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 develop and assess the reliability of new nomenclature system that systematically organizes osteotomy techniques and briefly describes the surgical approach, the surgical sequence, and the fixation technique for cervical spine deformity (CSD). ⋯ This study introduces the SOF system of the CSD surgery to understand the surgical sequence, the type of osteotomy and the fixation techniques. The investigation of the inter- and intra-observer agreement revealed 'excellent agreement' for both anterior and posterior osteotomies. Thus, SOF system can provide a consistent description of the various CSD surgeries and its use will provide a common frame for CSD surgery and help communicate between surgeons.
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Odontoid process fractures can extend rostral into the C2 arch. We investigated the clinical impact of a concurrent fracture of the pars interarticularis on odontoid failure. To overcome the surgical challenges related to the morphology of these fractures, we describe a novel surgical strategy using atlantoaxial joint distraction arthrodesis. ⋯ Odontoid fracture with extension into the pars interarticularis often present with atlantoaxial instability and may result in stable fibrous non-union if treated non-operatively. The C1-C2 segment can be stabilised with atlantoaxial distraction arthrodesis achieved through an osteotomy of the pars interarticularis.
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The Sonic Hedgehog (Shh) pathway has been associated with a protective role after injury to the central nervous system (CNS). We, therefore, investigated the effects of intrathecal Shh-administration in the subacute phase after thoracic spinal cord injury (SCI) on secondary injury processes in rats. ⋯ Intrathecal Shh-administration showed neuroprotective effects with attenuated neuroinflammation, reduced astrogliosis and improved functional recovery six weeks after severe contusion/compression SCI.