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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Randomized Controlled Trial Multicenter Study Comparative Study
A RCT comparing 7-year clinical outcomes of one level symptomatic cervical disc disease (SCDD) following ProDisc-C total disc arthroplasty (TDA) versus anterior cervical discectomy and fusion (ACDF).
The objective of this trial was to compare the safety and efficacy of TDA using the ProDisc-C implant to ACDF in patients with single-level SCDD between C3 and C7. ⋯ The ProDisc-C implant appears to be safe and effective for the treatment of SCDD. Patients with the implant retained motion at the involved segment and had a lower reoperation rate than those with an ACDF.
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To investigate the prevalence of axial symptoms (AS) in patients following posterior cervical decompression. ⋯ Posterior cervical surgery carries a high risk of postoperative AS. Postoperative AS may be reduced through preserving posterior muscles and structures, stabilizing cervical vertebrae, and reducing external cervical immobilization time.
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Review Case Reports
Esophageal perforation after anterior cervical surgery: a review of the literature for over half a century with a demonstrative case and a proposed novel algorithm.
To review relevant data for the management of esophageal perforation after anterior cervical surgery. ⋯ Following anterior cervical surgery, patients should be closely followed up in the postoperative period for risk of esophageal perforation. Development of symptoms like dysphagia, pneumonia, fever, odynophagia, hoarseness, weight loss, and breathing difficulty in patients with a history of previous anterior cervical surgery should alert us for a possible esophageal injury. Review of the literature revealed that conservative treatment is advocated for early and small esophageal perforations. Surgical treatment may be considered for large esophageal defects.
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Multicenter Study
Cervical cages placed bilaterally in the facet joints from a posterior approach significantly increase foraminal area.
Foraminal stenosis is a common cause of cervical radiculopathy. Posterior cervical cages can indirectly increase foraminal area and decompress the nerve root. The aim of this study was to assess the influence of bilateral posterior cervical cages on the surface area and shape of the neural foramen. ⋯ Implantation of bilateral posterior cervical cages can increase foraminal area and may indirectly decompress the nerve roots. Correlation between increase in foraminal area and clinical outcomes needs further investigation.
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The cervical spine has a linear chain of correlation or reciprocal relationship regionally (within the cervical spine) and globally (head to whole spine). The purpose of this study was to assess the sequential alignment change of the regional and global cervical spine after two-level anterior cervical discectomy and fusion (ACDF) performed on the lower cervical spine. ⋯ The ACDF procedure itself can induce regional slope change (C5-s and C7-s) directly at the surgical level and can also influence upper cervical slope change (C1-s and C2s) indirectly. Then the change in the upper cervical spine can induce a change in the St-CVA and spino-cranial angle (SCA).