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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In unique clinical situations where C1-C2 anterior transarticular screw (ATS) fixation is not available or has failed, an anterior transarticular crossing screw (ATCS) with transcorporal pathway of the screws inside the contralateral promontory of C2 may enhance the stabilization and achieve atlantoaxial arthrodesis. The present study was to describe a novel technique of ATCS fixation for atlantoaxial joint instability and its applied anatomy, and compared it with ATS fixation method. ⋯ Anterior transarticular crossing screw is a feasible and viable option for atlantoaxial fixation in selected cases. This technique achieved remarkable longer screw purchase and could enhance the atlantoaxial stability.
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The purpose of this study was to anatomically measure the width of the cervical nerve root and spinal cord segment in addition to clarifying the anatomical characteristics of the cervical nerve root. ⋯ We anatomically measured the width of cervical nerve roots and spinal segments. The spinal segment of C8 was significantly narrower than some of the roots located in the middle of the cervical spine, and this characteristic continued to the entry of the root in the vertebral foramen, although the difference disappeared at the maximum width point of the root.
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Cervicocephalic kinesthetic deficiencies have been demonstrated in patients with chronic neck pain (NP). On the other hand, authors emphasized the use of different motion speeds for assessing functional impairment of the cervical spine. ⋯ The assessment of proprioceptive performance in healthy and NP subjects allowed the validation of the HRT. The HRT is a simple, not expensive and fast test, easily implementable in daily practice to assess and monitor treatment and evolution of proprioceptive cervical deficits.
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Biomechanical investigation. ⋯ The supplemental dorsal instrumentation provided significantly more stability than the anterior-only instrumentation regardless of the number of levels resected and the direction of motion. After cyclic loading, the absolute differences in stability between the two instrumentations remained significant while both instrumentations showed a comparable increase of ROM after cyclic loading. The large difference in the absolute ROM of anterior-only compared to circumferential instrumentations supports a dorsal support in case of three-level approaches.
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Although advances have been made in surgical technique and intraoperative monitoring, the rate of postoperative C5 palsy remains the same. We attempt to define characteristics which may predict risk of developing postoperative C5 palsy. ⋯ Patients undergoing cervical decompression remain at risk for C5 root palsy despite use of monitoring. Given that all patients experienced delayed onset of C5 palsy, MEP, SSEP, and EMG may not be sensitive enough to assess the risk of developing C5 palsy.