European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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C3-6 laminoplasty preserving muscle insertions into the C7 spinous process is reportedly associated with a significantly decreased frequency of postoperative axial neck pain. However, no prospective study has reported medium-term outcomes of C3-6 laminoplasty. The purpose of this study was to elucidate medium-term outcomes after C3-6 laminoplasty. ⋯ At final follow-up, sagittal alignment of the cervical spine was more lordotic than before surgery. Medium-term outcomes of C3-6 laminoplasty were satisfactory. Frequencies of persistent axial neck pain and loss of cervical lordosis after surgery remained significantly decreased for ≥5 years postoperatively.
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Comparative Study
Computer tomography assessment of pedicle screw placement in lumbar and sacral spine: comparison between free-hand and O-arm based navigation techniques.
Transpedicular screw fixation has been accepted worldwide since Harrington et al. first placed pedicle screws through the isthmus. In vivo and in vitro studies indicated that pedicle screw insertion accuracy could be significantly improved with image-assisted systems compared with conventional approaches. The O-arm is a new generation intraoperative imaging system designed without compromise to address the needs of a modern OR like no other system currently available. ⋯ Screw implantation was performed during PLIF or TLIF mainly for spondylolisthesis, osteochondritis and post-laminectomy syndrome. The accuracy rate in our work was 94.1% in the free-hand group compared to 99% in the O-arm navigated group. Thus it was concluded that free-hand technique will only be safe and accurate when it is in the hands of an experienced surgeon and the accuracy of screw placement with O-arm can reach 100%.
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With minimally invasive technique becoming more popular, endoscopic operations such as arthroscopy or laparoscopy have become the standard of care in several other areas. In this study, we evaluated the 5-year follow-up outcomes of anterior cervical (Ahn et al. in Photomed Laser Surg 23:362-368, 2005) discectomy and interbody fusion (ACDF) performed via endoscopic approach. Sixty-seven patients who underwent anterior cervical discectomy and cage fusion performed using endoscopic technique were followed for at least 5 years. ⋯ It indicated endoscopic technique for ACDF can obtain satisfactory results in patients with cervical disc herniation, cervical myelopathy, or radiculopathy. Compared with a traditional approach, this technique may be associated with less morbidity while improving cosmesis and postoperative recovery. Prospective randomized control trials are needed to directly compare these two procedures.
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The present study was performed to determine the optimal entry points and trajectories for cervical pedicle screw insertion into C3-7. The study involved 40 patients (M:F = 20:20) with various cervical diseases. A surgical simulation program was used to construct three-dimensional spine models from cervical spine axial CT images. ⋯ The entry points for each vertebra should be adjusted according to the transverse angles of pedicles. The mean sagittal angles were 7° upward at C3, and parallel to the upper end plate at C4-7. The simulation study showed that the entry point and ideal pedicle trajectory led to screw placements that were safer than those used in other studies.
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The Neck Pain and Disability Scale (NPAD) is a 20-item instrument to measure neck pain and related disability. The aim of this study was to assess sensitivity to change of the NPAD. A total of 411 participants from 15 general practices in the middle of Germany completed a multidimensional questionnaire including the German version of the NPAD and self-reported demographic and clinical information. ⋯ Change in depression, anxiety, and social support scale between baseline and follow-up was significantly correlated with change in the NPAD score. Hence, these data are in the direction anticipated across all baseline factors investigated. In conclusion, the NPAD seems to be a sensitive measure for use in clinical practice and future studies of neck pain and related disability.