The spine journal : official journal of the North American Spine Society
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Atlantoaxial anterior transarticular screw fixation: a case series and reappraisal of the technique.
Atlantoaxial instability is commonly treated with C1-C2 fixation performed via posterior approaches. Although anterior transarticular screw (ATS) fixation, performed with a classic retropharyngeal approach, was described more than 10 years ago, the published literature still lacks a comprehensive analysis of the procedure and a real case series. ⋯ Although the procedure is still not widely known, ATS allows the effective and safe treatment of C1-C2 instability even in patients with systemic comorbidities. It offers several advantages over posterior approaches.
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Observational Study
Indirect effects of decompression surgery on glycemic homeostasis in patients with type 2 diabetes mellitus and lumbar spinal stenosis.
Lumbar spinal stenosis (LSS) patients with diabetes mellitus (DM) are presumed to experience difficulty when performing regular daily exercise, although such exercise is of paramount importance for glucose homeostasis and control. Therefore, decompression surgery, which can help patients perform regular physical activity, would have indirect positive effects on blood glucose control in LSS patients with DM. ⋯ The present study demonstrates the reduction in HbA(1c) level in patients with DM and LSS after decompression surgery with or without fusion. We believe this reduction in the HbA(1c) level may be a result of increased physical activity, subsequent to successful surgical decompression of the cauda equina.
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Comparative Study
The impact of generalized joint laxity on the occurrence and disease course of primary lumbar disc herniation.
Generalized joint laxity (GJL) has been associated with spine-related disorders such as low back pain, accelerated disc degeneration, and recurrence after discectomy surgery for primary lumbar disc herniation (p-LDH). Generalized joint laxity might be a causative factor of p-LDH, but this relationship is poorly understood. In addition, the impact of GJL on outcomes after the treatment for p-LDH has not been reported. ⋯ Generalized joint laxity was closely related to p-LDH and may be a causative factor. In addition, patients with GJL had worse clinical and radiological outcomes than patients without GJL. Consequently, GJL should be evaluated preoperatively, and this information should be communicated to p-LDH patients with GJL.