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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The purpose of this study was to evaluate the application of the minimum clinically important difference (MCID) concept to postoperative clinical results by using a prospective cohort study in Chinese patients with cervical spondylotic myelopathy (CSM). ⋯ The threshold value of the MCID was determined by the choice of the assessment approach. In addition, the recovery rate of the mJOA score appeared to be the most valid and responsive measure of effectiveness of surgery in CSM patients.
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Mucopolysaccharidosis IVA (MPS IVA) is a multisystemic storage disorder. Patient's disability and life expectancy depends upon skeletal complications, including cervical myelopathy due to upper cervical compression or instability. Posterior decompression followed by occipitocervical fixation or C1-2 fusion are the most frequently recommended surgical interventions. The bony elements of C1 and C2 are often inadequately developed making routine screw insertion difficult. The main purpose of this work was to present novel technique of occipitocervical fixation using two C2 laminar screws. ⋯ Decompression and fusion of the upper cervical spine is a generally accepted approach to treat upper cervical spine instability and myelopathy in MPS IVA patients. The feasibility and the suitability of the technique of C0-C2 stabilization using bilateral C2 laminar screws have been presented.
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The aim of this study is to report and quantify the associated factors for morbidity and mortality following surgical management of cervical spondylotic myelopathy (CSM). ⋯ The NIS database was used to provide national estimates of morbidity and mortality following surgical management of CSM in the United States. Several comorbidities, as well as demographic and surgical parameters, were identified as associated factors.
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A high rate of complications in multilevel cervical surgery with corpectomies and anterior-only screw-and-plate stabilization is reported. A 360°-instrumentation improves construct stiffness and fusion rates, but adds the morbidity of a second approach. A novel ATS-technique (technique that used anterior transpedicular screw placement) was recently described, yet no study to date has analyzed its performance after fatigue loading. Accordingly, the authors performed an analysis of construct stiffness after fatigue testing of a cervical 2-level corpectomy model reconstructed using a novel anterior transpedicular screw-and-plate technique (ATS-group) in comparison to standard antero-posterior instrumentation (360°-group). ⋯ 360°-instrumentation resembles the biomechanical standard of reference for stabilization of 2-level corpectomies. An ATS-construct was also shown to confer high construct stiffness, significantly reducing the percentage ROM beyond that of an intact specimen after 2,000 cycles. This type of instrumentation might be a clinical valuable and biomechanically sound adjunct to multilevel anterior surgical procedures.
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The aims of this study were to translate and culturally adapt the Patient-Specific Functional Scale (PSFS) and validate the Japanese version of the PSFS (PSFS-J) in outpatients with neck pain. ⋯ The Japanese version of the PSFS is a valid, reliable, and responsive instrument to assess Japanese outpatients with neck pain.