Objective: To extend the follow up period of previous studies undertaken by the senior author, looking at the clinical outcome and radiological changes observed in patients with either myelopathy or radiculopathy, following
Study Design: Retrospective review. Objectives: Rugby union has recently become a highly-paid professional sport. Players requiring
Introduction. Degeneration of the cervical spine can lead to neurological symptoms that require surgical intervention. Often, an
Introduction:
The February 2023 Spine Roundup. 360. looks at: S2AI screws: At what cost?; Just how good is spinal deformity surgery?; Is 80 years of age too late in the day for spine surgery?; Factors affecting the accuracy of pedicle screw placement in robot-assisted surgery; Factors causing delay in discharge in patients eligible for ambulatory lumbar fusion surgery;
Background: To assess the clinical and radiological results of motion-segment sparing
The April 2023 Spine Roundup. 360. looks at: Percutaneous transforaminal endoscopic discectomy versus microendoscopic discectomy; Spine surgical site infections: a single debridement is not enough; Lenke type 5, anterior, or posterior: systematic review and meta-analysis; Epidural steroid injections and postoperative infection in lumbar decompression or fusion; Noninferiority of posterior cervical foraminotomy versus
In a retrospective cohort study we compared the
clinical outcome and complications, including dysphagia, following
anterior cervical fusion for the treatment of cervical spondylosis
using either a zero-profile (Zero-P; Synthes) implant or an anterior
cervical plate and cage. A total of 83 patients underwent fusion
using a Zero-P and 107 patients underwent fusion using a plate and
cage. The mean follow-up was 18.6 months ( When compared with the traditional anterior cervical plate and
cage, the Zero-P implant is a safe and convenient procedure giving
good results in patients with symptomatic cervical spondylosis with
a reduced incidence of dysphagia post-operatively. Cite this article:
Aims: Presentation and evaluation of clinical outcomes of patients with cervical degenerative disc disease treated by Smith – Robinson method with interbody fusion by Cornerstone Carbon Cage (CCS) in own clinical experience. Methods: We operated 37 patients by
Study design: Retrospective review of patients with cervical spondylosis treated with three-level anterior cervical discectomy and fusion with plate fixation. Objective: To assess the radiographic and clinical outcome of three-level instrumented
Introduction: A prospective, randomized, controlled study has been conducted to compare the clinical outcomes of patients treated with an artificial cervical disc to patients who receive fusion after cervical discectomy for the treatment of primary cervical disc disease. It is hypothesized that maintenance of motion after
Introduction: A prospective, randomized, controlled study has been conducted to compare the clinical outcomes of patients treated with an Artificial Cervical Disc to patients who receive fusion after cervical discectomy for the treatment of primary cervical disc disease. It is hypothesized that maintenance of motion after
INTRODUCTION: A prospective, randomised, controlled study has been conducted to compare the clinical outcomes of patients treated with an Artificial Cervical Disc to patients who receive fusion after cervical discectomy for the treatment of primary cervical disc disease. It is hypothesised that maintenance of motion after
Introduction A prospective, randomised, controlled study has been conducted to compare the clinical outcomes of patients treated with a Presige® artificial cervical disc (Medtronic Sofamor Danek, Memphis, TN) to patients who receive fusion after cervical discectomy for the treatment of primary cervical disc disease. It is hypothesized that maintenance of motion after
Aims. Cervical spondylosis is often accompanied by dizziness. It has
recently been shown that the ingrowth of Ruffini corpuscles into
diseased cervical discs may be related to cervicogenic dizziness.
In order to evaluate whether cervicogenic dizziness stems from the
diseased cervical disc, we performed a prospective cohort study
to assess the effectiveness of
Aims. The aim of this study was to use diffusion tensor imaging (DTI) to investigate changes in diffusion metrics in patients with cervical spondylotic myelopathy (CSM) up to five years after decompressive surgery. We correlated these changes with clinical outcomes as scored by the Modified Japanese Orthopedic Association (mJOA) method, Neck Disability Index (NDI), and Visual Analogue Scale (VAS). Methods. We used multi-shot, high-resolution, diffusion tensor imaging (ms-DTI) in patients with cervical spondylotic myelopathy (CSM) to investigate the change in diffusion metrics and clinical outcomes up to five years after
Aims: Presentation of modified
Introduction: In comparison to anterior cervical decompression and fusion (ACDF), cervical disc arthroplasty has the potential of maintaining normal segmental lordosis, anatomical disc space height, and physiological motion patterns that may reduce or delay the onset of degenerative disc disease at adjacent cervical spinal motion segments. Aim: The objective of this study was to determine patient satisfaction post cervical disc arthroplasty. by evaluating each patient both clinically and radiologically. Materials and Methods: A retrospective study was performed on all patients with symptomatic cervical radiculopathy and/or myelopathy who had undergone cervical disc arthroplasty by a single surgeon after a standard
Objective:
The aim of this study was to investigate whether the type of cervical disc herniation influences the severity of symptoms at the time of presentation, and the outcome after surgical treatment. The type and extent of disc herniation at the time of presentation in 108 patients who underwent anterior discectomy for cervical radiculopathy were analyzed on MRI, using a four-point scale. These were dichotomized into disc bulge and disc herniation groups. Clinical outcomes were evaluated using the Neck Disability Index (NDI), 36-Item Short Form Survey (SF-36), and a visual analogue scale (VAS) for pain in the neck and arm at baseline and two years postoperatively. The perceived recovery was also assessed at this time.Aims
Methods
Background: Smaller versions of threaded lumbar cages were developed for cervical spine to obviate the need for allograft, iliac autograft use and to provide initial stability before fusion. Clinical trials of threaded cervical fusion cages have shown higher fusion rates and lower rates of graft-donor site complications. Study design/Aims: Prospective. Radiological and clinical outcomes of an age, sex and diagnosis matched patient population who underwent cervical fusion with (A) BAK/C cages filled with autograft reamings (Center-pulse Spine-tech Inc., Minneapolis, MN) (N=50) were compared with (B) Anterior cervical decompression and fusion (ACDF, N=50). Methods: Patients with symptomatic cervical discogenic radiculopathy were treated with either
Introduction Locking plates are the most used devices for achieving anterior cervical spinal fusion and offer considerable advantages such as faster and easier implantation and fewer implant-related failures than older plate systems. Recently polyaxial locking screws were introduced to make the implantation of these plates even easier by facilitating the implantation of the screw in all directions. However polyaxial screws may have the disadvantage of losing the angular stability with subsequent failure of the plate. The aim of this study was the radiological follow up of the patients with polyaxial screw and to compare them with the conventional looking plates. Methods Patients underwent anterior cervical discectomy and fusion in which either ventral cervical locking plates or a polyaxial locking screw were used for indications including cervical spondylotic radiculopathy, disc herniation, trauma, and myelopathy. Patients underwent
Introduction: Anterior cervical spine surgeries are associated with high incidence (up to 60%) of early postoperative dysphagia and hoarseness of voice. These symptoms have been attributed to retraction injury on the larynx, trachea and oesophagus. Pressure from retractors producing ischaemia might explain the soft tissues complications following anterior cervical approach. Conventional retractor systems rely on the soft tissues for stability and create a vertical surgical channel but a novel system (Seex retractor) is fixed directly to the spine and rotates to allow an oblique approach. This may reduce retraction pressure by the Seex retractor on tissues This is the first investigation of retraction pressures using any two different retractor systems for anterior cervical spine surgery. The aims of this study were to measure the retraction pressure on the larynx, trachea and oesophagus during the anterior surgical approach to the cervical spine, in cadavers using conventional (Cloward) retractor and Seex retractor and to investigate the effect of flat or curved blades on retraction pressure. Methods: In a cadaveric model, through a standard anteriomedial approach simulated
Background: Cervical myelopathy and radiculopathy has been treated commonly with anterior cervical decompression and fusion with autologous bone graft and anterior cervical plating. Long term results have shown excellent pain relief and 73%–90% fusion rates. However, the development of late adjacent-level disease has been reported following anterior cervical arthrodesis which recently have been correlated to clinical findings. The Bryan disc arthroplasty device was developed to preserve the kinematics of the functional spine unit thus preventing adjacent level disease. There have been few studies comparing the incidence of adjacent level changes in patients undergoing ACDF compared to implantation of a Bryan disc arthroplasty device. Objectives: The object of this study is to compare the clinical results and radiographic outcomes of anterior cervical decompression and fusion versus cervical disc replacement using the Bryan Cervical Disc Prosthesis (Medtronic Sofamor Danek, Memphis, TN) in terms of overall range of motion (ROM) of the cervical spine; ROM, anterior intervertebral height (AIH), posterior intervertebral height (PIH) and radiographic changes at the implanted and adjacent levels. Methods: The study consisted of 105 patients with symptomatic single or two-level cervical disc disease. Fifty-one received the Bryan Cervical Artificial Disc Prosthesis (Medtronic Sofamor Danek, Memphis, TN). A total of 63 Bryan disc were placed in these 51 patients. A single-level procedure was performed in 39 patients and a two-level procedure in the other twelve. The patient group who underwent ACDF totaled 54 patients which consisted of 26 single level cases and 28 double level cases. The Bryan group had a mean follow-up 19 months (12–38). The mean follow-up for the ACDF group was 20 months (12–40 months). All patients were evaluated using static and dynamic cervical spine radiographs as well as MR imaging. All patients underwent
The aim of this study was to determine how the short- and medium-
to long-term outcome measures after total disc replacement (TDR)
compare with those of anterior cervical discectomy and fusion (ACDF),
using a systematic review and meta-analysis. Databases including Medline, Embase, and Scopus were searched.
Inclusion criteria involved prospective randomized control trials
(RCTs) reporting the surgical treatment of patients with symptomatic
degenerative cervical disc disease. Two independent investigators
extracted the data. The strength of evidence was assessed using
the Grading of Recommendations, Assessment, Development and Evaluation
(GRADE) criteria. The primary outcome measures were overall and
neurological success, and these were included in the meta-analysis. Standardized
patient-reported outcomes, including the incidence of further surgery
and adjacent segment disease, were summarized and discussed.Aims
Patients and Methods
In order to evaluate the effectiveness of the Mobi-C implant
in cervical disc degeneration, a randomised study was conducted,
comparing the Mobi-C prosthesis arthroplasty with anterior cervical
disc fusion (ACDF) in patients with single level cervical spondylosis. From January 2008 to July 2009, 99 patients were enrolled and
randomly divided into two groups, those having a Mobi-C implant
(n = 51; 30 men, 21 women) and those undergoing ACDF (n = 48; 28
men, 20 women).The patients were followed up for five years, with
the primary outcomes being the Japanese Orthopaedic Association
score, visual analogue scale for pain and the incidence of further
surgery. The secondary outcomes were the Neck Disability Index and
range of movement (ROM) of the treated segment.Aims
Patients and Methods
The purpose of this retrospective study was to investigate the
clinical relevance of increased facet joint distraction as a result
of anterior cervical decompression and fusion (ACDF) for trauma. A total of 155 patients (130 men, 25 women. Mean age 42.7 years;
16 to 87) who had undergone ACDF between 1 January 2001 and 1 January
2016 were included in the study. Outcome measures included the Neck
Disability Index (NDI) and visual analogue scale (VAS) for pain.
Lateral cervical spine radiographs taken in the immediate postoperative
period were reviewed to compare the interfacet distance of the operated
segment with those of the facet joints above and below.Aims
Patients and Methods
Patients seeking cervical spine surgery are thought to be increasing
in age, comorbidities and functional debilitation. The changing
demographics of this population may significantly impact the outcomes
of their care, specifically with regards to complications. In this
study, our goals were to determine the rates of functionally dependent
patients undergoing elective cervical spine procedures and to assess
the effect of functional dependence on 30-day morbidity and mortality
using a large, validated national cohort. A retrospective analysis of the American College of Surgeons
National Surgical Quality Improvement Program data files from 2006
to 2013 was conducted to identify patients undergoing common cervical
spine procedures. Multivariate logistic regression models were generated
to analyse the independent association of functional dependence
with 30-day outcomes of interest.Aims
Patients and Methods
We present data relating to the Bryan disc arthroplasty for the treatment of cervical spondylosis in 46 patients. Patients with either radiculopathy or myelopathy had a cervical discectomy followed by implantation of a cervical disc prosthesis. Patients were reviewed at six weeks, six months and one year and assessment included three outcome measures, a visual analogue scale (VAS), the short form 36 (SF-36) and the neck disability index (NDI). The results were categorised according to a modification of Odom’s criteria. Radiological evaluation, by an independent radiologist, sought evidence of movement, stability and subsidence of the prosthesis. A highly significant difference was found for all three outcome measurements, comparing the pre-operative with the post-operative values: VAS (Z = 6.42, p <
0.0001), SF-36 (mental component) (Z = −5.02, p <
0.0001), SF-36 (physical component) (Z = −5.00, p <
0.0001) and NDI (Z = 7.03, p <
0.0001). The Bryan cervical disc prosthesis seems reliable and safe in the treatment of patients with cervical spondylosis.
The demand for spinal surgery and its costs have
both risen over the past decade. In 2008 the aggregate hospital
bill for surgical care of all spinal procedures was reported to
be $33.9 billion. One key driver of rising costs is spinal implants.
In 2011 our institution implemented a cost containment programme
for spinal implants which was designed to reduce the prices of individual
spinal implants and to reduce the inter-surgeon variation in implant costs.
Between February 2012 and January 2013, our spinal surgeons performed
1493 spinal procedures using implants from eight different vendors.
By applying market analysis and implant cost data from the previous
year, we established references prices for each individual type
of spinal implant, regardless of vendor, who were required to meet
these unit prices. We found that despite the complexity of spinal
surgery and the initial reluctance of vendors to reduce prices,
significant savings were made to the medical centre. Cite this article: 2015; 97-B:1102–5.