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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To evaluate and compare early radiographic and clinical outcomes of lower cervical and upper thoracic three-column osteotomies (3CO) for cervicothoracic kyphosis correction. ⋯ Three-column posterior osteotomies at the cervicothoracic junction restored regional sagittal alignment and improved quality of life in this series of patients with rigid cervicothoracic deformity, albeit with high complication rates. Lower cervical osteotomies provided greater cervical SVA correction and were shorter operations, although they were associated with more complications and longer hospital and ICU stays compared to upper thoracic osteotomies.
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When a deformity involves more than one area of the spine, it becomes a multifocal deformity; such a deformity could either be extending on two adjacent segments, or be two separated deformities on two non-adjacent segments. ⋯ All these questions about the management of multifocal deformities will be discussed and answered with technical details and concrete examples of the different situations that may be encountered.
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Comparative Study
The application of zero-profile anchored spacer in anterior cervical discectomy and fusion.
We aimed to analyze the clinical efficacy of the zero-profile anchored spacers in the treatment of one-level or two-level cervical degenerative disc disease. ⋯ The zero-profile anchored spacer achieved similar clinical outcomes compared to ACDF with anterior plating for the treatment of the cervical degenerative disc disease. However, zero-profile anchored spacer was associated with a lower risk of postoperative dysphagia, shorter operation time, less blood loss, and relatively greater simplicity than the stand-alone cage with a titanium plate.
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Evaluation of effectiveness of internal rigid fixation for occipito-cervical fusion with occipital hooks and cervical screws and/or hooks to improve fusion in young or small children with various bone dysplasia or congenital abnormality. ⋯ Instrumentation was technically feasible even in a very young child. Rigid internal fixation in the little children did not increase surgical complications and significantly increased the union rate of occipito-cervical arthrodesis.
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Spinal intramedullary arteriovenous malformations are uncommon and a challenging type of neurosurgical entities. They are rarely located to cervical segment. On the other hand, although hemangiomas are relatively common bone tumors, cervical involvement is again rare and clinically significant ones are infrequent. ⋯ A rare case of multiple pathologies affecting the cervical spine, coincidentally diagnosed after a pathological fracture during a bicycle accident as vertebral hemangioma and intradural-intramedullary AVM that was successfully treated with early detection, have been presented. One should assess such patients under multidisciplinary fashion and treat on a case-by-case basis for achieving the best results in patient care.