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
-
A fabricated mesh cage and/or posterior occipitocervical instrumentation alone has been used for reconstruction of ventral defect of the upper cervical spine. However, using a trimmed mesh cage it was hard to achieve optimal clival screw purchase and it migrated or broke. A specific instrumentation at the craniovertebral junction (CVJ) should incorporate the morphology of the CVJ and biomechanical validation. The purpose of the present study was to develop an innovative clivus plate integrated with the clinical anatomy of CVJ and to evaluate the stability of the clivus plate fixation (CPF), stand-alone or combined with a posterior occipitocervical fixation (POCF). ⋯ This study demonstrated screw purchase in the adult clivus and developed an innovative clivus plate fixation for reconstructing an extensive ventral defect in the upper cervical spine. The clivus plate fixation combined a posterior instrumentation ensuring reliable upper cervical stability.
-
Observational Study
Cervical canal stenosis and adjacent segment degeneration after anterior cervical arthrodesis.
Adjacent segment degeneration (ASD) is known to occur after anterior cervical arthrodesis. However, it is not known whether cervical canal stenosis enhances the risk of ASD. The purpose of this study was to explore whether congenital stenosis could be used as a predictor of ASD after anterior cervical decompression and fusion (ACDF). ⋯ Congenital stenosis can increase the rate of radiographic ASD after initial ACDF. The cutoff value of 13.0 mm for preoperative AP diameter of cervical canal had the highest validity for predicting radiographic ASD.
-
The aim of this research was to evaluate the long-term results of extensive laminectomy for the treatment of cervical spondylotic myelopathy due to multilevel cervical stenosis (MCS) with ligamentum flavum hypertrophy (LFH). ⋯ A series of clinical results were obtained after the extensive laminectomy for a long-term follow-up period exceeding 10 years. The extensive laminectomy may be an option for an alternative procedure for treatment of MCS with LFH.
-
Aberrant expression of miRNAs has been demonstrated to contribute to human carcinogenesis. This study was aimed at profiling differentially expressed miRNAs in formalin-fixed and paraffin-embedded tissues of spinal chordoma and testing the potential for using altered expression of miRNAs as prognostic markers for spinal chordoma patients. ⋯ The data from the current study identified a total of 29 differentially expressed miRNAs in chordoma tissues and reduced miR-1237-3p expression was associated with chordoma invasion and worse recurrence-free survival of the patients.
-
To investigate whether depression symptomatology is associated with low back pain (LBP) in twins aged 70+ and whether this effect depends on a person's physical activity (PA) status. ⋯ High depression symptomatology predicted incident LBP. This effect is supposedly not attributable to genetic or shared environmental factors. Physical activity did not moderate the effect of depression symptomatology on LBP.