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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Meta Analysis
Comparing two surgical approaches for treating multilevel cervical spondylotic myelopathy: A meta-analysis.
This meta-analysis aims to evaluate the therapeutic efficacy of anterior versus posterior surgical approaches for multisegment cervical spondylotic myelopathy (MCSM). ⋯ Bleeding was also less with the anterior surgical approach. The posterior approach provided a significantly higher range of motion of the cervical spine and showed fewer postoperative complications compared with the anterior approach. While both the surgical approaches have good clinical outcomes and show postoperative neurological function improvement, the meta-analysis shows that both anterior and posterior approaches have certain merits and shortcomings. A meta-analysis of a larger number of randomized controlled trials with longer follow-up can conclusively determine which of the surgical approaches is more beneficial in the treatment of MCSM.
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Previous reports on the outcome of conservative treatment for dropped head syndrome (DHS) are scarce. The purpose of this study was to elucidate the efficacy of conservative treatment for DHS and to identify possible predictive factors relating to the outcome. ⋯ The present study indicated that conservative treatment was successful in 22% of DHS patients, with improvement in their cervical kyphotic alignment. Shorter duration of disease, relatively smaller cervical kyphosis without anterior slippage of the vertebra, reducibility, and abundant compensation at the upper thoracic region were good indications for the success of conservative treatment.
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An ambispective review of consecutive cervical spine surgery patients enrolled in the Canadian Spine Outcomes and Research Network (CSORN) between January 2015 and September 2019. ⋯ Following degenerative cervical spine surgery, the older and younger age groups had significantly different complication rates at peri-operative time points, and the intra-operative and 3-month post-operative complication rates were similar in the groups.
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Multicenter Study
Trends in cervical laminoplasty and 30-day postoperative complications: 10-year results from a retrospective, multi-institutional study of 1095 patients.
This study aimed to investigate the recent 10-year trends in cervical laminoplasty and 30-day postoperative complications. ⋯ From 2008 to 2017, there were trends toward increasing age at surgery and surgeons' preference for refined open-door laminoplasty. The 30-day complication rate remained stable, but the C5 palsy rate halved.
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Multicenter Study
Relationship between pelvic incidence-adjusted relative spinopelvic parameters, global sagittal alignment and lower extremity compensations.
In response to sagittal malalignment, compensatory spinal and lower extremity mechanisms are recruited. Thoracolumbar realignment surgery has been shown to yield reciprocal changes in these compensations. Thus, whole-body radiographic assessment has come to the fore. This study aimed to evaluate the relationship between spinopelvic parameters and lower extremity compensation angles and to examine their coupled change with deformity correction. ⋯ PI-adjusted relative spinopelvic parameters significantly correlated with measurements of the lower extremity compensation. Postoperative changes in RPV, RLL and RSA reflected changes in FOA, KFA and GSA. These measurements may serve as a valuable proxy for surgical planning when whole-body imaging is not available.