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
-
To investigate the (1) radiographic and clinical accuracy of C1 anterior lateral mass screw (C1ALMS) and C2 anterior pedicle screw (C2APS) placement in the transoral atlantoaxial reduction plate (TARP)-III procedure, (2) screw insertion-associated clinical complications and (3) fusion status between C1 and C2. ⋯ C1ALMS placement in TARP-III procedures appears to be safe. The cortical breach rate of C2APS is high though clinically the neurovascular complication rate is similar to that of posterior atlantoaxial procedures. Advanced navigation strategies may help improve the accuracy of C2APS placement and decrease potential complications.
-
Observational Study
Dural tear and resultant cerebrospinal fluid leaks after cervical spinal trauma.
Traumatic cervical spinal cord injuries (SCIs) frequently develop dural tears and resultant cerebrospinal fluid (CSF) leaks. They are not usually identified with advanced imaging, and there are no reports on managing CSF leaks after cervical trauma. Hence, the authors evaluated the incidence of CSF leaks after cervical SCIs and described how to predict and manage CSF leaks. ⋯ The incidence of CSF leaks after traumatic cervical SCI is relatively higher than that of degenerative cervical spinal surgery. An initial poor neurological status and disruption of the ligamentum flavum on the MRI in patients were predictable factors of dural tears and CSF leaks.
-
Although direct transoral decompression and one-stage posterior instrumentation can obtain satisfactory cord decompression for the treatment of basilar invagination with atlantoaxial dislocation, surgical injuries run high as combinative anterior-posterior approaches were necessary. Furthermore, the complications will rise notably when involvement of dens and/or clivus in the decompression necessitates relatively complicated surgical techniques. First initiated in 2005, transoral atlantoaxial reduction plate (TARP) works as an internal fixation for the treatment of basilar invagination with irreducible atlantoaxial dislocation. Therefore, this article aimed to describe several operative experiences about this approach, which has delivered successful decompression, fixation and fusion. ⋯ The TARP operation and intra-operative traction could reduce the odontoid process superiorly migrating into the foramen magnum, directly ease the ventral compression of spinal cord, and fix the reduced atlantoaxial joints through a single transoral approach without the need of a posterior operation. In this stury, 21 patients were evaluated and 20 did well with TARP operation. The preliminary clinical result was satisfactory.
-
Comparative Study
Comparison of neck movement smoothness between patients with mechanical neck disorder and healthy volunteers using the spectral entropy method.
Mechanical neck disorder is one of the most common health issues. No related observations have applied spectral entropy to explore the smoothness of cervical movement. Therefore, the objectives were to ascertain whether the spectral entropy of time-series linear acceleration could extend to estimate the smoothness of cervical movement and compare the characteristics of the smoothness of cervical movement in patients with mechanical neck pain (MND) with healthy volunteers. ⋯ The spectral entropy would be suitable to discriminate the smoothness of cervical movement between patients with MND with healthy volunteers and demonstrated patients with MND had significantly less smooth cervical movement.
-
To determine the role of dynamic cervical implant (DCI) replacement for single-level degenerative cervical disc disease in Chinese patients. ⋯ DCI provided elastic dynamic stability for the targeted segment, and restored and sustained intervertebral space height and ROM of the cervical spine.