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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This article aims at presenting a scale that, through the analysis of MRI images, clearly charts the various degenerative stages of the cervical spine and establishes its biological age. We have created this scale by summing together various scores linked to a selection of parameters according to which MRI images are analyzed. ⋯ The effectiveness of the various treatments for cervical spine degenerative disorders is influenced by the overall anatomical conditions of the cervical spine. Up until now there has been no objective criterion for the evaluation of these anatomical conditions. We believe that this scale will be a useful tool to homogenize retrospective studies and to correctly set up prospective studies on the degenerative conditions of the cervical spine and relative treatments.
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Observational Study
Does lumbar spinal stenosis increase the risk of spondylotic cervical spinal cord compression?
The aim of this prospective cross-sectional observational comparative study was to determine the prevalence of spondylotic cervical cord compression (SCCC) and symptomatic cervical spondylotic myelopathy (CSM) in patients with symptomatic lumbar spinal stenosis (LSS) in comparison with a general population sample and to seek to identify predictors for the development of CSM. ⋯ The presence of symptomatic LSS increases the risk of SCCC; the prevalence of SCCC is higher in patients with symptomatic LSS in comparison with the general population, with an evident predominance of more serious types of MRI-detected compression and a clinically symptomatic form (CSM). Symptomatic CSM is more likely in LSS patients with higher disability as assessed by the Oswestry Disability Index.
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To determine and compare the biomechanical effects of single- and two-level anterior cervical decompression and fusion (ACDF) on the re-distribution of the segmental contribution to total cervical range of motion (ROM) in a prospective longitudinal design. ⋯ Single-level ACDF maintains and restores a more physiological re-distribution of segmental contribution of ROM compared with two-level ACDF, which required longer time to achieve stable FSU immobilization and coupled with significantly increased superior segment contribution.
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The association between intramedullary increased signal intensity (ISI) on T2-weighted magnetic resonance imaging and surgical outcome in cervical spondylotic myelopathy (CSM) remains controversial. The purpose of this study is to assess the impact of quantitative signal change ratio (SCR) on the surgical outcome for CSM. ⋯ Preoperative SCR significantly reflected the surgical outcome in patients with CSM. Patients with SCR greater than or equal to 1.46 can experience poor recovery after surgery.
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The purpose of this study was to clarify the characteristics of adult cases with instability due to upper cervical spine anomalies who needed fusion surgery regarding the clinical and radiological findings. ⋯ In adult cases with instability due to upper cervical spine anomalies, we acquired favorable clinical outcomes after surgery. Regarding the neurological severity before surgery, there was no relationship with the IHSI on T2-weighted MR image. Moreover, the regression or disappearance of IHSI after surgery was not frequently demonstrated.