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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Systematic review. ⋯ There is some evidence to suggest that MED performed by surgeons skilled in the technique in tertiary referral centres is as effective as OD.
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Randomized Controlled Trial
Ultrasound-guided versus computed tomography-controlled periradicular injections in the middle and lower cervical spine: a prospective randomized clinical trial.
We conducted this study to evaluate accuracy, time saving, radiation doses, safety, and pain relief of ultrasound (US)-guided periradicular injections versus computed tomography (CT)-controlled interventions in the cervical spine in a prospective randomized clinical trial. ⋯ US-guided periradicular injections are accurate, result in a significant reduction of procedure expenditure under the avoidance of radiation and show the same therapeutic effect as CT-guided periradicular injections.
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Retro-odontoid pseudotumor, not related to inflammatory or traumatic conditions, is an uncommon pathology. Atlanto-axial instability has been advocated to explain the pathophysiology of retro-odontoid pseudotumor's formation and growth. Despite pseudotumor direct removal through transoral or lateral approach represented the main surgical strategy for a long time, in the last decade several authors highlighted the possibility to treat retro-odontoid pseudotumor by occipito-cervical or C1-C2 fixation without removal of the intracanalar tissue. The goal of this study is to analyze the data collected in a series of patients suffering from cervical myelopathy due to non-inflammatory, degenerative retro-odontoid pannus and treated by posterior C1-C2 fixation. The relevant literature is also reviewed. ⋯ Although the etiopathogenesis of non-inflammatory, i.e., degenerative, retro-odontoid pseudotumor is still controversial, our series (the second largest on degenerative retro-odontoid pannus in the literature) confirms that a posterior approach may be sufficient and transoral surgery is not required.
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To investigate which pre- and postoperative radiographic parameters are significantly correlated with the immediate postoperative coronal balance (CB) in Lenke 5C AIS patients, and to identify any radiographic parameter that is correlated with the ultimate CB at a minimum follow-up of 2 years. ⋯ In Lenke 5C patients, preoperative UIV translation and LIV tilt are two important parameters that can predict the immediate postoperative CB. During the postoperative follow-up, UIV tilt may play a very important role in compensating for postoperative coronal imbalance.
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Gait impairment in cervical spondylotic myelopathy (CSM) is characterised by a number of kinematic and kinetic abnormalities. Surface electromyography (EMG) can evaluate the contributions of individual muscles to a movement pattern and provide insight into the underlying impairments that characterise an abnormal gait. This study aimed to analyse EMG signals from major lower limb muscles in people with CSM and healthy controls during gait. ⋯ The results provide evidence for paresis as a contributory factor to gait impairment in CSM, indicated by impaired amplitude and the need for proximal co-activation to compensate for lack of distal power generation. Poor proprioception may have contributed to prolonged activation of tibialis anterior. Analysis of muscle responses to lengthening suggested that spasticity was not an important contributor. These findings have implications for the assessment and rehabilitation of gait impairment in CSM.