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 compare the clinical features of patients with sacroiliac joint (SIJ)-related sciatica-like symptoms to those with sciatica from nerve root compression and to investigate the necessity to perform radiological imaging in patients with sciatica-like symptoms derived from the SIJ. ⋯ Sciatica-like symptoms derived from the SIJ can clinically mimic a radiculopathy. We suggest to perform a thorough physical examination of the spine, SI joints, and hips with additional radiological tests to exclude other causes.
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Magnetic resonance images (MRI) fluid sign and intravertebral vacuum phenomenon of the plain radiograph are considered as the characteristic radiological findings for vertebral osteonecrosis after spinal fractures. We aim to study the association between the radiological and histopathologic findings of vertebral osteonecrosis through the use of an open retrieval of specimens. ⋯ MRI fluid sign is more predictable to diagnose vertebral osteonecrosis in operative case, especially within the initial 5 months after injury.
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Clinical Trial
Abduction extension cervical nerve root stress test: anatomical basis and clinical relevance.
While the Lasègue straight leg raising test is an established test for lumbar nerve root compression, an established equivalent for cervical nerve root compression is missing. The aim of this bi-modal study was to find the most effective way to stretch the cervical nerve roots anatomically in cadavers and to assess its value in the clinical setting. ⋯ The described abduction extension test with posterior push on the humeral head creates a fulcrum over which the brachial plexus can be displaced to create stress on cervical nerve roots. This simple test is easy to perform clinically and aggravates radicular symptoms in most of the patients with cervical nerve root compression while it is negative in nearly all of the controls.
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To investigate the long-term impacts of different posterior operations on curvature, neurological improvement and axial symptoms for multilevel cervical degenerative myelopathy (CDM), and to study the relationship among loss of cervical lordosis, recovery rate and axial symptom severity. ⋯ Excellent neurological improvement was obtained by LP and LCS for patients with multilevel CDM, while loss of CI in groups LP and LC caused a high incidence of axial symptoms. Loss of CI was correlated with poor neurological recovery and axial symptom severity. Lateral mass screw fixation can effectively prevent loss of postoperative cervical curvature and reduce incidence of axial symptoms.
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The aim of this study was to analyze the correlation between cervical range of motion and cervical pedicle screw (CPS) misplacement in cervical posterior spinal fusion surgery using a CT-based navigation system. ⋯ The precision of CPS placement in CT-based navigation surgery was evaluated. The misplacement rate in single-time multilevel registration increased to 23.4 % compared to 6.2 % for separate registration. As the distance increased between the registered level and the level of CPS insertion, the preoperative cervical ROM and the rate of CPS misplacement significantly increased. Thus, the rate of misplacement of CPSs is reduced when performing separate registration. Furthermore, when there is greater preoperative cervical ROM, separate registration would likely improve the safety and accuracy of CPS insertion.