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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Construct subsidence is a relatively common complication following anterior cervical fusion. Its occurrence has been revealed to be closely related to endplate-implant contact interface. But current literature focusing on the anatomy of cervical endplate is very scarce. The purpose of this morphometric study was to analyse the sagittal geometry, especially the concavity and slope, of vertebral endplates from C3 to C7 by employing data from CT scans. ⋯ Superior endplate is more flat than its inferior counterpart in middle and lower cervical spine, and the concavity apex is always located in the posterior half of the endplate. Endplate slope is correlated with cervical curvature, greater slope implying more significant lordosis. These sagittal endplate geometrical parameters should be taken into consideration when investigating implant subsidence following anterior cervical fusion.
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To provide radiographic parameters for optimal placement of posterior second sacral alar iliac (S2AI) screw for instrumentation and fusion of scoliosis to the second sacral level in a Chinese population. ⋯ The feasibility to insert S2AI screws to the sacrum and ilium in an Asian population along with the ideal entry angle and length of trajectory were identified for clinical practice.
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Anterior foraminotomy (AF) is a surgical treatment for unilateral cervical radiculopathy that avoids fusion-related complications, but its long-term outcome has yet to be investigated. To clarify the efficacy of AF, the author retrospectively collected long-term data regarding the results of this technique. ⋯ In this retrospective study, patients who underwent AF for one- or two- level cervical radiculopathy showed a good long-term outcome with minimal adjacent segment degeneration. However, more data should be collected to clarify possible associations with these findings, such as delayed shoulder problems and aggravation of degeneration at the operated level.
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Previous studies have reported that the alignments of the occipital-cervical and subaxial spine were closely interrelated in asymptomatic individuals; however, none have focused on a population with atlantoaxial dislocation. ⋯ Anterior dislocations of the atlas are associated with diminished lordosis or even kyphosis of the occipital-cervical junction, and result in compensatory hyperlordosis of the subaxial cervical spine, collectively presenting as a "swan neck" deformity. Atlantoaxial dislocation may influence the global cervical alignment.
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To develop a clinically relevant anterior cervical approach (ACA) to the C2-3 level. ⋯ The C2-3 level can be exposed through the space between the HyN and the ISLN by retracting the LiA superiorly, the SLA inferiorly, the HyB medially, and the carotid sheath laterally.