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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Randomized Controlled Trial
Cervical spondylotic myelopathy: conservative versus surgical treatment after 10 years.
It is not known whether the results of decompressive surgery to treat the mild and moderate forms of spondylotic cervical myelopathy (CSM) are any better than those of a conservative approach. A 10-year prospective randomised study was performed. The objective of the study was to compare conservative and operative treatments of mild and moderate, non-progressive, or slowly progressive, forms of CSM. ⋯ In both groups, patients get better and worse. According to the power analysis it is necessary admit that these results possess the low ability to answer definitely the question which treatment is better for the patients with a mild and moderate non-progressive CSM because of the low number of patients for the final evaluation and for clinically negligible differences between two compared arms. These findings can serve as a worthy odds-on hypothesis which needs the confirmation.
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This study reviews the presentation, etiology, imaging characteristics and reasons for missed diagnosis of Andersson lesion (AL) and analyzes the surgical results of short segment fixation in the thoracolumbar region. This is a retrospective single center study. Fourteen patients (15 lesions) who were operated for AL were analyzed. ⋯ No major complications occurred. There is a lack of awareness of AL leading to misdiagnosis. Definite clinico-radiological features do exist in AL and short segment fixation is effective.
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The occipital condyle (OC) is an important area in craniovertebral surgery, but neither its anatomical features nor the procedures concerning the OC have been detailed yet. The morphological analysis of the structures were made in totally 704 sides of the occipital bones of adult skulls by 3D-Doctor Demo version. The length and width of the OC were found to be 23.9 ± 3.4 (right), 24 ± 3.3 (left) and 11.9 ± 2.3 (right), 10.7 ± 2.3 mm (left), respectively. ⋯ In Pearson correlation analysis, it was significant that a statistically strong relation was noticed between the length and area, and the circumference and area. The findings suggest that the oval type was more successful to work with, while the triangular, circular and two-portioned types were highly risky for the fixation resonance as the surface got quite smaller. As a result, we suggest that by resecting nearly half of the OC, the border of the hypoglossal canal can be involved.
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Single-stage posterior corpectomy for the management of spinal tumors has been well described. Anterior column reconstruction has been accomplished using polymethylmethacrylate (PMMA) or expandable cages (EC). The aim of this retrospective study was to compare PMMA versus ECs in anterior vertebral column reconstruction after posterior corpectomy for tumors in the lumbar and thoracolumbar spine. ⋯ Seven patients had complications that led to reoperation (5 infections). PMMA or ECs are viable options for reconstruction of the anterior vertebral column following tumor resection and corpectomy. Both approaches allow for correction of the kyphotic deformity, and stabilization of the anterior vertebral column with similar functional and performance status outcomes in the lumbar and thoracolumbar area.