Journal of neurosurgery. Spine
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Axial neck pain after C3-6 laminoplasty has been reported to be significantly lesser than that after C3-7 laminoplasty because of the preservation of the C-7 spinous process and the attachment of nuchal muscles such as the trapezius and rhomboideus minor, which are connected to the scapula. The C-6 spinous process is the second longest spinous process after that of C-7, and it serves as an attachment point for these muscles. The effect of preserving the C-6 spinous process and its muscular attachment, in addition to preservation of the C-7 spinous process, on the prevention of axial neck pain is not well understood. The purpose of the current study was to clarify whether preservation of the paraspinal muscles of the C-6 spinous process reduces postoperative axial neck pain compared to that after using nonpreservation techniques. ⋯ The C-6 paraspinal muscle preservation technique was not superior to the C6-nonpreservation technique for preventing postoperative axial neck pain.
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Review Meta Analysis
Biomechanical analysis of screw constructs for atlantoaxial fixation in cadavers: a systematic review and meta-analysis.
The unique and complex biomechanics of the atlantoaxial junction make the treatment of C1-2 instability a challenge. Several screw-based constructs have been developed for atlantoaxial fixation. The biomechanical properties of these constructs have been assessed in numerous cadaver studies. The purpose of this study was to systematically review the literature on the biomechanical stability achieved using various C1-2 screw constructs and to perform a meta-analysis of the available data. ⋯ Meta-analysis of the existing literature showed that all constructs provided significant stabilization in all axes of rotation, except for the C1LM-C2TL construct in lateral bending. There were significant differences in stabilization achieved in each axis of motion by the various screw constructs. These results underline the various strengths and weaknesses in biomechanical stabilization of different screw constructs. There was significant heterogeneity in the data reported across the studies. Standardized spinal motion segment configuration and injury models may provide more consistent and reliable results.
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The authors investigated quality of life (QOL) outcomes after primary versus revision discectomy. ⋯ QOL, pain and disability, and psychosocial outcomes improved after primary and revision discectomy, but the improvement diminished after revision discectomy.