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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Congenital cervical stenosis (CCS) occurs when the bony anatomy of the cervical canal is smaller than expected in the general population predisposing an individual to symptomatic neural compression. No studies have defined CCS based on the normal population. The diagnosis is currently made based on clinical impression from radiographic studies. The aim of this study is to establish parameters that are associated with CCS, based on anatomic measurements on a large sample of skeletal specimens. ⋯ Based on our study of a large population of adult skeletal specimens, we have defined CCS at each level. Values of SCD < 13 mm and IPD < 23 mm are strongly associated with the presence of CCS at all levels.
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The purpose is to study rates, trends, geographic variations and outcome of lumbar spine surgery in the Belgian population during the last decade. ⋯ Regional variations highlight professional uncertainty and controversy. The study results point to the need for peer comparisons and surgeon feedback.
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Granulocyte colony-stimulating factor (G-CSF) is a cytokine that is clinically used to treat neutropenia. G-CSF also has non-hematopoietic functions and could potentially be used to treat neuronal injury. To confirm the safety and feasibility of G-CSF administration for acute spinal cord injury (SCI), we have initiated a phase I/IIa clinical trial of neuroprotective therapy using G-CSF. ⋯ These results indicate that intravenous administration of G-CSF (10 μg/kg/day) for 5 days is essentially safe, and suggest that some neurological recovery may occur in most patients. We suggest that G-CSF administration could be therapeutic for patients with acute SCI.
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Cervical spondylotic myelopathy is a multifactorial disease that is directly correlated by the degree of spinal stenosis. Surgery remains the best therapy. A posterior approach is often recommended in patients with multilevel dorsal cervical compression. Aim of the present experimental study was to evaluate the feasibility of a full-endoscopic arcocristectomy in a cadaver study. ⋯ The full-endoscopic arcrocristectomy is feasible and achieves a sufficient decompression. This minimal invasive technique protects most of the dorsal structures and therefore probably preserves biomechanical functions, which has to be proven in future studies.
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Comparative Study
Comparative analysis of complications of different reconstructive techniques following anterior decompression for multilevel cervical spondylotic myelopathy.
Anterior approach was extensively used in surgical treatment of multilevel cervical spondylotic myelopathy. Following anterior decompression, many different reconstructive techniques (multilevel ACDF, hybrid construct and long corpectomy) all had satisfied outcomes. However, there are few studies focusing on the comparison of these three reconstructed techniques. The aim of this retrospective study was to analyze the complications of these three different methods. ⋯ Most of the complications of the three reconstructive techniques subsided gradually after conservative treatment; none of them needed revision surgery. The multilevel ACDF approach has the lowest rate of non-union, but a slightly higher morbidity of the laryngeal nerve-related complication if proximal segments were involved. The long corpectomy approach should be selected prudently because of the high rate of complication.