months for all cases,and JOA scoring criteria (29 points) of lower back pain were adopted to evaluate the clinical effects.Thin-layer helical CT scanning reconstruction was applied to evaluate the fusion rate of bone grafting.X-ray film of lumbar vertebra AP & LAT was employed to evaluate the intervertebral space height,the internal fixation and the position of cage.Results The operation time ranged between 50-90 min with a mean value of 65 min; blood loss ranged between 80-180 ml (average 110 ml); and postoperative drainage volume ranged between 20-70 ml (average 40 ml).Healing phase I was achieved in 49 cases,while post-operative local cutaneous necrosis around the incision site occurred in 2 case and the wound healed well after wound dressing.Dural laceration without nerve root injury occurred in 2 cases.The follow up in 51 patients ranged between 18 24 months (average 20 months).In terms of JOA scoring,the preoperative score was (9.7± 1.6),the post operative score was (21.4 ± 1.4) 7 d after operation and the score was (25.4 ± 1.2) in the final follow up.During the final follow-up,35 cases were evaluated as excellent,11 cases as good and 5 cases as moderate,the excellent and good rate was

  18. 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

  19. Multilevel decompressive laminectomy and transpedicular instrumented fusion for cervical spondylotic radiculopathy and myelopathy: A minimum follow-up of 3 years

    OpenAIRE

    Kadir Kotil; Emine Ozyuvaci

    2011-01-01

    Objective: Cervical laminectomies with transpedicular insertion technique is known to be a biomechanically stronger method in cervical pathologies. However, its frequency of use is low in the routine practice, as the pedicle is thin and risk of neurovascular damage is high. In this study, we emphasize the results of cervical laminectomies with transpedicular fixation using fluoroscopy in degenerative cervical spine disorder. Materials and Methods: Postoperative malposition of the transpedicul...

  20. 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.

  1. Fusão intersomática lombar transforaminal: experiência de uma instituição Fusión intersomática lumbar transforaminal: la experiencia de una institución Transforaminal lumbar interbody fusion: a single-center experience

    Directory of Open Access Journals (Sweden)

    Vinicius de Meldau Benites

    2012-12-01

    del dolor y/o claudicación neurogénicas en comparación con el status preoperatorio. Solamente cinco pacientes continuaron usando alguna medicación analgésica. Cinco pacientes presentaran alguna complicación, pero sólo dos de ellas están relacionadas directamente al procedimiento. CONCLUSIONES: Es una técnica segura, posible de ser realizada en todos los niveles de la columna lumbar y es aplicable a la mayoría de las enfermedades que afectan a esta región de la columna.OBJECTIVE: Describe the early results and experience from a reference center in spine surgery in São Paulo, Brazil with transforaminal lumbar interbody fusion (TLIF technique in its various indications. METHODS: We retrospectively reviewed the medical records of 25 patients who underwent surgery with TLIF technique in 2011. One patient was excluded because we considered that TLIF was not the most important technique used. The indications were 9 lumbar disc herniations, 7 spondylolistheses, 4 revision surgeries of which 2 were for pseudoarthroses and 2 for low back pain, and finally, 4 lumbar spinal stenoses. RESULTS: All the patients reported low back pain and/or neurologic claudication improvement when comparing to preoperative status. Only five patients continued using analgesics. Five patients presented some complication, but only two of them were related to the procedure. CONCLUSIONS: TLIF is a safe technique which can be performed at any lumbar level of the lumbar spine and is applicable to the majority of diseases that affect this region.

  2. 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

  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. Long-term outcome of laminectomy and instrumented fusion for cervical ossification of the posterior longitudinal ligament

    OpenAIRE

    Chen, Yu; Guo, Yongfei; Chen, Deyu; Wang, Xinwei; Lu, Xuhua; Yuan, Wen

    2008-01-01

    Between January 2000 and December 2003, a total of 83 patients (64 men and 19 women, average age: 56.4 years, range: 42–78 years) who underwent posterior laminectomy and instrumented fusion for ossification of the posterior longitudinal ligament (OPLL) were included in this study to investigate the long-term outcome of this surgical option and clarify which factors affect the prognosis. After an average 4.8-year follow-up, the mean Japanese Orthopaedic Association (JOA) score significantly in...

  5. 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

  6. Biomechanical effects of polyaxial pedicle screw fixation on the lumbosacral segments with an anterior interbody cage support

    Directory of Open Access Journals (Sweden)

    Chen Hsiang-Ho

    2007-03-01

    Full Text Available Abstract Background Lumbosacral fusion is a relatively common procedure that is used in the management of an unstable spine. The anterior interbody cage has been involved to enhance the stability of a pedicle screw construct used at the lumbosacral junction. Biomechanical differences between polyaxial and monoaxial pedicle screws linked with various rod contours were investigated to analyze the respective effects on overall construct stiffness, cage strain, rod strain, and contact ratios at the vertebra-cage junction. Methods A synthetic model composed of two ultrahigh molecular weight polyethylene blocks was used with four titanium pedicle screws (two in each block and two rods fixation to build the spinal construct along with an anterior interbody cage support. For each pair of the construct fixed with polyaxial or monoaxial screws, the linked rods were set at four configurations to simulate 0°, 7°, 14°, and 21° lordosis on the sagittal plane, and a compressive load of 300 N was applied. Strain gauges were attached to the posterior surface of the cage and to the central area of the left connecting rod. Also, the contact area between the block and the cage was measured using prescale Fuji super low pressure film for compression, flexion, lateral bending and torsion tests. Results Our main findings in the experiments with an anterior interbody cage support are as follows: 1 large segmental lordosis can decrease the stiffness of monoaxial pedicle screws constructs; 2 polyaxial screws rather than monoaxial screws combined with the cage fixation provide higher compression and flexion stiffness in 21° segmental lordosis; 3 polyaxial screws enhance the contact surface of the cage in 21° segmental lordosis. Conclusion Polyaxial screws system used in conjunction with anterior cage support yields higher contact ratio, compression and flexion stiffness of spinal constructs than monoaxial screws system does in the same model when the spinal segment

  7. 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.

  8. 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

  9. 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

  10. 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%.

  11. 融合与非融合固定治疗脊髓型颈椎病:谁更易于椎体的活动度及稳定性?%Fusion and non-fusion fixation for cervical spondylotic myelopathy:which is more appropriate for maintaining range-of-motion and stability of vertebrae?

    Institute of Scientific and Technical Information of China (English)

    申超; 王文军; 晏怡果

    2014-01-01

    BACKGROUND:In recent years, many scholars adopted a joint non-fusion and fusion spinal fixation for multisegmental cervical spondylotic myelopathy, and achieved good clinical results. However, long-term clinical efficacy and possible related complications also require long-term fol ow-up of more in-depth study. OBJECTIVE:To review the research and application progress of anterior fusion and non-fusion fixation surgical operation for cervical myelopathy. METHODS:Computer-based search was conducted in China Journal Ful-text Database and PubMed database by the first author for articles related to anterior fusion and non-fusion fixation surgical operation for cervical myelopathy published between January 2004 and January 2014. The key words were“implant material;cervical spondylotic myelopathy;anterior;surgery;fusion;non-fusion;progress;hybrid;summary”in Chinese and“implant material;cervical spondylotic myelopathy;anterior;surgery/operation;fusion;non-fusion;research progress;hybrid;summary”in English. Final y, 35 articles were included for review. RESULTS AND CONCLUSION:Fusion and non-fusion fixation methods for cervical spondylotic myelopathy had their own advantages. From the view point of indications, the non-fusion fixation was relatively limited. Currently, the fusion fixation was stil the main method in treatment of cervical myelopathy. Non-fusion method as an emerging fixation method also achieved good short-period results, but it needs a long fol ow-up study. Hybrid fixation integrates the advantages of both methods, and can reduce the pressure. Simultaneously, Hybrid fixation also can reduce fusion segments, and retain the range-of-motion of the cervical spine as much as possible. Hybrid fixation becomes a hot topic in recent studies. However, most current researches on Hybrid fixation are retrospective study, lack of control. The overal fol ow-up time is short. Thus, Hybrid fixation needs to be researched more deeply.%背景:近年来,许多国

  12. 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

    paciente con síndrome de Brown-Séquard por hernia de disco cervical.This article presents a case in which Brown-Séquard syndrome resulted from a double level cervical disc herniation. A 40-year-old man without previous history of cervical pathology, presented with insidious right arm and leg paresis associated with associated with decreased pain and thermal sensitivity in the left hemibody after diving which caused indirect trauma of the cervical spine. Magnetic resonance imaging of the cervical spine showed double level disc herniation in C4-C5 and C5-6 with compression of the right half of spinal cord and hyperintensity in T2-weighted images. After a complete decompression of neural structures, a double level interbody fusion was performed. There was partial recovery of neurological status after a long period of physical therapy. Early surgical intervention and prompt rehabilitation are paramount to achieve neurological recovery in patients with Brown-Séquard syndrome resulting from a cervical disc herniation.

  13. 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

  14. 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.

  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. 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

  17. Outcome of instrumented spinal fusion for chronic low back pain: review of 100 patients

    International Nuclear Information System (INIS)

    Objective of this study was to evaluate the outcome of instrumented spinal fusion in selected patients with Chronic Low Back Pain (CLBP) in our setup. Consecutive first one hundred patients were selected from spine unit database that underwent instrumented spinal fusion for chronic low back pain lasting more than one year, due to degenerative disease of spine. Average age was 42 years. There were 62 males and 38 females. Diagnosis included; spinal stenosis (26%), failed disc surgery (22%), spondylolisthesis (19%), degenerative disc disease (17%), and instability (16%). Operations performed; Pedicle Screw Fixation (PSF) with Postero-lateral Fusion (PLF) in 3% patients. Trans Laminar Facet Screw (TLFS) with PLF in 24% patients. Anterior Lumbar Inter-body Fusion (ALIF) in 9% patients. Posterior Lumbar Inter-body Fusion (PLIF) in 40% patients and Trans-foraminal Lumbar Inter-body Fusion (TLIF) in 24% patients. Average follow up was for 30 months. 86% patients had full spinal fusion. 71% patients were fully satisfied with treatment, 28% were partially satisfied. Post-operatively, on average, visual analogue scale (VAS) showed 48 points significant improvement and Oswestry Disability Index (ODI) showed 53 points significant improvement. Instrumented Spinal Fusion is effective in our set up for relieving symptoms and improving functional outcome in selected patients with debilitating Chronic Low Back Pain due to degenerative disease of spine. Single fusion technique is not ideal for all types of patients and surgeon has to be versatile and trained in using different fusion techniques as the situation demands. (author)

  18. Tissue identification with micro-magnetic resonance imaging in a caprine spinal fusion model

    OpenAIRE

    Uffen, M.; Krijnen, M.; Hoogendoorn, R.; Strijkers, G.; Everts, V.; Wuisman, P.; Smit, T.

    2008-01-01

    Nonunion is a major complication of spinal interbody fusion. Currently X-ray and computed tomography (CT) are used for evaluating the spinal fusion process. However, both imaging modalities have limitations in judgment of the early stages of this fusion process, as they only visualize mineralized bone. Magnetic resonance imaging (MRI) could be of great value as it is able to discriminate between different types of tissue. A feasibility study was performed in nine animals from a goat spinal fu...

  19. 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

  20. 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, ...

  1. 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

  2. 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.

  3. 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

  4. 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.

  5. Occipitocervical fusion angle and lower cervical spine degeneration in patients with craniocervical junction malformation%枕颈融合角度与颅颈交界区畸形患者下颈椎退变的关系

    Institute of Scientific and Technical Information of China (English)

    王鑫鑫; 王利民; 王卫东; 刘屹林

    2014-01-01

    背景:枕颈融合是颅颈交界区畸形的主要治疗方法。对于非骨质疏松症患者,颈椎的退变主要表现在椎间盘,而椎体的高度基本保持恒定不变,所以可用颈椎间盘高度和与颈椎体高度和的比值(S值)衡量颈椎的退变,S值越小则颈椎退变越严重。  目的:测量颅颈畸形枕颈融合内固定患者的颈椎侧位X射线片,分析融合过程中枕颈固定角度和融合后下颈椎退变的关系,确定最佳枕颈融合角度范围。  方法:纳入因颅颈畸形行枕颈融合患者21例,根据融合后即刻枕颈角度(0c-C2角度),将颅颈畸形枕颈融合患者分为3组,即枕颈角9°-22°组、枕颈角22°组,其中融合后即刻0c-C2角度在9°-22°属于正常范围。测量融合前及融合后终末随访时各组S值及JOA评分,并进行统计学比较。  结果与结论:融合前枕颈角9°-22°组、枕颈角22°组JOA评分分别为(7.3±1.7)分、(7.2±1.6)分、(7.3±1.5)分,融合后随访分别为(14.2±1.5)分、(13.5±1.6)分、(13.3±1.5)分,3组 JOA 评分均有明显改善,枕颈角9°-22°组JOA改善程度明显较枕颈角22°组好。融合前S值枕颈角9°-22°组、枕颈角22°组分别为0.440±0.017,0.441±0.016,0.440±0.018,3组间差异无显著性意义。枕颈角9°-22°组融合后终末随访S值与融合前S值差异无显著性意义,枕颈角22°组融合后终末随访S值均较其融合前S值明显减小。提示枕颈融合内固定时枕颈角应尽量在正常范围内,超过或小于正常范围均会加速下颈椎的退变进程。%BACKGROUND:Occipitocervical fusion is a major method for malformation of craniocervical junction. In patients without osteoporosis, the degeneration of cervical vertebra mainly presents in the intervertebral disk. The height of the vertebral body is constant basical y. Thus, the ratio (S value) of the height of cervical disc and the height of cervical

  6. 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

  7. 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

  8. 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

  9. Pedicle-Screw-Based Dynamic Systems and Degenerative Lumbar Diseases: Biomechanical and Clinical Experiences of Dynamic Fusion with Isobar TTL

    OpenAIRE

    Cédric Barrey; Gilles Perrin; Sabina Champain

    2013-01-01

    Dynamic systems in the lumbar spine are believed to reduce main fusion drawbacks such as pseudarthrosis, bone rarefaction, and mechanical failure. Compared to fusion achieved with rigid constructs, biomechanical studies underlined some advantages of dynamic instrumentation including increased load sharing between the instrumentation and interbody bone graft and stresses reduction at bone-to-screw interface. These advantages may result in increased fusion rates, limitation of bone rarefaction,...

  10. 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

  11. 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.

  12. 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.

  13. 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

  14. 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

  15. 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.

  16. 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.

  17. Immunization strategy against cervical cancer involving an alphavirus vector expressing high levels of a stable fusion protein of human papillomavirus 16 E6 and E7

    NARCIS (Netherlands)

    Daemen, T; Regts, J; Holtrop, M; Wilschut, J

    2002-01-01

    We are developing immunization strategies against cervical carcinoma and premalignant disease, based on the use of recombinant Semliki Forest virus (SFV) encoding the onco-proteins E6 and E7 from high-risk human papilloma viruses (HPV). Thus far, protein-based, as well as genetic immunization studie

  18. 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

  19. Nursing care of occipital-cervical fusion patients with pedicle screws and lateral mass screws%经椎弓根螺钉加侧块螺钉内固定行枕颈融合的术后护理

    Institute of Scientific and Technical Information of China (English)

    彭玉慧

    2011-01-01

    目的 探讨经椎弓根螺钉加侧块螺钉内固定行枕颈融合术的术后护理要点.方法 回顾性总结3例经椎弓根螺钉加侧块螺钉内固定行枕颈融合术患者的临床资料及护理效果.结果 3例患者术后恢复良好,2例脊髓损伤患者术后感觉运动功能均有恢复,生活可以自理.结论 术后严密观察生命体征的变化和脊髓神经功能的变化,严格体位护理和呼吸道管理以及通过引导式教育训练等对于促进患者伤口愈合、预防术后并发症的发生起着重要的作用.%Objective To evaluate nursing care of occipital - cervical fusion patients with pedicle screws and lateral mass screws. Methods The clinical data and nursing effect of three patients who underwent occipital - cervical fusion with lateral mass screws during January 2009 to June 2010 were reviewed. Results Three patients recovered well after surgery, among which 2 cases of spinal cord injury had sensory- motor function recovery, and could take care of themselves.Conclusion After surgery, the close observation of vital signs and the changes in spinal cord function, strict posture and respiratory care management, and conductive education to patients for the wound healing promotion, prevention of postoperative complications are very important.

  20. 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 ...

  1. Comparison of zero-profile anchored spacer versus plate-cage construct in treatment of cervical spondylosis with regard to clinical outcomes and incidence of major complications: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Liu WJ

    2015-09-01

    <0.05, OR =0.20, 95% CI 0.04–0.90], and at the final follow-up time [P<0.05, OR =0.13, 95% CI 0.04–0.45]. Conclusion: Our meta-analysis suggested that surgical treatments of single or multiple levels of cervical spondylosis using Zero-P and PCC were similar in terms of JOA score, NDI score, cervical lordosis, and fusion rate. Although the Zero-P group had a higher subsidence rate than the PCC group, Zero-P had a lower postoperative dysphagia rate and might have a lower adjacent-level ossification rate. Keywords: cervical spondylosis, anterior cervical decompression and fusion, integrated ­interbody device, dysphagia, meta-analysis, subsidence, adjacent-level ossification

  2. In vitro-analysis of kinematics and intradiscal pressures in cervical arthroplasty versus fusion – A biomechanical study in a sheep model with two semi-constrained prosthesis

    OpenAIRE

    Daentzer, Dorothea; Welke, Bastian; Hurschler, Christof; Husmann, Nathalie; Jansen, Christina; Flamme, Christian Heinrich; Richter, Berna Ida

    2015-01-01

    Background As an alternative technique to arthrodesis of the cervical spine, total disc replacement (TDR) has increasingly been used with the aim of restoration of the physiological function of the treated and adjacent motions segments. The purpose of this experimental study was to analyze the kinematics of the target level as well as of the adjacent segments, and to measure the pressures in the proximal and distal disc after arthrodesis as well as after arthroplasty with two different semi-c...

  3. 以咽异物感为表现的食管型颈椎病1例%One cases of esophageal cervical spondylosis with pharyngeal foreign body sensation

    Institute of Scientific and Technical Information of China (English)

    齐志勇; 张治平; 呼和牧仁; 鄂建新

    2012-01-01

    The patient was treated as pharyngeal foreign body sensation for six months. Laryngeal endosco-pys one about 1 cmX2 cmX2 cm,hard.smooth bulge in hypopharyngeal wall at the plane of epiglottis valley. The cervical MRI showed that the C3-C4 disc herniation and degeneration of the C3-C4 vertebrae. Cervical CT showed the C3-C4 disc osteophyte formation and forward bulge. After orthopedic consultation, the patient was diagnosed as esophageal cervical spondylosis. C3-C4 diskectomy and vertebral interbody bone grafted with plate fixation were undertaken. At postoperational day 2, the pharyngeal foreign body sensation disappeared.

  4. Hybrid手术治疗脊髓型颈椎病的临床疗效分析%Clinical efficacy analysis of hybrid spinal fusion surgery in the treatment of cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    马迅; 梅军; 冯皓宇; 张丽; 关晓明

    2013-01-01

    Objective To investigate the clinical efficacy,operative essentials and indications of hybrid spinal fusion surgery for cervical spondylotic myelopathy.Methods From August 2008 to December 2011,thirty-eight patients with cervical spondylotic myelopathy underwent hybrid spinal fusion surgery in our hospital.There were 27 males and 11 females,aged from 33 to 70 years (average,51 years).A total of 86 segments were treated (fusion 48 vs.non-fusion 38).Twenty-eight patients underwent a two-level surgery,and ten patients received a three-level surgery.The Japanese Orthopaedic Association (JOA) score and Visual analogue scale (VAS) were used to evaluate pre-and post-operative neurological function and pain,respectively.The pre-and post-operative range of motion of the cervical spine was measured according to Xrays.Moreover,the surgical complications were recorded and analyzed.Results Thirty-seven patients were followed up for 15 to 55 months (average,29.1 months).The improvement of neurological function was obtained in 36 patients.The JOA score was improved from preoperative 10.5±1.57 to 14.3±1.97 at final follow-up,with an improvement rate of 58.46%,and the results were excellent in 16 cases,fair in 20 cases and poor in 1 case.The VAS was improved from preoperative 7.3±1.04 to 3.2±1.41 at final follow-up.The Cobb angle changed from preoperative 25°±3.21°to 20°±2.56°at final follow-up.After operation,the neurological function was not restored in 1 case; hoarseness and bucking occurred in 2 cases; sore throat occurred in 22 cases; anterior displacement of prosthesis (PCM) occurred in 3 cases.Other patients had no complications,such as displacement,loosening and heterotopic ossification.Conclusion In hybrid spinal fusion surgery,the lesions segments are decompressed fully,the severely degenerative segments are fused,and the motion of the non-fusion segments is reserved.As a result,not only the stability of the cervical spine is achieved,but also an obvious

  5. 颈前路经椎间隙减压盒状cage植骨融合术治疗单间隙颈椎病-附86例随访结果%Study on clinical results of single - level cervical discectomy and box - shape bone graft fusion in treatment of single - level cervical disease. A report of results in follow - up study of 86 cases.

    Institute of Scientific and Technical Information of China (English)

    唐拥军; 曾凡伟; 池雷霆

    2011-01-01

    目的 观察经颈前路椎间隙减压盒状椎体护架(cage)植融合术治疗单间隙颈椎病的结果.方法 选择86例患者应用盒状Cage行颈前路减压,植骨融合术治疗单间隙颈椎病,随访3个月至4年.结果 神经功能恢复率为86.0%(GDA评分),所有患者术后CT证实融合,术后并发症发生率7.0%.结论 经颈前路椎间隙减压盒状Cage植骨融合术治疗单间隙颈椎病,目前已成为公认的最佳术式之一.%Objective To observe the effectiveness and prognosis of anterior approach for decompression and bone - graft fusion in treatment of patients with cervical spondylosis. Methods Altogether 86 cases of cervical spondylosis were treated with anterior approach decompression and bone - graft fusion. All these cases were followed up for 3 to 4 months. Results The rate of symptomatic relief is 86% ( by JOA scores ),and all these cases are proved to be getting fusion by CT scanning. The rate of occurrence of complications is 7% ( 6 cases ). Conlusion The anterior approach for decompression and titanium cage bone - graft fusion are considered to be the best method for treatment of patients with cervical spondylosis.

  6. Application of the cervical fusion cage of high molecular weight polyethylene in goats%高分子聚乙烯颈椎融合器在山羊体内的应用

    Institute of Scientific and Technical Information of China (English)

    皮国富; 王利民; 陈风苞

    2005-01-01

    BACKGROUND: Titanium cage of cervical vertebral fusion is often used during a surgical operation for cervical syndrome; however, it has a bad impact on the operative effect because of submerging.OBJECTIVE: To observe the biocompatibility and stability of cervical fusion cage of high molecular polyethylene in animals.DESIGN: A randomized grouping and observational control experiment.SETTING: The Animal Experimental Center of Zhengzhou University.MATERIALS: Twenty female goats without pregnancy at 1.1-1.6 years of age.METHODS: The experiment was conducted at the Animal Experimental Center of Zhengzhou University between June and November 2001. Twenty goats were equally randomized into experimental group and control group.Self-made cervical fusion cage filled with autogenous spongy bone was implanted into the goats in the experimental group, only autogenous iliac bone was implanted in the control group. X-ray for observing the changes in the height of intervertebral space was performed in two groups 6 weeks later. All the animals were killed under anesthesia to extract cervical vertebra samples, which were placed on YJ-14 Biomechanical Tester to measure anti-compression ability and height of intervertebral space and to observe pathological changes.space: Compression loading in the experimental group was significantly higher than that in the control group [(358.64±15.63),(268.82±11.36)N,P < 0.05]; however, there was no difference in the height of interverteA great amount of osteoblasts were found in the tissues around the cage in the experimental group, but there was no difference between the two groups.CONCLUSION: The self-designed cervical vertebral fusion cage possesses high upholding strength, good biocompatibility and stability and can play a role in stabilizing the height of intervertebral space.%背景:颈椎病手术中常用钛合金颈椎融合器,但其出现下沉等情况常影响疗效.目的:观察自制高分子聚乙烯颈椎融合器在动物体

  7. 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 ...

  8. 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, ...

  9. 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 ...

  10. Clear Zone Formation around Screws in the Early Postoperative Stages after Posterior Lumbar Fusion Using the Cortical Bone Trajectory Technique

    OpenAIRE

    Ninomiya, Koshi; Iwatsuki, Koichi; Ohnishi, Yu-ichiro; Ohkawa, Toshika; Yoshimine, Toshiki

    2015-01-01

    Study Design Retrospective study. Purpose To evaluate the initial fixation using the cortical bone trajectory (CBT) technique for posterior lumbar fusion through assessment of the clear zones around the screws and the risk factors involved. Overview of Literature Postoperative radiolucent zones (clear zones) are an indicator of poor conventional pedicle screw fixation. Methods Between January 2013 and April 2014, 19 patients (8 men and 11 women) underwent posterior lumbar interbody fusion or ...

  11. 枕颈融合联合枕下减压术治疗枕颈畸形并脊髓损伤%Treatment of occipital -cervical deformity and spinal cord injury with foramen magnum decompression combined with occipital -cervical fusion

    Institute of Scientific and Technical Information of China (English)

    喻志; 刘学森; 严鹏辉; 郝志全; 李兵兵; 黄宗强

    2016-01-01

    目的:探讨枕颈融合联合枕下减压内固定术治疗枕颈畸形并脊髓损伤的临床疗效及安全性。方法选择郑州大学第一附属医院2011年7月至2014年7月收治的38例枕颈畸形并脊髓损伤患者作为研究对象,男22例,女16例,年龄16~57(38.2±12.1)岁,入院后均行枕颈融合联合枕下减压植骨融合钛板内固定术。通过随访对术前、术后JOA 评分进行对比,评估患者神经功能改善情况。根据术后随访影像学资料评价椎管减压、植骨融合等情况。结果所有病例均获随访,平均15.6个月。术中未出现脊髓、椎动脉损伤等严重并发症。术后螺钉位置良好,无松动、断钉,均呈骨性愈合。所有患者神经功能恢复良好,JOA 评分:术前5~12(7.1±1.8)分,术后12个月8~17(14.9±1.6)分,差异有统计学意义(P <0.05)。结论枕颈融合联合枕下减压内固定术是治疗枕颈畸形并脊髓损伤的简单、安全、有效方法,值得临床推广。%Objective To investigate the clinical efficacy and safety of foramen magnum decompression combined with occipital -cervical fusion for the treatment of occipital -cervical deformity and spinal cord injury.Methods 38 patients with occipital -cervical deformity and spinal cord injury from July of 201 1 to July of 201 4 were selected as the research objects, including 22 males and 1 6 females,aged 1 6 ~57(38.2 ±1 2.1 )years old.All the patients were treated with foramen magnum decompression combined with occipital -cervical fusion with internal fixation.The improvement of neurological function was eval-uated by the comparison of preoperative JOA scores and postoperative JOA scores.The spinal canal decompression and bone graft fusion were monitored by radiology or computed tomography.Results All cases were followed up for an average of 1 5.6 months. There was no serious complication such as spinal cord and vertebral

  12. 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.

  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. Acute Hydrocephalus Following Cervical Spinal Cord Injury

    OpenAIRE

    Son, Seong; Lee, Sang Gu; Park, Chan Woo; Kim, Woo Kyung

    2013-01-01

    We present a case of acute hydrocephalus secondary to cervical spinal cord injury in a patient with diffuse ossification of the posterior longitudinal ligament (OPLL). A 75-year-old male patient visited the emergency department with tetraparesis and spinal shock. Imaging studies showed cervical spinal cord injury with hemorrhage and diffuse OPLL from C1 to C4. We performed decompressive laminectomy and occipitocervical fusion. Two days after surgery, his mental status had deteriorated to drow...

  15. 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...

  16. Treatment of hyperexsion injury with severe cervical spondylotic myelopathy by early posterior laminectomy and fusion.%颈椎过伸伤伴颈椎管狭窄症的早期后路手术治疗

    Institute of Scientific and Technical Information of China (English)

    谭俊铭; 王金鑫; 来津; 王朝阳; 陈德纯; 邢顺民; 申练兵; 苏加向; 廖腾; 时国华; 何翔

    2012-01-01

    Objective To retrospectively evaluate lite therapeutic effect of 18 patients with hy — percxsion injury and severe multilevel cervical spondylotic myelopathy treated by early posterior laminectomy and fusion. Methods All patients had. preoperative radiographs,computed tomography and magnetic resonance imaging,and noted 11 patients had abnormal T2—weighted MR] signal. Neurologic function and clinical assessment of myelopathy were graded preoperatively and postoperative— ly by the grading system of Nurick and Niu respectively. The mean follow—up period were 26 months (from 6 months to 5.5 years ). Results Mean Niu score improved from 6.221, range 5—7) to 4.72 (range 3—7.) postoperatively. Fifteen patients (83.3%) had improvement in Nurick grade of at least one level,and three showed no improvement. There were 6 cases had residual abnormal T2 — weighted MRI signal postoperatively. Conclusion Good clinical effectiveness are obtained from early laminectomy and fusion in hyperexsion injury with severe multilevel cervical myelopathy and obviously improvement of myelopalhy are observed, with low complication rales were.%目的 回顾分析了早期颈后路切除减压融合治疗18 例颈椎过伸伤伴颈椎管狭窄患者.方法 术前常规X 线、CT 和MRI 检查,其中11 例患者存在异常T2加权MRI 信号,手术前后分别行Nurick 和Niu 系统评估.随访6 个月~5.5 年,平均2.4 年.结果 平均Niu 评分由术前6.22(5~7)提高到术后4.72(3~7),15 例患者(83.3%)的最后随访示Nurick 评分至少提高Ⅰ级,3 例无明显改善和恶化.术后6 例患者仍存在T2加权MRI 信号异常.结论 颈椎过伸伤伴颈椎管狭窄症患者行早期后路椎板切除减压融合可取得较好的临床效果,术后疗效改善明显,并发症发生率较低.

  17. Adjacent Lumbar Disc Herniation after Lumbar Short Spinal Fusion

    OpenAIRE

    Koshi Ninomiya; Koichi Iwatsuki; Yu-ichiro Ohnishi; Toshika Ohkawa; Toshiki Yoshimine

    2014-01-01

    A 70-year-old outpatient presented with a chief complaint of sudden left leg motor weakness and sensory disturbance. He had undergone L4/5 posterior interbody fusion with L3–5 posterior fusions for spondylolisthesis 3 years prior, and the screws were removed 1 year later. He has been followed up for 3 years, and there had been no adjacent segment problems before this presentation. Lumbar magnetic resonance imaging (MRI) showed a large L2/3 disc hernia descending to the L3/4 level. Compared to...

  18. Management of delayed posttraumatic cervical kyphosis.

    Science.gov (United States)

    Lopez, Alejandro J; Scheer, Justin K; Abode-Iyamah, Kingsley; Smith, Zachary A; Hitchon, Patrick W; Dahdaleh, Nader S

    2016-01-01

    We describe three patients with misdiagnosed unstable fractures of the cervical spine, who were treated conservatively and developed kyphotic deformity, myelopathy, and radiculopathy. All three patients were then managed with closed reductions by crown halo traction, followed by instrumented fusions. Their neurologic function was regained without permanent disability in any patient. Unstable fractures of the cervical spine will progress to catastrophic neurologic injuries without surgical fixation. Posttraumatic kyphosis and the delayed reduction of partially healed fracture dislocations by preoperative traction are not well characterized in the subaxial cervical spine. The complete evaluation of any subaxial cervical spine fracture requires CT scanning to assess for bony fractures, and MRI to assess for ligamentous injury. This allows for assessment of the degree of instability and appropriate management. In patients with delayed posttraumatic cervical kyphosis, preoperative closed reduction provided adequate realignment, facilitating subsequent operative stabilization. PMID:26321304

  19. MRI-based Preplanning Using CT and MRI Data Fusion in Patients With Cervical Cancer Treated With 3D-based Brachytherapy: Feasibility and Accuracy Study

    Energy Technology Data Exchange (ETDEWEB)

    Dolezel, Martin, E-mail: dolezelm@email.cz [Oncology Centre, Multiscan and Pardubice Regional Hospital, Pardubice (Czech Republic); First Faculty of Medicine, Charles University, Prague (Czech Republic); Odrazka, Karel [Oncology Centre, Multiscan and Pardubice Regional Hospital, Pardubice (Czech Republic); First Faculty of Medicine, Charles University, Prague (Czech Republic); Zizka, Jan [Department of Radiology, Charles University Teaching Hospital, Hradec Kralove (Czech Republic); Vanasek, Jaroslav; Kohlova, Tereza; Kroulik, Tomas [Oncology Centre, Multiscan and Pardubice Regional Hospital, Pardubice (Czech Republic); Spitzer, Dusan; Ryska, Pavel [Department of Radiology, Multiscan and Pardubice Regional Hospital, Pardubice (Czech Republic); Tichy, Michal; Kostal, Milan [Department of Gynaecology, Multiscan and Pardubice Regional Hospital, Pardubice (Czech Republic); Jalcova, Lubica [Oncology Centre, Multiscan and Pardubice Regional Hospital, Pardubice (Czech Republic)

    2012-09-01

    Purpose: Magnetic resonance imaging (MRI)-assisted radiation treatment planning enables enhanced target contouring. The purpose of this study is to analyze the feasibility and accuracy of computed tomography (CT) and MRI data fusion for MRI-based treatment planning in an institution where an MRI scanner is not available in the radiotherapy department. Methods and Materials: The registration inaccuracy of applicators and soft tissue was assessed in 42 applications with CT/MRI data fusion. The absolute positional difference of the center of the applicators was measured in four different planes from the top of the tandem to the cervix. Any inaccuracy of registration of soft tissue in relation to the position of applicators was determined and dose-volume parameters for MRI preplans and for CT/MRI fusion plans with or without target and organs at risk (OAR) adaptation were evaluated. Results: We performed 6,132 measurements in 42 CT/MRI image fusions. Median absolute difference of the center of tandem on CT and MRI was 1.1 mm. Median distance between the center of the right ovoid on CT and MRI was 1.7 and 1.9 mm in the laterolateral and anteroposterior direction, respectively. Corresponding values for the left ovoid were 1.6 and 1.8 mm. Rotation of applicators was 3.1 Degree-Sign . Median absolute difference in position of applicators in relation to soft tissue was 1.93, 1.50, 1.05, and 0.84 mm in the respective transverse planes, and 1.17, 1.28, 1.27, and 1.17 mm in selected angular directions. The dosimetric parameters for organs at risk on CT/MRI fusion plans without OAR adaptation were significantly impaired whereas the target coverage was not influenced. Planning without target adaptation led to overdosing of the target volume, especially high-risk clinical target volume - D{sub 90} 88.2 vs. 83.1 (p < 0.05). Conclusions: MRI-based preplanning with consecutive CT/MRI data fusion can be safe and feasible, with an acceptable inaccuracy of soft tissue registration.

  20. 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。

  1. Os Odontoideum: Rare Cervical Lesion

    Directory of Open Access Journals (Sweden)

    Kristie A Robson

    2011-05-01

    Full Text Available We report the case of a 22-year-old Marine who presented to the emergency department, after a martial arts exercise, with transient weakness and numbness in all extremities. Computed tomography cervical spine radiographs revealed os odontoideum. Lateral flexion–extension radiographs identified atlanto-axillary instability. This abnormality is rare and can be career ending for military members who do not undergo surgical fusion. [West J Emerg Med. 2011;12(4:520–522.

  2. Pseudarthrosis of the Cervical Spine: Risk Factors, Diagnosis and Management

    Science.gov (United States)

    Leven, Dante

    2016-01-01

    Cervical myelopathy and radiculopathy are common pathologies that often improve with spinal decompression and fusion. Postoperative complications include pseudarthrosis, which can be challenging to diagnose and manage. We reviewed the literature with regard to risk factors, diagnosis, controversies, and management of cervical pseudarthrosis. PMID:27559462

  3. 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...

  4. 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

  5. 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.

  6. 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

  7. 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 ...

  8. 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 ...

  9. 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 ...

  10. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... so much different than the fusion. The ProDisc C total disc replacement from Synthes Spine is an ... intervertebral disc in the cervical spine. The ProDisc C is indicated for patients suffering from intractable symptomatic ...

  11. Incidence of secondary surgical procedures after cervical disc arthroplasty compared to fusion: a meta-analysis%颈椎人工椎间盘置换术与前路减压融合固定术再手术率的Meta分析

    Institute of Scientific and Technical Information of China (English)

    姜东杰; 顾庆国; 王占超; 王新伟; 袁文

    2015-01-01

    目的 比较颈椎人工椎间盘置换术与前路减压融合固定术治疗单节段颈椎病术后相邻节段和手术节段再手术的发生率.方法 计算机检索Pubmed、Medline、Ovid、Embase、Cochrane Library和中国生物医学文献数据库、万方、维普等数据库,英文检索词为"cervical"、"replacement OR arthroplasty OR prosthesis’,、"fusion OR arthrodesis","reoperation ORsecondary surgical procedure",中文检索词为"颈椎"、"间盘置换"、"融合"、"再手术".由2名评价者严格按照纳入及排除标准进行文献筛选,收集关于颈椎人工椎间盘置换术与前路减压融合固定术再手术发生率的前瞻性随机对照研究.根据Cochrane Reviews Handbook 5.1.0的RCT偏倚风险评价标准对纳入文献的偏倚风险进行独立评价,并采用Review Manager5.2软件进行统计分析相邻节段和手术节段的再手术发生率.结果12篇文献纳入研究,短期(2年)随机对照研究6篇,中远期(4~8.8年)随机对照研究6篇.4篇为低偏倚风险,7篇为中偏倚风险,1篇为高偏倚风险.Meta分析显示,短期随访结果 中两种术式在相邻节段的再手术发生率无明显差异,而中远期随访结果显示非融合组术后相邻节段再手术率低于融合组;非融合组手术节段再手术率均低于融合组.短期随访中两组患者采用Removal翻修方法的例数无差别;中远期随访中融合组患者采用该翻修方法进行翻修的人数多于非融合组.结论 非融合术式能在一定程度上降低相邻节段再手术的发生率,但是在短期(2年)内对降低邻近节段再手术的发生率效果并不明显.减少融合术后假关节形成是降低融合术式手术节段再手术率的有效方法.%Objective To compare the incidence of secondary surgical procedures after cervical disc arthroplasty vs anterior cervical discectomy with fusion in patients treated for symptomatic single level cervical spondylosis.Methods An online

  12. In Vivo and In Vitro Study of a Polylactide-Fiber-Reinforced β-Tricalcium Phosphate Composite Cage in an Ovine Anterior Cervical Intercorporal Fusion Model

    Directory of Open Access Journals (Sweden)

    Janek Frantzén

    2011-01-01

    Full Text Available A poly-70L/30DL-lactide (PLA70–β-tricalcium phosphate (β-TCP composite implant reinforced by continuous PLA-96L/4D-lactide (PLA96 fibers was designed for in vivo spinal fusion. The pilot study was performed with four sheep, using titanium cage implants as controls. The composite implants failed to direct bone growth as desired, whereas the bone contact and the proper integration were evident with controls 6 months after implantation. Therefore, the PLA70/β-TCP composite matrix material was further analyzed in the in vitro experiment by human and ovine adipose stem cells (hASCs and oASCs. The composites proved to be biocompatible as confirmed by live/dead assay. The proliferation rate of oASCs was higher than that of hASCs at all times during the 28 d culture period. Furthermore, the composites had only a minor osteogenic effect on oASCs, whereas the hASC osteogenesis on PLA70/β-TCP composites was evident. In conclusion, the composite implant material can be applied with hASCs for tissue engineering but not be evaluated in vivo with sheep.

  13. 人工椎体配合中药在颈椎前路减压融合术中的应用%Application of the Vertebral Body Replacement in the Intervertebral Fusion Road ahead the Close with Traditional Chinese Medicine Treatment Spinal Cord Cervical Vertebra

    Institute of Scientific and Technical Information of China (English)

    华江; 杜文喜

    2011-01-01

    [Objective] Discussion on the sick application effect of the Vertebral Body Replacement, VBR, in the intervertebral fusion road ahead the close with traditional Chinese medicine treatment spinal cord cervical vertebra. [ Method ] To 3 spinal cord cervical vertebra sickness patients undergoing ahead centrum excision, VBR intervertebral fusion, in titanium board road ahead fixed, coordinate traditional Chinese medicine treatment, revisit at least 6 months, after the technique, makes a follow-up visit the observation nerve function to restore the situation and the fusion effect.[Result] 3 example patient technique, the symptom is improved, a follow-up 6-10 months not to have the recrudescence, attain the fusion, the cervical vertebra intervertebral, the cervical vertebra stability maintains highly good, does not have the submersion, the collapse occurrence, after complete patient technique, has not seen any allergy, the repel or the toxic response. After the technique, make a follow-up visit the JOA grading to enhance from the technique previous point to the technique latterpoint, the difference has statistics significance. [Conclusion] VBR plants the bone fusion rate to be high, the security is reliable, is one kind of ideal artificial centrum substitute, the union traditional Chinese medicine may treat the spinal cord cervical vertebra sickness effectively, the promotion centrum fusion and the maintenance cervical vertebra intervertebral altitude.%[目的]探讨人工椎体(VBR)椎间融合前路内固定配合中药治疗脊髓型颈椎病的治疗效果.[方法]对3例脊髓型颈椎病患者行前路椎体切除、VBR椎间融合、钛板前路内固定,配合中药治疗,随访至少6个月,术后随访观察神经功能恢复情况及融合效果.[结果]3例患者术前症状均得到改善,随访6~10个月无复发,均获融合,优2例,良1例.颈椎椎间高度、颈椎稳定性均维持良好,无下沉、塌陷发生.JOA评分较术前明显提高(P<0

  14. 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...

  15. Clinical implications of alignment of upper and lower cervical spine

    Directory of Open Access Journals (Sweden)

    Sherekar S

    2006-01-01

    Full Text Available Aims and Objectives: The alignment of upper and lower cervical spine is presumed to be closely interrelated and the knowledge of this is mandatory when performing occipito-cervical and upper cervical fusions. The aim of this study was to establish standard values for upper and lower cervical spine alignment in the Indian population. Materials and Methods: Five hundred eighteen asymptomatic volunteers (261 males and 257 females between 12 and 80 years of age underwent lateral radiography with their neck in the neutral position. Angles for occipital to 2nd cervical (Oc-C2, 1st to 2nd cervical (C1-C2 and sagittal alignment of 2nd to 7th cervical vertebrae (C2-C7 were measured. Statistical analyses were performed using a statistical package SPSS 10 for windows and the students ′t′ test. Results: The mean Oc-C2, C1-C2 and C2--C7 angles were 14.66 + 9.5°, 25.6 + 7.9° and 16.8 + 12.7° in male, while same angles in female were 15.59 + 8.26°, 26.9 + 6.8° and 9.11 + 10.4° respectively. Weak statistically significant negative correlation was observed between the measured angles of the upper (Oc-C2 and C1-C2 and lower (C2-C7 cervical spines, which means if the lordosis of the occiput and upper cervical spine increases (if the Oc-C2 angle increases, the alignment of lower cervical spine becomes kyphotic and vice versa. This negative correlation was stronger between the Oc-C2 and C2-C7 angles than between the C1-C2 and C2-C7 angles. Conclusions: Relationship between alignment of the upper and the lower cervical spine should be taken into consideration when performing cervical fusion.

  16. Minimally invasive transforaminal lumbar interbody fusion Results of 23 consecutive cases

    Directory of Open Access Journals (Sweden)

    Amit Jhala

    2014-01-01

    Conclusion: The study demonstrates a good clinicoradiological outcome of minimally invasive TLIF. It is also superior in terms of postoperative back pain, blood loss, hospital stay, recovery time as well as medication use.

  17. Cervical Laminoplasty

    Science.gov (United States)

    ... years with excellent results and low rates of complications. Surgery can be performed quite quickly and a fusion ... the surgery is very well tolerated, and serious complications are very rare. After surgery, patients usually remain in the hospital for 2 – ...

  18. 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.

  19. Neurological Recovery after Traumatic Cervical Spinal Cord Injury Is Superior if Surgical Decompression and Instrumented Fusion Are Performed within 8 Hours versus 8 to 24 Hours after Injury: A Single Center Experience.

    Science.gov (United States)

    Jug, Marko; Kejžar, Nataša; Vesel, Miloš; Al Mawed, Said; Dobravec, Marko; Herman, Simon; Bajrović, Fajko F

    2015-09-15

    A prospective study was performed to evaluate the impact of surgical decompression (SD) and instrumented fusion within 8 h versus 8-24 h after injury on neurological recovery after cervical traumatic spinal cord injury (tSCI) in patients operated on in the UMC Ljubljana, Slovenia. Only patients with the American Spinal Injury Association (ASIA) Impairment Scale (AIS) grades of A through C and with MRI-confirmed spinal cord compression were enrolled. The primary outcome was the change in AIS grade at the 6-month follow-up. Of the 48 enrolled patients, 22 patients who underwent surgery within 8 h (group 8 h) and 20 patients who underwent surgery between 8 and 24 h (Group 8-24 h) after injury concluded the study. At admission, there was no statistically significant difference in AIS grade between the study groups. At the 6-month follow-up, an improvement of at least two AIS grades was found in 45.5% of patients in group 8 h and in 10% of patients in group 8-24 h (p=0.017). The median improvement in the ASIA motor score was 38.5 (10.0-61.0) motor points in group 8 h and 15.0 (8.8-34.0) motor points in group 8-24 h (p=0.0468). In a multivariate analysis, adjusted for the preoperative AIS grade and the degree of spinal canal compromise, the odds of an at least two-grade AIS improvement were at least 106% higher for patients in group 8 h than for patients in group 8-24 h (odds ratio=11.08, p=0.004). No statistically significant difference was found in the rate of perioperative complications, pneumonia, and the number of ventilator-dependent days or the mortality between the groups. Our results suggest that the patients with tSCI who undergo SD within 8 h after injury have superior neurological outcomes than patients who undergo SD 8-24 h after injury, without any increase in the rate of adverse effects. PMID:25658291

  20. Activ C cervical disc replacement for myelopathy

    Directory of Open Access Journals (Sweden)

    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.

  1. Modern posterior screw techniques in the pediatric cervical spine

    OpenAIRE

    Hedequist, Daniel J

    2014-01-01

    Treatment of children with cervical spine disorders requiring fusion is a challenging endeavor for a variety of reasons. The size of the patients, the corresponding abnormal bony anatomy, the inherent ligamentous laxity of children, and the relative rarity of the disorders all play a part in difficulty of treatment. The benefits of modern posterior cervical instrumentation in children, defined as rigid screw-rod systems, have been shown to be many including: improved arthrodesis rates, dimini...

  2. CT、MR、X线联合观察骨赘填充颈椎cage的短期融合率%The short-term fusion rate of osteophyte filled cervical cage evaluated by a combination of CT, MR and X-ray film

    Institute of Scientific and Technical Information of China (English)

    刘宁; 孙宇

    2010-01-01

    Objective To observe the short-term fusion rate of using osteophyte filled cage in ante-rior cervical disectomy and fusion. Methods From May 2007 to May 2009, 103 patients receiving anterior cervical disectomy, spine fusion by different surgeons were performed with cages containing exclusively au-tologous osteophyte collected from both anterior and posterior vertebral edges adjacent to the intervertebral space. There are 69 males, 34 females, from 25 to 77 years of age, average 53.6 years. 60 patients received one level fusion. 33 and 10 patients received two-level and three-level fusion respectively. Patients were re-viewed 3 months after operation and fusion was evaluated by X-ray film, reconstructive CT and MR. Results 1. Only 1.9% (2/103) of patients' X-ray films indicate non-fusion (internal fixation failure) while 31.7% (32/ 103) of patients' CT and 30.1% (31/103) of patients' MR indicate non-fusion or being confusing to make a diagnosis. 2. The diagnostic coherence between CT and MR as to evaluate fusion is good (kappa=0.686, P= 0.00). 3. The total fusion rate was 77.7%(80/103) while the highest fusion rate achieved by single surgeon was 90%(18/20). The total one level fusion rate was 80%(48/60) while the highest rate by single surgeon was 88.2%(15/17). The total two-level fusion rate was 78.6%(26/33) while the highest rate by single sur-geon was 90%(9/10). The total three-level fusion rate was 60%(60/100) while the highest rate by single surgeon was 100%(3/3). No statistic significant difference in fusion rate was found between any two of the three groups. Conclusion The method of using osteophyte filled cage can acquire ideal short-term fusion rate in one and two-level anterior cervical disectomy, fusion and plate fixation.%目的 观察单纯采用椎体骨赘填充cage行颈前路椎体间融合的短期融合率.方法 2007年5月至2009年5月,不同医生对103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

  3. 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 ...

  4. 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 ...

  5. 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

  6. 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 ...

  7. 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 ...

  8. 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 ...

  9. 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 ...

  10. Anterior Cervical Discectomy and Fusion with Plating

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    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 ...

  11. Anterior Cervical Discectomy and Fusion with Plating

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    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 ...

  12. Anterior Cervical Discectomy and Fusion with Plating

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    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 ...

  13. Anterior Cervical Discectomy and Fusion with Plating

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    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 ...

  14. 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 ...

  15. Anterior Cervical Discectomy and Fusion with Plating

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    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, ...

  16. 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 ...

  17. 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. ...

  18. 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 ...

  19. Anterior Cervical Discectomy and Fusion with Plating

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    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 ...

  20. 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 ...

  1. [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

  2. 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 ...

  3. Cervical Disc Herniation Causing Brown-Séquard's Syndrome: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Tarush Rustagi

    2011-01-01

    Full Text Available Brown-Séquard's syndrome (BSS is caused by hemisection or hemicompression of the cord leading to ipsilateral motor deficit and contralateral sensory loss. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. We describe a rare case of multilevel cervical disc herniation presenting as BSS. The condition was confirmed by MRI scan. Cervical corpectomy, decompression, and fusion gave a satisfying result. Pertinent literature has been reviewed.

  4. Bryan total disc arthroplasty: a replacement disc for cervical disc disease

    OpenAIRE

    Wenger, Markus

    2010-01-01

    Markus Wenger1, Thomas-Marc Markwalder21Neurosurgery, Klinik Beau-Site and Salem-Spital, Berne, Switzerland; 2Attending Neurosurgeon FMH, Private Practice Spine Surgery, Berne-Muri, SwitzerlandAbstract: Total disc arthroplasty is a new option in the treatment of cervical degenerative disc disease. Several types of cervical disc prostheses currently challenge the gold-standard discectomy and fusion procedures. This review describes the Bryan Cervical Disc System and presents the Bryan prosthes...

  5. 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...

  6. Hot fusion, cold fusion

    International Nuclear Information System (INIS)

    The publication of observations of nuclear fusion reactions in electrolysis experiments has led to hope that an easy way to domesticate this major source of energy had been found. In this article are recalled the classical solutions which are studied for hot fusion, the state of the art the difficulties and the perspectives, followed by the present situation concerning the experiments related to what has been called, perhaps a little too quickly, cold fusion

  7. 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)

  8. 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.

  9. Biological performance of a polycaprolactone-based scaffold used as fusion cage device in a large animal model of spinal reconstructive surgery.

    Science.gov (United States)

    Abbah, Sunny A; Lam, Christopher X L; Hutmacher, Dietmar W; Goh, James C H; Wong, Hee-Kit

    2009-10-01

    A bioactive and bioresorbable scaffold fabricated from medical grade poly (epsilon-caprolactone) and incorporating 20% beta-tricalcium phosphate (mPCL-TCP) was recently developed for bone regeneration at load bearing sites. In the present study, we aimed to evaluate bone ingrowth into mPCL-TCP in a large animal model of lumbar interbody fusion. Six pigs underwent a 2-level (L3/4; L5/6) anterior lumbar interbody fusion (ALIF) implanted with mPCL-TCP + 0.6 mg rhBMP-2 as treatment group while four other pigs implanted with autogenous bone graft served as control. Computed tomographic scanning and histology revealed complete defect bridging in all (100%) specimen from the treatment group as early as 3 months. Histological evidence of continuing bone remodeling and maturation was observed at 6 months. In the control group, only partial bridging was observed at 3 months and only 50% of segments in this group showed complete defect bridging at 6 months. Furthermore, 25% of segments in the control group showed evidence of graft fracture, resorption and pseudoarthrosis. In contrast, no evidence of graft fractures, pseudoarthrosis or foreign body reaction was observed in the treatment group. These results reveal that mPCL-TCP scaffolds could act as bone graft substitutes by providing a suitable environment for bone regeneration in a dynamic load bearing setting such as in a porcine model of interbody spine fusion. PMID:19540586

  10. Percutaneous endoscopic cervical discectomy for discogenic cervical headache due to soft disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Y.; Lee, S.H.; Shin, S.W. [Wooridul Spine Hospital, Department of Neurosurgery, Kangnam-gu (Korea); Chung, S.E.; Park, H.S. [Wooridul Spine Hospital, Department of Radiology, Kangnam-gu (Korea)

    2005-12-01

    A discogenic cervical headache is a subtype of cervicogenic headache (CEH) that arises from a degenerative cervical disc abnormality. The purpose of this study was to evaluate the clinical outcome of percutaneous endoscopic cervical discectomy (PECD) for patients with chronic cervical headache due to soft cervical disc herniation. Seventeen patients underwent PECD for intractable headache. The inclusion criteria were soft disc herniation without segmental instability, proven by both local anesthesia and provocative discography for headache unresponsive to conservative treatment. The mean follow-up period was 37.6 months. Fifteen of the 17 patients (88.2%) showed successful outcomes based on the Macnab criteria. Pain scores on a visual analog scale (VAS) improved from a preoperative mean of 8.35{+-}0.79 to 2.12{+-}1.17, postoperatively (P<0.01). The mean disc height decreased from 6.81{+-}1.08 to 5.98{+-}1.07 mm (P<0.01). There was no newly developed segmental instability or spontaneous fusion on follow-up radiography. In conclusion, PECD appears to be effective for chronic severe discogenic cervical headache under strict inclusion criteria. (orig.)

  11. Percutaneous endoscopic cervical discectomy for discogenic cervical headache due to soft disc herniation

    International Nuclear Information System (INIS)

    A discogenic cervical headache is a subtype of cervicogenic headache (CEH) that arises from a degenerative cervical disc abnormality. The purpose of this study was to evaluate the clinical outcome of percutaneous endoscopic cervical discectomy (PECD) for patients with chronic cervical headache due to soft cervical disc herniation. Seventeen patients underwent PECD for intractable headache. The inclusion criteria were soft disc herniation without segmental instability, proven by both local anesthesia and provocative discography for headache unresponsive to conservative treatment. The mean follow-up period was 37.6 months. Fifteen of the 17 patients (88.2%) showed successful outcomes based on the Macnab criteria. Pain scores on a visual analog scale (VAS) improved from a preoperative mean of 8.35±0.79 to 2.12±1.17, postoperatively (P<0.01). The mean disc height decreased from 6.81±1.08 to 5.98±1.07 mm (P<0.01). There was no newly developed segmental instability or spontaneous fusion on follow-up radiography. In conclusion, PECD appears to be effective for chronic severe discogenic cervical headache under strict inclusion criteria. (orig.)

  12. Adjacent Lumbar Disc Herniation after Lumbar Short Spinal Fusion

    Directory of Open Access Journals (Sweden)

    Koshi Ninomiya

    2014-01-01

    Full Text Available A 70-year-old outpatient presented with a chief complaint of sudden left leg motor weakness and sensory disturbance. He had undergone L4/5 posterior interbody fusion with L3–5 posterior fusions for spondylolisthesis 3 years prior, and the screws were removed 1 year later. He has been followed up for 3 years, and there had been no adjacent segment problems before this presentation. Lumbar magnetic resonance imaging (MRI showed a large L2/3 disc hernia descending to the L3/4 level. Compared to the initial MRI, this hernia occurred in an “intact” disc among multilevel severely degenerated discs. Right leg paresis and bladder dysfunction appeared a few days after admission. Microscopic lumbar disc herniotomy was performed. The right leg motor weakness improved just after the operation, but the moderate left leg motor weakness and difficulty in urination persisted.

  13. Cervical vertebral column morphology in patients with obstructive sleep apnoea assessed using lateral cephalograms and cone beam CT. A comparative study

    DEFF Research Database (Denmark)

    Sonnesen, L; Jensen, K E; Petersson, A R;

    2013-01-01

    beam CT (CBCT) in adult patients with OSA and to compare 2D lateral cephalograms with three-dimensional (3D) CBCT images. METHODS: For all 57 OSA patients, the cervical vertebral column morphology was evaluated on lateral cephalograms and CBCT images and compared according to fusion anomalies and...... combination with block fusions. The agreement between the occurrence of morphological deviations in the cervical vertebral column between lateral cephalograms and CBCT images showed good agreement (κ = 0.64). CONCLUSIONS: Prevalence and pattern in the cervical column morphology have now been confirmed on CBCT...... posterior arch deficiency. RESULTS: The CBCT assessment showed that 21.1% had fusion anomalies of the cervical column, i.e. fusion between two cervical vertebrae (10.5%), block fusions (8.8%) or occipitalization (1.8%). Posterior arch deficiency occurred in 14% as partial cleft of C1 and in 3.5% in...

  14. 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 ...

  15. 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 ...

  16. 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 ...

  17. 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 ...

  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. 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...

  20. 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...