MedWorm: Cervical Corpectomy

Comparison between anterior and posterior decompression for cervical spondylotic myelopathy: subjective evaluation and cost analysis

Orthopaedic Surgery — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Both anterior and posterior decompressions (with instrumentation) are effective procedures for improving the neurological outcomes of patients with CSM. However, although the two approaches have similar health care costs, anterior cervical corpectomy (with instrumentation) seems to be subjectively assessed by patients as better. (Source: Orthopaedic Surgery)

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Cervical Disc Herniation Causing Brown-Séquard's Syndrome: A Case Report and Literature Review

Journal of Nanomaterials — Sun, 22 Jan 2012 16:10:59 +0100

We describe a rare case of multilevel cervical disc herniation presenting as BSS. The condition was confirmed by MRI scan. Cervical corpectomy, decompression, and fusion gave a satisfying result. Pertinent literature has been reviewed. (Source: Journal of Nanomaterials)

Multilevel oblique corpectomy for cervical spondylotic myelopathy preserves segmental motion

European Spine Journal — Tue, 10 Jan 2012 16:59:55 +0100

Conclusions The OCC preserves segmental motion in the short-term, however, the tendency towards straightening of the spine, albeit without clinical worsening, warrants serial follow-up imaging to determine whether this motion preservation is long lasting. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00586-011-2137-3Authors Ari George Chacko, Section of Neurosurgery, Department of Neurological Sciences, Christian Medical College, Vellore, 632004 Tamil Nadu, IndiaMathew Joseph, Section of Neurosurgery, Department of Neurological Sciences, Christian Medical College, Vellore, 632004 Tamil Nadu, IndiaMazda Keki Turel, Section of Neurosurgery, Department of Neurological Sciences, Christian Medical College, Vellore, 632004 Tamil Nadu, IndiaKris...

Cervical ossification of the posterior longitudinal ligament: Anterior versus posterior approach

Table of Contents : Indian Journal of Orthopaedics : 2007 - 41(1) — Tue, 10 Jan 2012 05:00:00 +0100

Conclusions: The posterior indirect decompression and fixation has now been adopted as the primary treatment for cervical OPLL involving multiple levels with the canal occupancy by OPLL <50% at our institution because this approach leads to significantly less implant failures. Those patients with the occupancy ≥50% managed with anterior approach surgeries had better outcomes, but approach was more difficult and associated with higher risk and complications. (Source: Table of Contents : Indian Journal of Orthopaedics : 2007 - 41(1))

Two level cervical corpectomy with iliac crest fusion and rigid plate fixation: a retrospective study with a three-year follow-up.

Turkish Neurosurgery — Thu, 29 Dec 2011 18:00:03 +0100

CONCLUSION: Excellent fusion rates can be achieved following two-level corpectomy with iliac bone graft repacement. This techique is easy, cost effective and safe. If the bone graft is harvested from the iliac crest by standart approach and between anatomical landmarks, most patients do not experience persistent pain at the donor site. PMID: 22194123 [PubMed - in process] (Source: Turkish Neurosurgery)

Association of magnetic resonance imaging signal changes and outcome prediction after surgery for cervical spondylotic myelopathy. Vedantam A, Jonathan A, Rajshekhar V. J Neurosurg Spine 2011;15(6):660–6. Epub 2011 Sep 16.

The Spine Journal — Thu, 01 Dec 2011 05:00:00 +0100

Few studies have evaluated the prognostic significance of different types of T2-weighted MR imaging changes in patients with cervical spondylotic myelopathy (CSM). The object of this study was to determine whether the type of increased signal intensity (ISI) was an independent predictor of outcome following central corpectomy in patients with CSM or ossification of the posterior longitudinal ligament (OPLL). (Source: The Spine Journal)

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Evaluation of pain as a preference-based health status measure in patients with cervical spondylotic myelopathy undergoing central corpectomy

Acta Neurochirurgica — Wed, 23 Nov 2011 16:32:39 +0100

Conclusions Pain was reported by about half the patients with CSM, but was not severe in any of them. Following decompressive surgery, the intensity of all these pain components decreased significantly. Low axial pain, a reflection of CSM–related spasticity perceived in the lumbosacral region, became prominent in many patients after surgery. Content Type Journal ArticleCategory Clinical ArticlePages 1-6DOI 10.1007/s00701-011-1229-5Authors Sumit Thakar, Department of Neurological Sciences, Christian Medical College, Vellore, 632004 IndiaVedantam Rajshekhar, Department of Neurological Sciences, Christian Medical College, Vellore, 632004 India Journal Acta NeurochirurgicaOnline ISSN 0942-0940Print ISSN 0001-6268 (Source: Acta Neurochirurgica)

Long-term follow-up of cervical radiographic sagittal spinal alignment after 1- and 2-level cervical corpectomy for the treatment of spondylosis of the subaxial cervical spine causing radiculomyelopathy or myelopathy: a retrospective study.

Journal of Neurosurgery.Spine — Fri, 28 Oct 2011 04:00:00 +0100

Conclusions Long-term follow-up data in our veteran population support cervical corpectomy as an effective, long-lasting treatment for spondylotic myelopathy of the cervical spine. Use of CTMCs without end caps was associated with statistically significant increased postoperative kyphotic angulation and chronic pain. Despite an increase in focal kyphosis over time, regional cervical sagittal lordotic alignment had increased at the latest follow-up. Further investigation will include the association of chronic neck pain and postoperative kyphosis, and high fusion rates among a veteran population of heavy smokers. PMID: 22035103 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)

Oblique Corpectomy to Manage Cervical Myeloradiculopathy

Advances in Urology — Wed, 19 Oct 2011 11:41:58 +0100

Conclusion. Multilevel cervical oblique corpectomy and/or lateral foraminotomy allow wide decompression of nervous structures, while maintaining optimal stability and physiological motion of the cervical spine. (Source: Advances in Urology)

Functioning paraganglioma of the cervical spine.

Orthopedics — Thu, 06 Oct 2011 12:30:03 +0100

Authors: Chen G, Luo Z, Liu T, Yang H Abstract Extradural paraganglioma of the cervical spine is rarely seen. Few reports of this functioning disorder appear in the literature. A 29-year-old woman presented with a 1-year history of left shoulder pain and occasional transitional dizziness. This is the first case of a functioning cervical spinal paraganglioma with symptoms of catecholamine excess throughout the operation. A mass in the neck region was discovered by the patient 2 months prior to hospital admission. Physical examination revealed an egg-shaped soft and unflexible mass with no clear boundary in the anterior left part of the neck. Neither sensory disturbance nor motor weakness was evident in the upper and lower extremities. Laboratory studies were normal. Both computed to...

Anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion for multilevel cervical spondylosis: a systematic review

Archives of Orthopaedic and Trauma Surgery — Tue, 04 Oct 2011 05:52:38 +0100

Conclusion Nonunion rates of ACDF are higher than those of ACCF for multilevel cervical spondylosis. Sometimes, clinical outcome of ACCF was better than ACDF for multilevel cervical spondylosis. Content Type Journal ArticleCategory Orthopaedic SurgeryPages 1-7DOI 10.1007/s00402-011-1402-6Authors Sheng-Dan Jiang, Department of Orthopaedic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 ChinaLei-Sheng Jiang, Department of Orthopaedic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 ChinaLi-Yang Dai, Department of Orthopaedic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China ...

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Anterior corpectomy versus posterior laminoplasty: is the risk of postoperative C-5 palsy different?

Neurosurgical Focus — Sat, 01 Oct 2011 04:00:00 +0100

Conclusions Both ACCF and laminoplasty are effective treatments for patients with cervical stenosis. The authors found no difference in the rate of deltoid paresis between ACCF and laminoplasty to treat cervical stenosis. PMID: 21961856 [PubMed - in process] (Source: Neurosurgical Focus)

Evaluation of the rate of decompression in anterior cervical corpectomy using an intra-operative computerized tomography scan (O-Arm system)

European Spine Journal — Fri, 23 Sep 2011 15:47:02 +0100

Conclusion Intra-operative CT scan performed during cervical corpectomy is a really useful tool in helping to ensure complete bone removal and the adequacy of surgery. The O-arm™ Image system grants optimal image quality, allowing correctly assessing the rate of decompression and, in any case of doubt, allows an intra-operative evaluation of the final correct positioning of the graft. Content Type Journal ArticleCategory Ideas and Technical InnovationsPages 1-5DOI 10.1007/s00586-011-2028-7Authors Francesco Costa, Neurosurgery Department - Istituto Clinico Humanitas, IRCCS, Rozzano, MI, ItalyMassimo Tomei, Neurosurgery Department, Istituto IRCCS Galeazzi, Via R. Galeazzi, 4, 20100 Milan, ItalyMarco Sassi, Neurosurgery Department, Istituto IRCCS Galeazzi, Via R. Gal...

Association of magnetic resonance imaging signal changes and outcome prediction after surgery for cervical spondylotic myelopathy.

Journal of Neurosurgery.Spine — Fri, 16 Sep 2011 04:00:00 +0100

Conclusions Increased signal intensity on preoperative T2-weighted MR images was seen in more than 80% of the cases. However, only Type 2 ISI on T2-weighted images had a prognostic significance of being associated with a decreased likelihood of cure in patients with CSM or OPLL. Hypointensity on T1-weighted images predicted a lower probability of cure among patients with Type 2 ISI on T2-weighted images. PMID: 21923236 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)

Anterior surgery in selective patients with massive ossification of posterior longitudinal ligament of cervical spine: technical note

European Spine Journal — Wed, 31 Aug 2011 05:53:00 +0100

Conclusion Anterior surgery using our technique may be a relatively simple and safe procedure in selective patients with massive ossification of posterior longitudinal ligament of cervical spine. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00586-011-1996-yAuthors Xinwei Wang, Department of Orthopedics, Changzheng Hospital, Second Military Medical University of China, 415 Fengyang Road, Shanghai, 200003 ChinaDeyu Chen, Department of Orthopedics, Changzheng Hospital, Second Military Medical University of China, 415 Fengyang Road, Shanghai, 200003 ChinaWen Yuan, Department of Orthopedics, Changzheng Hospital, Second Military Medical University of China, 415 Fengyang Road, Shanghai, 200003 ChinaYing Zhang, Department of Orthopedics, Changzh...

Surgical treatment of spontaneous intracranial hypotension secondary to degenerative cervical spine pathology: a case report and literature review

European Spine Journal — Sat, 27 Aug 2011 05:52:06 +0100

Conclusion Two months after this novel surgical blood patch procedure the patient was asymptomatic and follow-up imaging demonstrated complete resolution. Content Type Journal ArticleCategory Case ReportPages 1-6DOI 10.1007/s00586-011-1979-zAuthors Christopher D. Witiw, School of Medicine, University of Manitoba, Winnipeg, MB, CanadaAria Fallah, Division of Neurosurgery, St. Michaels Hospital, University of Toronto, Toronto, ON, CanadaPaul J. Muller, Division of Neurosurgery, St. Michaels Hospital, University of Toronto, Toronto, ON, CanadaHoward J. Ginsberg, Division of Neurosurgery, St. Michaels Hospital, University of Toronto, Toronto, ON, Canada Journal European Spine JournalOnline ISSN 1432-0932Print ISSN 0940-6719 (Source: European Spine Journal)

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Systematic Review of Cohort Studies Comparing Surgical Treatment for Multilevel Ossification of Posterior Longitudinal Ligament: Anterior vs Posterior Approach.

Orthopedics — Sat, 13 Aug 2011 16:16:12 +0100

Authors: Xu J, Zhang K, Xiangyang M, Yin Q, Wu Z, Xia H, Wang Z There have been no standards or guidelines for the treatment of ossification of posterior longitudinal ligament, especially multilevel ossification of posterior longitudinal ligament. The purpose of this study was to compare results of major surgical treatment for multilevel ossification of posterior longitudinal ligament. Databases including MEDLINE, EMBASE, the Cochrane library, and bibliographies of identified and review articles were searched to find randomized, controlled trials or retrospective cohort studies comparing anterior and posterior approach from 1980 to December 2010. Approximately 1375 articles were found initially, 92 abstracts were screened, 23 articles were retrieved in full; 3 studies were included in ...

A comparison of anterior cervical discectomy and corpectomy in patients with multilevel cervical spondylotic myelopathy

European Spine Journal — Mon, 08 Aug 2011 19:54:37 +0100

Conclusions Surgical managements of 3- or 4-level CSM by ACDF or ACCF showed no significant differences in terms of achieved clinical symptom improvements, with the exception of better postoperative NDI scores in ACDF. In addition, ACDF is better than ACCF in terms of blood loss, lordotic curvature improvement and instrumentation and graft related-complication rates, with the exception of operation times. Content Type Journal ArticlePages 1-8DOI 10.1007/s00586-011-1961-9Authors Qiushui Lin, Department of Orthopedics, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003 ChinaXuhui Zhou, Department of Orthopedics, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003 ChinaXinwei Wang, Depa...

Anterior migration of spinal cord after cervical corpectomy

European Spine Journal — Sat, 04 Jun 2011 05:53:29 +0100

This report presents a case of anterior migration of spinal cord after cervical corpectomy. A 65-year-old male underwent a cervical corpectomy of the C4 and C5 for cervical spondylotic myelopathy. The postoperative MRI showed that spinal cord was decompressed. However, at 12 months postoperatively, the patient complained that improved gait aggravated again, and the MRI showed an anterior migration of the spinal cord at the level of the C4 and C5, and a compression of spinal cord at the level of caudal endplate of C3. Secondary surgery, laminaplasty of C3 and C4 was conducted. The postoperative MRI showed that the spinal canal increased at the C3 and C4 levels, and the spinal cord went through smoothly without sharp turning. Content Type Journal ArticlePages 1-4DOI 10.1007/s...

One stage anterior-posterior approach for traumatic atlantoaxial instability combined with subaxial cervical spinal cord injury.

Chinese Journal of Traumatology — Tue, 31 May 2011 23:00:00 +0100

Conclusions: Traumatic atlantoaxial instability may combine with subaxial CSCI, misdiagnosis of which should be especially alerted and avoided. For severe cases, one stage anterior-posterior approach to decompress the upper and lower cervical spine, together with reposition, bone grafting and fusion, as well as internal fixation can immediately restore the normal alignments and stability of the cervical spine and effectively improve the spinal nervous function, thus being an ideal approach. PMID: 21635798 [PubMed - in process] (Source: Chinese Journal of Traumatology)

Anterior corpectomy and reconstruction with titanium mesh cage and dynamic cervical plate for cervical spondylotic myelopathy in elderly osteoporosis patients

Archives of Orthopaedic and Trauma Surgery — Sat, 14 May 2011 15:53:00 +0100

Conclusions Despite the fact that there is a significant difference of the cage subsidence rate between the two groups no clinical outcome, nor sagittal alignment or fusion rate differences among groups was observed in elderly CSM patients. Content Type Journal ArticlePages 1-6DOI 10.1007/s00402-011-1317-2Authors Denglu Yan, Orthopaedic Department, Baoan People’s Hospital, Shenzhen, 518101 People’s Republic of ChinaZhaojie Wang, Orthopaedic Department, Fifth Hospital of Zunyi Medical College, Zhuhai, 519100 People’s Republic of ChinaShaojie Deng, Orthopaedic Department, Baoan People’s Hospital, Shenzhen, 518101 People’s Republic of ChinaJian Li, Orthopaedic Department, Third Hospital of Guangzhou Medical College, Guangzhou, 510150 People’s Republic of Chi...

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Sub-axial cervical spine injuries: Modified Stellerman's algorithm

Table of Contents : Indian Journal of Orthopaedics : 2007 - 41(1) — Mon, 25 Apr 2011 23:00:00 +0100

Conclusion: We feel that on table decompression and reduction followed by anterior stabilization can be used as the initial surgical approach to manage most types of cervical injuries. In rotation/translational cases where reduction cannot be achieved, monitored cervical traction on the decompressed spine can safely achieve reduction and hence avoid the need for a posterior facetectomy in a large percentage of cases. (Source: Table of Contents : Indian Journal of Orthopaedics : 2007 - 41(1))

Erratum to: The stabilizing potential of anterior, posterior and combined techniques for the reconstruction of a 2-level cervical corpectomy model: biomechanical study and first results of ATPS prototyping

European Spine Journal — Wed, 20 Apr 2011 06:05:51 +0100

Content Type Journal ArticlePages 1-1DOI 10.1007/s00586-011-1792-8Authors Heiko Koller, Department for Traumatology and Sport Injuries, Paracelsus Medical University, Salzburg, AustriaRene Schmidt, Department of Orthopedics and Traumatology, University Medical Center, Mannheim, GermanyMichael Mayer, Department for Traumatology and Sport Injuries, Paracelsus Medical University, Salzburg, AustriaWolfgang Hitzl, Research Office, Department of Biostatistics, Paracelsus Medical University, Salzburg, AustriaJuliane Zenner, German Scoliosis Center, Werner-Wicker-Clinic, Bad Wildungen, GermanyStefan Midderhoff, Department of Orthopedic Research and Biomechanics, University of Ulm, Ulm, GermanyNicolaus Graf, Department of Orthopedic Research and Biomechanics, University of Ulm, Ulm, GermanyH. R...

Surgical management of ventral intradural spinal lesions.

Journal of Neurosurgery.Spine — Thu, 14 Apr 2011 23:00:00 +0100

Conclusions Most intradural spinal lesions can be treated with contemporary microsurgical techniques with long-term control or cure of the lesion and preservation of neurological function. Standard posterior approaches provide adequate exposure to safely remove the vast majority of these lesions without the need for a potentially destabilizing resection of the facet or pedicle. Posterior exposures with varying degrees of lateral bone resection, dentate ligament division, and gentle cord rotation may also provide adequate exposure for safe removal of nonmidline ventrolateral superficial pial presenting spinal cord lesions. Nevertheless, in certain cases of ventral intradural lesions, anterior approaches are necessary and should be considered under appropriate circumstances. PMID: 214958...

Biomechanical effects of anterior, posterior, and combined anterior-posterior instrumentation techniques on the stability of a multilevel cervical corpectomy construct: a finite element model analysis

The Spine Journal — Thu, 31 Mar 2011 23:00:00 +0100

Conclusions: A combined fixation technique should be balanced against increased operating room time and surgery costs because of dual anterior and posterior fixation and the increased risk of long anterior plating, such as dysphasia, plate or screw dislodgement, or migration. Our study suggests that the use of posterior fixation, whether alone or in combination with anterior fixation, infers comparable stability. Further studies are warranted to identify whether the current findings are consistent with other biomechanical studies. (Source: The Spine Journal)

Outcomes of three anterior decompression and fusion techniques in the treatment of three-level cervical spondylosis

European Spine Journal — Tue, 29 Mar 2011 17:32:29 +0100

Abstract The purpose of this article is to compare the outcomes of three different anterior approaches for three-level cervical spondylosis. The records of 120 patients who underwent anterior approaches because of three-level cervical spondylosis between 2006 and 2008 were reviewed. Based on the type of surgery, the patients were divided into three groups: Group 1 was three-level anterior cervical discectomy and fusion (ACDF); Group 2 anterior cervical hybrid decompression and fusion (ACHDF, combination of ACDF and ACCF); and Group 3 two-level anterior cervical corpectomy and fusion (ACCF). The clinical outcomes including blood loss, operation time, complications, Japanese Orthopedic Association (JOA) scores, C2–C7 angle, segmental angle, and fusion rate were compared. T...

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Comparison of Nurick grading system and modified Japanese Orthopaedic Association scoring system in evaluation of patients with cervical spondylotic myelopathy

European Spine Journal — Sun, 20 Mar 2011 05:32:42 +0100

Abstract The purpose of this study was to determine the correlation between Nurick grade and modified Japanese Orthopaedic Association (mJOA) scores in the preoperative and postoperative follow-up evaluation of patients with cervical spondylotic myelopathy (CSM). This retrospective study included 93 patients with CSM who underwent central corpectomy (CC) between 1998 and 2008. Preoperative and postoperative Nurick grade and total mJOA (tmJOA) and lower limb mJOA (llmJOA) score of each patient was documented and the correlation between the Nurick grades and the mJOA scores was studied. At presentation and follow-up, correlation between Nurick grade and llmJOA (Spearman’s ρ 0.901 and 0.886) was better than with tmJOA (0.846 and 0.862). The Nurick grade recovery rate (NGRR)...

Changes in the range of motion of the cervical spine and adjacent segments at ≥24 months after uninstrumented corpectomy for cervical spondylotic myelopathy

Acta Neurochirurgica — Sun, 06 Mar 2011 06:35:15 +0100

Conclusions CC significantly reduces the motion of the cervical spine and increases the adjacent segment mobility at intermediate follow-up. The inferior adjacent segment shows greater compensation of motion as compared to the superior adjacent segment in our series. Adjacent segment degeneration as estimated by Nathan’s grade was seen in one-third of the cases. Content Type Journal ArticlePages 1-7DOI 10.1007/s00701-011-0986-5Authors Aditya Vedantam, Department of Neurological Sciences, Christian Medical College and Hospital, Vellore, 632004 Tamil Nadu IndiaKumbhar Kartik Revanappa, Department of Neurological Sciences, Christian Medical College and Hospital, Vellore, 632004 Tamil Nadu IndiaVedantam Rajshekhar, Department of Neurological Sciences, Christian Medica...

Analysis of demographics, risk factors, clinical presentation, and surgical treatment modalities for the ossified posterior longitudinal ligament.

Neurosurgical Focus — Tue, 01 Mar 2011 00:00:00 +0100

Conclusions Ossification of the posterior longitudinal ligament can no longer be viewed as a disease of the Asian population exclusively. Since OPLL among white populations is being diagnosed more frequently, surgeons must be aware of the most appropriate surgical option. The outcomes of the various surgical treatments among the different populations with OPLL appear similar. Compared with other procedures, however, anterior decompression led to the best neurological outcomes. PMID: 21361749 [PubMed - in process] (Source: Neurosurgical Focus)

Ossification of the posterior longitudinal ligament: pathogenesis, management, and current surgical approaches.

Neurosurgical Focus — Tue, 01 Mar 2011 00:00:00 +0100

Authors: Smith ZA, Buchanan CC, Raphael D, Khoo LT Ossification of the posterior longitudinal ligament (OPLL) is an important cause of cervical myelopathy that results from bony ossification of the cervical or thoracic posterior longitudinal ligament (PLL). It has been estimated that nearly 25% of patients with cervical myelopathy will have features of OPLL. Patients commonly present in their mid-40s or 50s with clinical evidence of myelopathy. On MR and CT imaging, this can be seen as areas of ossification that commonly coalesce behind the cervical vertebral bodies, leading to direct ventral compression of the cord. While MR imaging will commonly demonstrate associated changes in the soft tissue, CT scanning will better define areas of ossification. This can also provide the clinician...

Dorsal versus ventral surgery for cervical ossification of the posterior longitudinal ligament: considerations for approach selection and review of surgical outcomes.

Neurosurgical Focus — Tue, 01 Mar 2011 00:00:00 +0100

Authors: Shin JH, Steinmetz MP, Benzel EC, Krishnaney AA Ossification of the posterior longitudinal ligament is a common cause of radiculopathy and myelopathy that often requires surgery to achieve decompression of the neural elements. With the evolution of surgical technique and a greater understanding of the biomechanics of cervical deformity, the criteria for selecting one approach over the other has been the subject of increased study and remains controversial. Ventral approaches typically consist of variations of the cervical corpectomy, whereas dorsal approaches include a wide range of techniques including laminoplasty, laminectomy, and laminectomy with instrumented fusion. Herein, the features and limitations of these approaches are reviewed with an emphasis on complications and...

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A simple method for making a hollow cylindrical polymethylmethacrylate strut for cervical spinal reconstruction.

Journal of Neurosurgery.Spine — Fri, 21 Jan 2011 00:00:00 +0100

Conclusions It is simple to make a hollow cylindrical PMMA strut with plastic syringes during a discectomy and/or corpectomy. The strut can provide adequate support at less cost than other methods. The hollow cylindrical strut is also of suitable size and length for anterior spinal reconstruction. It serves as an alternative for patients who cannot afford the expense of similar instruments or who cannot or do not want to take the risk of a human graft for anterior spinal reconstruction. PMID: 21250815 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)

Spondyloptosis of C6-C7: a rare case report.

Chinese Journal of Traumatology — Wed, 01 Dec 2010 00:00:00 +0100

Authors: Chadha M, Singh AP, Singh AP A 35 years old female presented to us after falling from a height. She complained of a neck pain and a complete quadriplegia and was diagnosed as having spondyloptosis of the C6-C7. Skeletal traction was performed on her. CT scan showed fractures of the C5, C6, and C7 vertebral body. The patient underwent anterior approach partial corpectomy with anterior cervical locking plate and strut grafting from ipsilateral iliac crest. Intraoperatively it was found that the disc was completely ruptured and there was a dural tear and cerebrospinal fluid leak. Her postoperative period was complicated by cerebrospinal fluid collection and posterior instrumentation was not performed due to the poor general condition. She had no neural recovery at the last follow...

Cervical chordoma managed with multidisciplinary surgical approach

ANZ Journal of Surgery — Wed, 17 Nov 2010 00:00:00 +0100

Conclusion: An interdisciplinary approach should be used in the management of upper cervical chordomas to facilitate tumour resection and reduce the potential for recurrence. (Source: ANZ Journal of Surgery)

Surgery for cervical stenosis: anterior cervical decompression, corpectomy, and fusion

European Spine Journal — Thu, 23 Sep 2010 17:19:12 +0100

Content Type Journal ArticleDOI 10.1007/s00586-010-1571-yAuthors Dieter Grob, Heidelberg, GermanyAndrea Luca, Heidelberg, Germany Journal European Spine JournalOnline ISSN 1432-0932Print ISSN 0940-6719 (Source: European Spine Journal)

Midline trough corpectomies for the evacuation of an extensive ventral cervical and upper thoracic spinal epidural abscess.

Journal of Neurosurgery.Spine — Sat, 31 Jul 2010 23:00:00 +0100

Authors: Deshmukh VR The author reports on a 59-year-old woman with a history of a chronic, nonhealing skin ulcer who presented with sepsis, neck pain, and rapidly progressive quadriparesis. Precontrast and postcontrast MR imaging studies revealed a multifocal ventral cervical and upper thoracic spinal epidural abscess. Compression of the spinal cord from the abscess was greatest behind the disc space of C2-3 and C7-T1. Because of the patient's tenuous medical status, the author elected to apply a technique that would allow expeditious decompression without necessitating concomitant fusion and instrumentation. Multilevel, contiguous trough corpectomies were performed for evacuation of the compressive lesions. A high-speed matchstick bur was used to create a 5- to 7-mm midline trough in...

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Langerhans cell histiocytosis of the cervical spine in an adult: a case report.

Turkish Neurosurgery — Wed, 30 Jun 2010 23:00:00 +0100

We present a case of a 47-year-old-woman with a complaint of cervical pain with paresthetic appearance on her left arm. She was treated with analgetics. Further radiological evaluation because of the persistent pain revealed an osteolytic destruction of the fourth cervical vertebra. The patient underwent anterior cervical corpectomy with total excision of the tumor. Stabilization of the cervical spine was performed. Histology confirmed the diagnosis of Langerhans cell histiocytosis (LCH) of the cervical spine. This case report presents the histopathological evaluation, diagnostic work-up and the treatment procedures because of rarity of cervical spinal LCH cases in the literature. PMID: 20669118 [PubMed - in process] (Source: Turkish Neurosurgery)

The stabilizing potential of anterior, posterior and combined techniques for the reconstruction of a 2-level cervical corpectomy model: biomechanical study and first results of ATPS prototyping

European Spine Journal — Wed, 30 Jun 2010 15:14:24 +0100

Abstract Clinical studies reported frequent failure with anterior instrumented multilevel cervical corpectomies. Hence, posterior augmentation was recommended but necessitates a second approach. Thus, an author group evaluated the feasibility, pull-out characteristics, and accuracy of anterior transpedicular screw (ATPS) fixation. Although first success with clinical application of ATPS has already been reported, no data exist on biomechanical characteristics of an ATPS-plate system enabling transpedicular end-level fixation in advanced instabilities. Therefore, we evaluated biomechanical qualities of an ATPS prototype C4–C7 for reduction of range of motion (ROM) and primary stability in a non-destructive setup among five constructs: anterior plate, posterior all-lateral...

Sternal cancellous bone graft harvest for anterior cervical discectomy and fusion with interbody cage devices

Clinical Neurology and Neurosurgery — Fri, 04 Jun 2010 15:15:24 +0100

Conclusions: We describe a modified technique of harvesting the sternal graft and also for the first time describe the long-term clinical outcome of using sternal autograft for ACDF. The sternal manubrium provides a viable alternative to AIC grafting. It confers the advantages of autograft fusion without the complications associated with AIC graft harvesting. (Source: Clinical Neurology and Neurosurgery)

Cages with Fixation Wings Versus Cages Plus Plating for Cervical Reconstruction after Corpectomy – Is there any Difference?

Zentralblatt fur Neurochirurgie - Central European Neurosurgery — Sat, 08 May 2010 15:28:13 +0100

Cen Eur Neurosurg 2010; 71: 59-63DOI: 10.1055/s-0029-1246135Abstract Different expandable and non-expandable fusion cages have gained acceptance in spinal surgery. We compared the radiological outcome of titanium cages with mounted wings to cages with additional anterior plating.[...]© Georg Thieme Verlag KG Stuttgart · New YorkGet connected:Table of contents | Abstract | Full text (Source: Zentralblatt fur Neurochirurgie - Central European Neurosurgery)

Surgical results and complications in a series of 71 consecutive cervical spondylotic corpectomies

Acta Neurochirurgica — Wed, 05 May 2010 08:12:16 +0100

Conclusions Cervical corpectomy is efficient for spinal cord decompression, especially when anterior components (disk osteophyte, OPLL...) bulge in the spinal cord. A three or more level corpectomy was not considered in this series since they may be associated to high rate morbidity. We found that this decompression led to better clinical results in patient grades 0 and 1 and to poorer results as myelopathy progressed. Among complications, subsidence was the most frequent specific one, but since it was rarely associated with symptoms, the majority of patients were successfully treated conservatively. Content Type Journal ArticleCategory Clinical ArticleDOI 10.1007/s00701-010-0660-3Authors Gaizka Bilbao, University of the Basque Country, Cruces Hospital Department ...

Serious complication of cement augmentation for damaged pilot hole.

Yonsei Medical Journal — Sat, 10 Apr 2010 07:50:17 +0100

Authors: Jung MY, Shin DA, Hahn IB, Kim TG, Huh R, Chung SS Polymethl methacrylate (PMMA) screw reinforcement is frequently used in osteoporotic bone as well as in damaged pilot holes. However, PMMA use can be dangerous, since the amount of applied cement is uncontrolled. A 47-year-old male with traumatic cervical spondylolisthesis at C6-7 underwent anterior cervical plate fixation. During repeated drilling and tapping for false trajectory correction, a pilot hole was damaged. Although it was an unconventional method, PMMA augmentation was tried. However, PMMA was accidentally injected to the cervical spinal cord owing to lack of fluoroscopic guidance. The PMMA was surgically removed after corpectomy and durotomy. The patient had left side hemiparesis (Grade 2/5) immediately post opera...

Single-Stage Posterolateral Corpectomy and Circumferential Stabilization without Laminectomy in the Upper Thoracic Spine: Cadaveric Study and Report of Three Cases.

Turkish Neurosurgery — Wed, 31 Mar 2010 23:00:00 +0100

CONCLUSION: The corpectomy procedure could be clearly performed under bilateral visualization of healthy bony margins with this technique. Although preserved laminae and spinous process lose the connection to the involved segment and hanged to adjacent levels only with posterior ligamentous complex, we propose that a chance of interlaminar fusion could further contribute to spinal stabilization rather than posterior instrumentation only. PMID: 20401851 [PubMed - in process] (Source: Turkish Neurosurgery)

Kyphosis in spinal tuberculosis - Prevention and correction

Table of Contents : Indian Journal of Orthopaedics : 2007 - 41(1) — Sat, 27 Mar 2010 15:00:07 +0100

Jain Anil K, Dhammi Ish Kumar, Jain Saurabh, Mishra PuneetIndian Journal of Orthopaedics 2010 44(2):127-136Spinal deformity and paraplegia/quadriplegia are the most common complications of tuberculosis (TB) of spine. TB of dorsal spine almost always produces kyphosis while cervical and lumbar spine shows reversal of lordosis to begin with followed by kyphosis. kyphosis continues to increase in adults when patients are treated nonoperatively or by surgical decompression. In children, kyphosis continues to increase even after healing of the tubercular disease. The residual, healed kyphosis on a long follow-up produces painful costopelvic impingement, reduced vital capacity and eventually respiratory complications; spinal canal stenosis proximal to the kyphosis and paraplegia with healed dise...

In vitro evaluation of stiffness and load sharing in a two-level corpectomy: comparison of static and dynamic cervical plates

The Spine Journal — Thu, 25 Mar 2010 00:00:00 +0100

Abstract: Background context: Anterior cervical plating has been accepted in corpectomy and fusion of the cervical spine. Constrained plates were criticized for stress shielding that may lead to subsidence and pseudarthrosis. A dynamic plate allows load sharing as the graft subsides. Ideally, the dynamic plate design should maintain adequate stiffness of the construct while providing a reasonable load sharing with the strut graft.Purpose: The purpose of the study was to compare dynamic and static plate kinematics with graft subsidence.Study design/setting: The study designed was an in vitro biomechanical study in a porcine cervical spine model.Methods: Twelve spines were initially tested in intact condition with 20-N axial load in 15 degrees of flexion and extension range of motion (ROM). ...

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The long-term results of anterior surgical reconstruction in patients with postlaminectomy cervical kyphosis

The Spine Journal — Mon, 15 Mar 2010 00:00:00 +0100

This study was designed to determine the long-term results and outcomes of anterior surgical treatment alone for the patients of postlaminectomy cervical kyphosis.Study design/setting: This is a retrospective review of prospectively collected data in an academic institution.Patient sample: The sample comprises 23 patients who underwent anterior reconstruction surgery for the treatment of postlaminectomy kyphosis.Outcome measures: The outcome measures were neck disability index (NDI), visual analog scale (VAS) for neck and arm pain, Nurick grades, kyphosis angles, fusion status, and complications.Methods: Two independent spine surgeons reviewed the completed medical records and radiographs of 23 patients who had undergone multilevel anterior cervical hybrid decompression (corpectomy and dis...

Comparison between anterior and posterior decompression with instrumentation for cervical spondylotic myelopathy: sagittal alignment and clinical outcome.

Neurosurgical Focus — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions . These results demonstrate that both anterior and posterior decompression (with instrumentation) are effective procedures to improve the neurological outcome of patients with CSM. However, sagittal alignment may be better restored using the anterior approach, but harbors a higher rate of loss of correction. In cases involving a preexisting cervical kyphosis, an anterior or combined approach might be necessary to restore the lordotic cervical alignment. PMID: 20192660 [PubMed - in process] (Source: Neurosurgical Focus)

Noncontiguous anterior decompression and fusion for multilevel cervical spondylotic myelopathy: a prospective randomized control clinical study

European Spine Journal — Sat, 20 Feb 2010 06:51:32 +0100

In conclusion, in the patients with MCSM, without developmental stenosis and continuous or combined ossification of posterior longitudinal ligaments, NADF and CCF showed an identical effect of decompression. In terms of surgical time, blood loss, VAS, fusion rate and cervical alignment, NADF was superior compared with CCF. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00586-010-1319-8Authors Xiao-Feng Lian, Sixth People’s Hospital, Shanghai Jiaotong University Department of Orthopedics Shanghai ChinaJian-Guang Xu, Sixth People’s Hospital, Shanghai Jiaotong University Department of Orthopedics Shanghai ChinaBing-Fang Zeng, Sixth People’s Hospital, Shanghai Jiaotong University Department of Orthopedics Shanghai ChinaWei Zhou, Sixth People’s Hospital, Shan...

The use of expandable cages in patients undergoing multilevel corpectomies for metastatic tumors in the cervical spine.

Orthopedics — Mon, 01 Feb 2010 00:00:00 +0100

We report our experience with the use of expandable cages in this subgroup of patients.From August 2006 to May 2008, 5 patients presenting with myelopathy, pain, and/or radiculopathy secondary to metastatic disease of the cervical spine underwent multilevel cervical corpectomies and placement of expandable cages in our institution. All procedures were supplemented with an anterior cervical plate and with posterior instrumentation to achieve a 360 degrees fusion. A visual analog scale (VAS), Nurick grade, Frankel grade, American Spinal Injuries Association (ASIA) grade, and Ranawat grade were used to evaluate patients pre- and postoperatively. The mean follow-up period was 13.2 months. Three patients underwent a 2-level corpectomy, 1 a 3-level corpectomy, and 1 a 4-level corpectomy. Postope...

"Skip" corpectomy in the treatment of multilevel cervical spondylotic myelopathy and ossified posterior longitudinal ligament.

Journal of Neurosurgery.Spine — Fri, 01 Jan 2010 00:00:00 +0100

Conclusions The authors conclude that the preservation of the C-5 vertebral body provided an additional screw purchase and strengthened the construct. The results of the current study demonstrated effectiveness and safety of the skip corpectomy in patients with multilevel CSM and OPLL. PMID: 20043761 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)

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Choice of surgical approach for ossification of the posterior longitudinal ligament in combination with cervical disc hernia

European Spine Journal — Fri, 11 Dec 2009 06:52:38 +0100

In conclusion, surgeons should consider the potential for CDH when performing spinal cord decompression and deciding the surgical approach in patients presenting with OPLL. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00586-009-1239-7Authors Hai-song Yang, Changzheng Hospital Department of Orthopaedic Surgery No. 415 Feng Yang Road 200003 Shanghai ChinaDe-yu Chen, Changzheng Hospital Department of Orthopaedic Surgery No. 415 Feng Yang Road 200003 Shanghai ChinaXu-hua Lu, Changzheng Hospital Department of Orthopaedic Surgery No. 415 Feng Yang Road 200003 Shanghai ChinaLi–li Yang, Changzheng Hospital Department of Orthopaedic Surgery No. 415 Feng Yang Road 200003 Shanghai ChinaWang-jun Yan, Changzheng Hospital Department of Orthopaedic Surgery No. 415 Feng Yang R...

Comparison of anterior cervical fusion after two-level discectomy or single-level corpectomy: sagittal alignment, cervical lordosis, graft collapse, and adjacent-level ossification

The Spine Journal — Thu, 22 Oct 2009 00:00:00 +0100

Abstract: Background context: Single-level corpectomy and two-level discectomy with anterior cervical plating have been reported to have comparable fusion and complication rates. However, there are few large series that have compared the two for sagittal alignment, cervical lordosis, graft subsidence, and adjacent-level ossification.Purpose: To determine the differences between these two procedures for patients with two-level spondylosis by comparing the pre- and postoperative radiographic data.Study design: Retrospective review of prospectively collected data in an academic institution.Patient sample: Fifty-two with a single-level corpectomy and 45 with a two-level anterior cervical discectomy and fusion (ACDF).Outcome measures: Pre- and postoperative radiographic data for sagittal alignm...

Pseudomorbidity in iliac crest bone graft harvesting: the rise of rhBMP-2 in short-segment posterior lumbar fusion

The Spine Journal — Wed, 21 Oct 2009 14:03:56 +0100

In this study, it is clear that the autologous technique has serious and frequent problems. The other two studies in this issue look at the most common cited complication associated with posterior iliac crest bone graft (ICBG) harvesting, pain. (Source: The Spine Journal)

Posterior transpedicular corpectomy for malignant cervical spine tumors

European Spine Journal — Tue, 13 Oct 2009 08:17:44 +0100

Abstract The goal of this study was to assess surgical clinical and radiographic outcomes of using a posterior transpedicular approach (posterolateral) for ventral malignant tumors of the cervical spine. Access to ventral lesions of the cervical spine can be challenging in patients with malignant tumors. Anterior approaches are the gold standard for ventral pathology in the cervical spine, however, there are cases, where a posterior approach is indicated due to multilevel disease, previous radiation, swallowing difficulty with difficulty in retraction of trachea and esophagus, and in cases where circumferential fusion cannot be done due to patients’ poor medical condition. A single approach could provide spinal stabilization and removal of tumor. Eight cases of ventral c...

Screw angulation affects bone-screw stresses and bone graft load sharing in anterior cervical corpectomy fusion with a rigid screw-plate construct: a finite element model study

The Spine Journal — Mon, 12 Oct 2009 00:00:00 +0100

Conclusion: This study suggests that screw divergence from the end plates not only increases load transmission to the graft but also predisposes the screws to higher shear forces after corpectomy reconstruction. In particular, the inferior screw demonstrated larger stress than the upper-level screws. In the proposed hybrid fusion model, lower stresses on the bone graft, end plates, and bone-screw interface were recorded, inferring lower construct failure (end-plate fractures and screw pullout) potential at the inferior construct end. (Source: The Spine Journal)

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Quality of life assessment after central corpectomy for cervical spondylotic myelopathy: comparative evaluation of the 36-Item Short Form Health Survey and the World Health Organization Quality of Life-Bref.

Journal of Neurosurgery.Spine — Thu, 01 Oct 2009 00:00:00 +0100

Conclusions The WHOQOL-Bref, like the SF-36, is valid and reliable in assessing outcome in patients with CSM. It measures impairment in CSM in a more uniform manner than the SF-36, but its domains are less responsive to postoperative changes. Because the WHOQOL-Bref measures different constructs and has additive value, it should be used along with the SF-36 for QOL assessment in patients with CSM. PMID: 19929335 [PubMed - in process] (Source: Journal of Neurosurgery.Spine)

A combined posterior, lateral, and anterior approach to ventrolaterally situated chordoma of the upper cervical spine

Surgical Neurology — Mon, 07 Sep 2009 17:59:50 +0100

Conclusion: When a direct posterior approach makes it difficult or impossible to reach tumors extending to the far lateral margins of the spine and soft tissues, the posterior-lateral approach described here allows excellent visualization and safe access with minimal neural retraction for treating these laterally situated lesions. We describe the surgical technique for a combined approach as an alternative to the direct posterior or anterior retropharyngeal approach. (Source: Surgical Neurology)

Brown-Sequard-type myelopathy due to cervical disc herniation associated with severe carotid stenosis prompting rapid combined corpectomy and carotid endarterectomy under deep anticoagulant therapy

The Spine Journal — Tue, 01 Sep 2009 23:00:00 +0100

Conclusions: This case suggests that such a combined carotid endarterectomy and cervical corpectomy with fusion under anticoagulant and antiplatelet therapy is feasible. However, even if the unique clinical presentation of our patient led us to undertake such a surgical strategy, therapeutic decision in patients presenting with both severe carotid stenosis and cervical spinal cord compression should rely on a case-by-case analysis. (Source: The Spine Journal)

Anterior neurodecompression of kyphotic spondylogenic myelopathy Ranawat grade III and posterior decompression of lordotic spine improve walking ability.

Collegium Antropologicum — Tue, 01 Sep 2009 00:00:00 +0100

Authors: Margetić P, Elabjer E, Milosević M, Skoro I, Milanov B, Stancić M Cervical spondylosis is common condition rarely associated with radiculomyelopathy which surgical treatment, according to meta-analysis, is not better than nonsurgical. Our hypothesis was that neurodecompression which type is chosen according to spinal alignment should result in better functional improvement comparing with nonsurgical treatment. Between January 1, 1998 and December 31, 2007 a total of 77 patients with spondylogenic myelopathy were selected for the study. The inclusion criteria were symptoms and signs of myelopathy Ranawat grade III. Exclusion criteria were amyotrophic lateral sclerosis (ALS) and multiple sclerosis (MS). The curvature of the cervical spine was determined by Ishi...

Hybrid decompression technique and two-level corpectomy are effective treatments for three-level cervical spondylotic myelopathy.

J Zhejiang Univ Sci ... — Mon, 31 Aug 2009 23:00:00 +0100

Authors: Liu Y, Yu KY, Hu JH The optimal surgical strategy for multilevel cervical spondylotic myelopathy (CSM) has not been defined, and few comparative researches between hybrid decompression and multilevel corpectomy have been conducted. Here, we reported 28 patients of three-level CSM, of whom 12 underwent hybrid decompression and 16 two-level corpectomy, with each type of procedure chosen according to radiologic characteristics of those patients. Clinical and radiologic parameters of both groups showed various degrees of improvement. However, no statistically significant differences in Japanese Orthopedic Association (JOA) score improvement rate, graft fusion rate, post-operative neck disability index (NDI) or segmental lordosis between the two groups were found. We conclude that ...

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Commentary

Surgical Neurology — Mon, 10 Aug 2009 00:00:00 +0100

Anterior corpectomy with direct removal of prominent OPLL and fixation is one of the most difficult and challenging procedures in cervical spine surgery. Wound-peritoneal shunt with LP shunt reported by the author is one way to deal with dural tear with CSF leakage, which is one of the annoying complications of this procedure. In my personal series of 185 cases of cervical OPLL for the last decade, only 4 cases (2.1%) needed a combined approach—which consisted of multilevel corpectomy for removal of prominent OPLL and fixation after expansive laminoplasty because of neurologic deterioration in follow-ups. Therefore, expansive laminoplasty, either open-door or double-door, is an effective and less invasive procedure with a few complications for extensive OPLL of continuous or mixed type. ...

Comparison of ventral corpectomy and plate-screw-instrumented fusion with dorsal laminectomy and rod-screw-instrumented fusion for treatment of at least two vertebral-level spondylotic cervical myelopathy

European Spine Journal — Fri, 07 Aug 2009 11:18:25 +0100

The objective of the article is to verify the hypothesis that the dorsal multilevel laminectomy and rod-screw-instrumented fusion (DLF) for multilevel spondylotic cervical myelopathy (MSCM) is less strenuous for patients, and less prone to perioperative complications, than ventral multilevel corpectomy and plate-screw-instrumented fusion (VCF), while clinical outcome is comparable. One hundred and three successive patients were treated for at least two vertebral-level MSCM, 42 of them by VCF and 61 by DLF. The two patients groups were retrospectively compared. VCF patients were slightly younger than DLF patients (62.5 ± 10.61 years versus 66 ± 12.4 years, P = 0.012). In VCF patients, a median of 2 (2–3) corpectomies and in DLF patients a med...

Cervical surgical techniques for the treatment of cervical spondylotic myelopathy.

Journal of Neurosurgery.Spine — Fri, 31 Jul 2009 23:00:00 +0100

Conclusions Multiple approaches exist with similar near-term improvements; however, laminectomy appears to have a late deterioration rate that may need to be considered when appropriate. PMID: 19769492 [PubMed - in process] (Source: Journal of Neurosurgery.Spine)

Cervical spine lateral approach for myeloradiculopathy: technique and pitfalls

Surgical Neurology — Wed, 15 Jul 2009 23:00:00 +0100

Conclusion: The cervical lateral multilevel corpectomy/foraminotomy technique allows wide anterior decompression of the spinal cord and complete unilateral nerve root decompression preserving spinal stability and physiological spinal motion. (Source: Surgical Neurology)

Differences between subtotal corpectomy and laminoplasty for cervical spondylotic myelopathy

Spinal Cord — Tue, 14 Jul 2009 23:00:00 +0100

Authors: S Shibuya, S Komatsubara, S Oka, Y Kanda, N Arima & T Yamamoto (Source: Spinal Cord)

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Brucella cervical spondylitis complicated by spinal cord compression: a case report

Cases Journal — Wed, 08 Jul 2009 23:00:00 +0100

A case of 65-year-old farmer who presented with Brucella-related cervical spondylitis is described. Because of the advanced form of the infection resulted in neurological impairment, cervical vertebra corpectomy and debridement of the paravertebral granulomatous tissue deposits were performed followed by stabilization with anterior plating and bone grafting. In addition, double antimicrobial chemotherapy regimen was administered for 12 weeks. After one year, follow up evaluation demonstrated resolution of the infection. The authors recommend that brucellosis should be included in the differential diagnosis of cervical spondylitis, particularly in patients who reside in countries where the zoonosis is still endemic. (Source: Cases Journal)

Donor-site complications of autogenous nonvascularized fibula strut graft harvest for anterior cervical corpectomy and fusion surgery: experience with 163 consecutive cases

The Spine Journal — Sun, 14 Jun 2009 23:00:00 +0100

Abstract: Background context: The fibula is a source of bone graft for reconstruction of the appendicular and axial skeleton.Purpose: The aim of this study is to determine donor-site complications and morbidity in a large series of patients who underwent autogenous fibula harvesting for anterior cervical corpectomy and fusion (ACCF) surgery.Study design/setting: Retrospective review (Level III).Patient sample: One hundred sixty-three patients over an eight-year period who underwent ACCF with autogenous fibula.Outcome measures: Donor site complications (such as infection, cellulitis, pain, damage to the superficial peroneal nerve, ankle instability, tibial stress fracture, and so forth), treatment, and final outcome were determined from patient records.Methods: Retrospective study of patien...

Diagnosis and surgery of ossification of posterior longitudinal ligament associated with dural ossification in the cervical spine

European Spine Journal — Tue, 19 May 2009 05:55:25 +0100

This study reviewed 138 patients who received anterior cervical corpectomy and fusion (ACCF) for OPLL, and 40 patients were found in the association with DO during anterior procedure. Radiological studies revealed that the patients with severe OPLL (higher occupying rate and larger extent) have increasing opportunity of association with DO. The double-layer sign, as a specific indicator for association with DO was sensitive in the patients with mild OPLL, but less frequent in those with severe OPLL with DO. Two surgical techniques were used for the patients with DO in anterior decompression procedure. When the double-layer sign was observed on CT scans, the OPLL could be separated from DO through a thin layer consisting a nonossified degenerated PLL to avoid CSF leakage. Otherwise, t...

Anterior subaxial cervical spine fixation using a plate with single screw per vertebral body: A simple and efficient construct - Clinical series and a cadaver study

Neurology India — Fri, 15 May 2009 15:14:12 +0100

Conclusion:</b> A conservative construct utilizing a single screw per vertebral body and a one-holed plate system appears to be strong enough to afford stability in both traumatic and nontraumatic lesions of subaxial cervical spine, comparable to others. (Source: Neurology India)

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Functional outcome of corpectomy in cervical spondylotic myelopathy

Table of Contents : Indian Journal of Orthopaedics : 2007 - 41(1) — Thu, 07 May 2009 18:01:02 +0100

Conclusions:</b> Cervical corpectomy is a reliable and rewarding procedure for CSM, with functional improvement in most patients. (Source: Table of Contents : Indian Journal of Orthopaedics : 2007 - 41(1))

Multilevel oblique corpectomy without fusion in managing cervical myelopathy: long-term outcome and stability evaluation in 268 patients.

Journal of Neurosurgery.Spine — Thu, 30 Apr 2009 23:00:00 +0100

CONCLUSIONS: Multilevel oblique corpectomy was demonstrated to be a safe procedure that provided good results in terms of improved functional status and long-term spinal stability. PMID: 19442008 [PubMed - indexed for MEDLINE] (Source: Journal of Neurosurgery.Spine)

Distal-type cervical spondylotic amyotrophy: incidence and outcome after central corpectomy.

Journal of Neurosurgery.Spine — Tue, 31 Mar 2009 23:00:00 +0100

CONCLUSIONS: Distal-type CSA is a rare form of CSM that should be differentiated from motor neuron disease on the basis of subtle sensory symptoms or signs in the upper limbs, and the presence of significant cord compression on the MR imaging. Patient outcome after central corpectomy is good and long lasting. PMID: 19441997 [PubMed - indexed for MEDLINE] (Source: Journal of Neurosurgery.Spine)

Pharyngocutaneous fistula after anterior cervical spine surgery

European Spine Journal — Sat, 28 Mar 2009 08:55:46 +0100

We report a case of a 19 year old female who sustained a C6 burst fracture with complete quadriplegia. She was treated urgently with a C6 corpectomy with anterior cage and plating followed by posterior cervical stabilization at another institution. Post operatively she developed a pharyngocutaneous fistula that failed to heal despite several attempts of closure and esophageal exclusion with a Jpeg tube. The patient was eventually successfully treated with a three-stage procedure consisting of firstly a posterior approach to reinforce the posterior stabilization of the cervical spine that was felt to be inadequate, secondly an anterior approach with removal of all the anterior instrumentation followed by iliac crest bone graft and thirdly a superior based sternocleidomastoid flap...

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Comparative study of anterior versus posterior decompression in elderly patients of cervical myelopathy with co-morbid conditions

European Journal of Orthopaedic Surgery & Traumatology — Sat, 07 Mar 2009 11:00:43 +0100

Conclusion Anterior decompression is the gold standard. However, in medically unfit patients with multi-level circumferential compression laminectomy is an equally rewarding option. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00590-009-0444-8Authors Sudeep Jain, All India Institute of Medical Sciences New Delhi 79 First Floor, Raja Garden New Delhi 110015 IndiaSaurabh Singh, All India Institute of Medical Sciences New Delhi 79 First Floor, Raja Garden New Delhi 110015 IndiaAnil Kumar Joshi, All India Institute of Medical Sciences New Delhi 79 First Floor, Raja Garden New Delhi 110015 IndiaChirayu Pamecha, Nathiba Hargovindas Lallubhai Municipal Medical College Ahmedabad Ahmedabad IndiaBharat Dave, Nathiba Hargovindas Lallubhai Municipal Medical Co...

[Clinical application of expansive unilateral open-door laminoplasty of the cervical spine with OsteoMed M3 plate and screws.]

Journal of Southern Medical University — Sun, 01 Mar 2009 05:00:00 +0100

CONCLUSION: Unilateral open-door laminoplasty with OsteoMed M3 titanium plate and screw fixation can effectively maintain the expansion of the spinal canal and resist closure while preserving the spinal alignment and stability. This modified technique is easy to perform and is associated with a low complication rate. PMID: 19304533 [PubMed - in process] (Source: Journal of Southern Medical University)

Spinal cord herniation after multilevel anterior cervical corpectomy and fusion for ossification of the posterior longitudinal ligament of the cervical spine.

Journal of Neurosurgery.Spine — Sun, 01 Mar 2009 05:00:00 +0100

Authors: Min JH, Jung BJ, Jang JS, Kim SK, Jung DJ, Lee SH The authors report the case of a 52-year-old man who had undergone resection of an ossified posterior longitudinal ligament via the anterior approach. The patient experienced postoperative neurological deterioration that may have been caused by a massive cord herniation associated with a dural defect at the corpectomy site. Spinal cord herniation may develop as a complication of anterior cervical decompression. Surgeons should be alert to this condition when planning to treat cervical ossification of the ossified posterior longitudinal ligament via the anterior approach. PMID: 19320584 [PubMed - in process] (Source: Journal of Neurosurgery.Spine)

Comparison between anterior cervical discectomy fusion and cervical corpectomy fusion using titanium cages for reconstruction: analysis of outcome and long-term follow-up

European Spine Journal — Fri, 13 Feb 2009 08:10:12 +0100

Abstract Retrospective comparative study of 80 consecutive patients treated with either anterior cervical discectomy fusion (ACDF) or anterior cervical corpectomy fusion (ACCF) for multi-level cervical spondylosis. To compare clinical outcome, fusion rates, and complications of anterior cervical reconstruction of multi-level ACDF and single-/multi-level ACCF performed using titanium mesh cages (TMCs) filled with autograft and anterior cervical plates (ACPs). Reconstruction of the cervical spine after discectomy or corpectomy with titanium cages filled with autograft has become an acceptable alternative to both allograft and autograft; however, there is no data comparing the outcome of multi-level ACDF and single-/multi-level ACCF using this reconstruction. We evaluated 80 ...

Long-term Follow-up After Open-window Corpectomy in Patients With Advanced Cervical Spondylosis and/or Ossification of the Posterior Longitudinal Ligament.

Journal of Spinal Disorders & Techniques — Wed, 04 Feb 2009 07:07:56 +0100

Page: 14DOI: 10.1097/BSD.0b013e31815f49feAuthors: Ozer, Ali Fahir MD *; Oktenoglu, Tunc MD *; Cosar, Murat MD +; Sasani, Mehdi MD *; Sarioglu, Ali Cetin MD * (Source: Journal of Spinal Disorders & Techniques)

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Analysis of Reoperations after Surgical Treatment of Degenerative Cervical Spine Disorders: A Report on 900 Cases.

Zentralblatt fur Neurochirurgie — Tue, 03 Feb 2009 05:00:00 +0100

CONCLUSIONS: The influence of the fusion length on the revision rate was unexpectedly high. Adjacent level decompensation was neither influenced by the length of the fusion nor the performed procedure. Compared to anterior instrumentation, posterior instrumentation showed a tendency for a lower revision rate without statistical significance. However, the posterior procedures showed a high revision rate regarding to wound healing problems. PMID: 19191203 [PubMed - as supplied by publisher] (Source: Zentralblatt fur Neurochirurgie)

Posterior transpedicular corpectomy and reconstruction of the axial vertebra for metastatic tumor.

Journal of Neurosurgery.Spine — Sun, 01 Feb 2009 05:00:00 +0100

Authors: Ames CP, Wang VY, Deviren V, Vrionis FD Management of metastatic disease is a significant challenge in modern spinal surgery. Previously, radiation therapy alone was the most commonly employed treatment. Recent data, however, suggest that surgical decompression in addition to radiation therapy improves functional recovery compared with radiation therapy alone. Metastatic disease most commonly affects the thoracic spine. Over the past decade surgical treatment has changed significantly for thoracic disease, shifting from transthoracic resection and reconstruction to single-stage posterolateral approaches that allow transpedicular resection and reconstruction. In posterolateral approaches, patients are spared the morbidity associated with transcavitary approaches while receiving...

Degenerative spondylolisthesis of the cervical spine: analysis of 58 patients treated with anterior cervical decompression and fusion

The Spine Journal — Mon, 29 Dec 2008 05:00:00 +0100

Conclusions: Degenerative spondylolisthesis is relatively common in the cervical spine. Common to all cases is facet arthropathy and neurologic compression. Anterior cervical decompression and arthrodesis appears to yield excellent union rates and neurological improvement in those patients having cervical degenerative spondylolisthesis and significant neurological sequelae who have failed nonoperative treatments. (Source: The Spine Journal)

Circumferential fusion for cervical kyphotic deformity.

Journal of Neurosurgery.Spine — Sat, 29 Nov 2008 12:07:45 +0100

Conclusions In cases of cervical kyphosis, management with decompression, osteotomy, and stabilization from both anterior and posterior approaches can restore cervical lordosis. Furthermore, such surgical techniques can produce measurable improvements in neurological function (as measured with Nurick grades and mJOA scores) and achieve high fusion rates. However, there is a significant rate of complications. PMID: 19035741 [PubMed - in process] (Source: Journal of Neurosurgery.Spine)

Cervical Intradural Ventral Arachnoid Cyst Resected Via Anterior Corpectomy With Reconstruction: A Case Report.

Turkish Neurosurgery — Fri, 26 Sep 2008 17:06:20 +0100

CONCLUSION: For purely ventral cervical intradural arachnoid cysts, which compress the spinal cord dorsally, an anterior approach can allow access to the lesion without any need for intraoperative manipulation of the spinal cord. For such cases, the anterior approach prevents the consequent risk of neurological injury due to posterior approaches. PMID: 18814111 [PubMed - as supplied by publisher] (Source: Turkish Neurosurgery)

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Pharyngoesophageal diverticulum following cervical corpectomy and plating. Case report.

Journal of Neurosurgery.Spine — Mon, 01 Sep 2008 04:00:00 +0100

Authors: Joanes V, Belinchón J This case of a pharyngoesophageal diverticulum was diagnosed 3 years after a corpectomy and fusion for a cervical fracture. The diverticulum was excised, the plate and screws were removed, and the patient was asymptomatic 3 years later. The dense scar tissue around the hardware probably caused traction on the posterior pharyngoesophageal region, followed by development of the diverticulum. The authors speculate that the malpositioning of the hardware was an irritative factor promoting such a scar. To the best of their knowledge, this is the first reported case of pharyngoesophageal diverticulum following cervical corpectomy and plating. PMID: 18928221 [PubMed - in process] (Source: Journal of Neurosurgery.Spine)

Anterior approach to cervical intramedullary pilocytic astrocytoma. Case report.

Journal of Neurosurgery.Spine — Mon, 01 Sep 2008 04:00:00 +0100

Authors: Ogden AT, Feldstein NA, McCormick PC Although there has been considerable experience with anterior approaches to ventral intradural, extramedullary, and pial-based spinal lesions, there is no information in the literature regarding the safety and feasibility of the resection of an intramedullary tumor via an anterior approach. The authors report on the gross-total resection of an intramedullary cervical pilocytic astrocytoma via a C-7 corpectomy and anterior myelotomy. The surgery proceeded without complication, and postoperatively the patient maintained the preoperative deficit of mild unilateral hand weakness but had no sensory deficits. Follow-up MR imaging at 6 months showed gross-total macroscopic resection. Selected intramedullary tumors can be safely removed via an ante...

Correlation between change in graft height and change in segmental angle following central corpectomy for cervical spondylotic myelopathy.

Journal of Neurosurgery.Spine — Fri, 01 Aug 2008 04:00:00 +0100

Conclusions Among patients undergoing uninstrumented CC for CSM, there is a significant correlation between postoperative settling and kyphotic change across fused segments in those who had straight or kyphotic cervical spines or segments preoperatively but not in those who had lordotic cervical spines or segments preoperatively. A more vigorous surgical correction of the segmental kyphosis than achieved in this study might have caused the kyphotic segments to behave like the lordotic segments. Paraspinal muscles and ligaments may play a role in determining the segmental angle as graft settling in patients with lordotic spines or segments is not linearly correlated with angular change. PMID: 18764748 [PubMed - in process] (Source: Journal of Neurosurgery.Spine)

Surgical treatment of cervical spondylotic myelopathy with anterior compression: a review of 67 cases.

Journal of Neurosurgery.Spine — Fri, 01 Aug 2008 04:00:00 +0100

Conclusions Significant improvement in Nurick grade can be achieved in patients who undergo anterior surgery for cervical myelopathy for primarily ventral disease or loss of cervical lordosis. In selected high-risk patients who undergo multilevel ventral decompression, supplemental posterior fixation and arthrodesis allows for low rates of construct failure with acceptable added morbidity. PMID: 18764747 [PubMed - in process] (Source: Journal of Neurosurgery.Spine)

Effects of Disc Height and Distractive Forces on Graft Compression in an Anterior Cervical Corpectomy Model.

Spine — Sat, 31 May 2008 14:45:59 +0100

The role of defect and graft size on compressive loading of strut grafts was tested in 17 cadaveric cervical specimens using a calibrated Caspar distractor and subminiature load cells. Although defect size did not predict graft loading, increases in strut graft height led to significant increases in graft compressive loads.Page: 1438DOI: 10.1097/BRS.0b013e318175c315Authors: Truumees, Eeric MD +; Demetropoulos, Constantine K. PhD +; Yang, King H. PhD *; Herkowitz, Harry N. MD + (Source: Spine)

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Long-term Biomechanical Stability and Clinical Improvement After Extended Multilevel Corpectomy and Circumferential Reconstruction of the Cervical Spine Using Titanium Mesh Cages.

Journal of Spinal Disorders & Techniques — Tue, 06 May 2008 20:04:41 +0100

Page: 165DOI: 10.1097/BSD.0b013e3180654205Authors: Acosta, Frank L. Jr MD; Aryan, Henry E. MD; Chou, Dean MD; Ames, Christopher P. MD (Source: Journal of Spinal Disorders & Techniques)

Cerebrospinal Fluid Leaks Following Cervical Spine Surgery

JBJS [Am] — Thu, 01 May 2008 04:00:00 +0100

Conclusions: Many cervical dural tears can be managed by observation alone or by placement of a lumbar cerebrospinal fluid shunt either during the index procedure or in the postoperative period. At an average follow-up of 5.4 years, there were no long-term sequelae of the cervical dural tears in our series. Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence. (Source: JBJS [Am])

Cervical fusion.

Journal of Neurosurgery.Spine — Thu, 01 May 2008 04:00:00 +0100

Conclusions The anticipated fusion rate is one of several factors that may guide surgical decision making. Anterior cervical decompression and fusion results in high fusion rates. The results of the authors' study show that regardless of the number of levels fused, the use of an anterior cervical plate system significantly increases the fusion rate. For two-disc-level disease, there was no significant difference between ACD with a plate system or corpectomy with a plate system. For three-disc-level disease, however, the evidence suggests that corpectomy with plate placement is associated with higher fusion rates than discectomy with plate placement. PMID: 18447700 [PubMed - in process] (Source: Journal of Neurosurgery.Spine)

Cerebrospinal fluid leaks following cervical spine surgery.

The Journal of Bone and Joint Surgery. American volume — Thu, 01 May 2008 04:00:00 +0100

CONCLUSIONS: Many cervical dural tears can be managed by observation alone or by placement of a lumbar cerebrospinal fluid shunt either during the index procedure or in the postoperative period. At an average follow-up of 5.4 years, there were no long-term sequelae of the cervical dural tears in our series. PMID: 18451403 [PubMed - indexed for MEDLINE] (Source: The Journal of Bone and Joint Surgery. American volume)

Anterior pedicle screw fixation for multilevel cervical corpectomy and spinal fusion

Acta Neurochirurgica — Wed, 23 Apr 2008 16:19:50 +0100

Conclusions. The insertion of APSs is feasible and safe. APS fixation enables us to obtain rigid fixation anteriorly, and we propose that APS fixation is an attractive option for multilevel cervical corpectomy and fusion. Content Type Journal ArticleCategory Technical NoteDOI 10.1007/s00701-008-1574-1Authors M. Aramomi, Chiba University Graduate School of Medicine Spine Section, Department of Orthopaedic Surgery Chuo-ku Chiba JapanY. Masaki, Chiba University Graduate School of Medicine Spine Section, Department of Orthopaedic Surgery Chuo-ku Chiba JapanS. Koshizuka, Chiba University Graduate School of Medicine Spine Section, Department of Orthopaedic Surgery Chuo-ku Chiba JapanR. Kadota, Chiba University Graduate School of Medicine Spine Section, Department of Orthopaedic Surgery...

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Cervical spondylotic myelopathy treated by oblique corpectomy: a prospective study.

Neurosurgery — Sat, 19 Apr 2008 07:36:09 +0100

Page: 674DOI: 10.1227/01.neu.0000317316.56235.a7Authors: Kiris, Talat M.D.; Kilincer, Cumhur M.D. (Source: Neurosurgery)

Anterior corpectomy and fusion for severe ossification of posterior longitudinal ligament in the cervical spine

International Orthopaedics — Sat, 12 Apr 2008 09:28:17 +0100

Abstract Between May 2002 and October 2006, 19 patients (17 men and 2 women; average age 57.2; range 47–71 years) received anterior corpectomy and fusion for severe ossification of the posterior longitudinal ligament (OPLL) in our department. Preoperative radiological evaluation showed the narrowing by the OPLL exceeded 50% in all cases, and OPLL extended from one to three vertebrae. We followed-up all patients for 12–36 months (mean 18 months). The Japanese Orthopaedic Association (JOA) score before surgery was 9.3 ± 1.8 (range 5–12) which significantly increased to 14.2 ± 1.3 (range 11–16) points at the last follow-up (P < 0.01). The improvement rate (IR) of neurological function ranged from 22.2–87.5%, with a mean of 63.2% ± ...

Laser-Assisted Anterior Cervical Corpectomy versus Posterior Laminoplasty for Cervical Myelopathic Patients with Multilevel Ossification of the Posterior Longitudinal Ligament

Photomedicine and Laser Surgery — Sun, 16 Mar 2008 17:10:45 +0100

This study reports on the comparative results of a series of patients with multilevel cervical ossification of the posterior longitudinal ligament (OPLL) who were treated with laser-assisted anterior corpectomy or laminoplasty. ... (Source: Photomedicine and Laser Surgery)

Anterior corpectomy approach for removal of a cervical intradural schwannoma.

The Canadian Journal of Neurological Sciences — Sat, 01 Mar 2008 05:00:00 +0100

Authors: Casha S, Xie JC, Hurlbert RJ PMID: 18380288 [PubMed - indexed for MEDLINE] (Source: The Canadian Journal of Neurological Sciences)

Anterior Corpectomy With Iliac Bone Fusion or Discectomy With Interbody Titanium Cage Fusion for Multilevel Cervical Degenerated Disc Disease.

Journal of Spinal Disorders & Techniques — Thu, 29 Nov 2007 01:32:01 +0100

Page: 565DOI: 10.1097/BSD.0b013e318036b463Authors: Hwang, Shiuh-Lin MD, PhD *; Lee, Kung-Shing MD *; Su, Yu-Feng MD *; Kuo, Tai-Hung MD +; Lieu, Ann-Shung MD *; Lin, Chih-Lung MD *; Howng, Shen-Long MD, PhD *; Hwang, Yan-Feng MD * (Source: Journal of Spinal Disorders & Techniques)

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Mediastinal migration of distal occipito-thoracic instrumentation

European Spine Journal — Wed, 14 Nov 2007 15:30:49 +0100

We present the occurrence and management of mediastinal migration of the distal aspect of a posterior occipito-thoracic screw–rod construct. No similar occurrence was found in the literature. This event occurred following an emergency tracheotomy (requiring neck hyperextension) in a patient with severe rheumatoid arthritis, who had previously undergone decompression and an Occiput-T2 instrumented fusion for cranio-cervical and sub-axial cervical spine instability. Imaging showed fracture-subluxation of T1/2 and T2/3 with the bilateral C7, T1 and T2 screws in the mediastinum causing tracheal and esophageal compression. Removal of the instrumentation, decompression (T2 corpectomy) and construct revision down to T10 was safely performed from a posterior approach. Severe osteoporosis, ...

Surgical results of anterior corpectomy in the aged patients with cervical myelopathy

European Spine Journal — Wed, 31 Oct 2007 14:45:18 +0100

Abstract Retrospective study on the results of anterior corpectomy for the treatment of cervical myelopathy in patients over 70 years old. To evaluate the surgical results of anterior corpectomy in aged patients with multilevel cervical myelopathy and to investigate the probable pathomechanism by radiographic study. There are few data focused on the surgical results and post-operative complications of anterior corpectomy in aged patients with cervical myelopathy. Twenty patients 70 years of age or older who underwent anterior corpectomy, titanium mesh cage (TMC) reconstruction and anterior plate fixation for the treatment of compressive cervical myelopathy were reviewed. The average age at the time of operation was 75 years. Neurologic deficits before and aft...

Multilevel Cervical Oblique Corpectomy in the Treatment of Ossified Posterior Longitudinal Ligament in the Presence of Ossified Anterior Longitudinal Ligament.

Spine — Sat, 15 Sep 2007 00:50:13 +0100

We describe the utility of the oblique corpectomy in 3 patients who presented with cervical myelopathy caused by OPLL in whom a coexistent OALL was asymptomatic. The oblique corpectomy, by virtue of its anterolateral approach, facilitated the removal of the OPLL while preserving the OALL, thus avoiding complex reconstructive procedures.Page: E575DOI: 10.1097/BRS.0b013e31814b84feAuthors: Chacko, Ari G. MCh; Daniel, Roy T. MCh (Source: Spine)

Successful treatment of extended epidural abscess and long segment osteomyelitis: a case report and review of the literature.

Surgical Neurology — Wed, 05 Sep 2007 04:00:00 +0100

CONCLUSIONS: This case illustrates that spinal instrumentation is not an absolute contraindication in the presence of epidural abscesses and vertebral osteomyelitis. Combined surgical debridement at a critical level, with adjuvant antibiotics and hyperbaric oxygenation, is a safe and effective therapy in those with neurologic deficits, spinal instability, and extended epidural abscess. PMID: 17825364 [PubMed - as supplied by publisher] (Source: Surgical Neurology)

Use of the clavicle in anterior cervical discectomy/corpectomy fusion procedures: cadaveric feasibility study

Child's Nervous System — Wed, 18 Jul 2007 06:47:34 +0100

Conclusions Based on our cadaveric study, such a bony substitute as autologous clavicle might be a reasonable alternative to the iliac crest for use in anterior cervical fusion procedures. Content TypeJournal Article JournalChild's Nervous SystemOnline ISSN 1433-0350Print ISSN 0256-7040 (Source: Child's Nervous System)

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Utilization of Predonated Autologous Blood in Anterior Cervical Corpectomy and Fusion Surgery.

Journal of Spinal Disorders & Techniques — Tue, 03 Jul 2007 03:04:39 +0100

Page: 357DOI: 10.1097/BSD.0b013e31802d8383Authors: Espiritu, Michael T. MD; Khan, Mustafa H. MD; Hannallah, David MD; Donaldson, William F. III MD; Kang, James D. MD; Lee, Joon Y. MD (Source: Journal of Spinal Disorders & Techniques)

4- and 5-level anterior fusions of the cervical spine: review of literature and clinical results

European Spine Journal — Fri, 29 Jun 2007 08:27:56 +0100

Abstract In the future, there will be an increased number of cervical revision surgeries, including 4- and more-levels. But, there is a paucity of literature concerning the geometrical and clinical outcome in these challenging reconstructions. To contribute to current knowledge, we want to share our experience with 4- and 5-level anterior cervical fusions in 26 cases in sight of a critical review of literature. At index procedure, almost 50% of our patients had previous cervical surgeries performed. Besides failed prior surgeries, indications included degenerative multilevel instability and spondylotic myelopathy with cervical kyphosis. An average of 4.1 levels was instrumented and fused using constrained (26.9%) and non-constrained (73.1%) screw-plate systems. At all, fou...

Cervical Corpectomy With Preserved Posterior Vertebral Wall for Cervical Spondylotic Myelopathy: A Randomized Control Clinical Study.

Spine — Sun, 17 Jun 2007 07:05:43 +0100

A total of 178 patients with cervical spondylotic myelopathy randomly underwent corpectomy with preserved posterior vertebral wall or conventional corpectomy during a 3-year period. Surgical parameter, complication, neurologic improvement, and fusion rate in both groups were recorded and compared. It was proved that corpectomy with preserved posterior vertebral wall had decreased operative time and less blood loss against conventional corpectomy.Page: 1482DOI: 10.1097/BRS.0b013e318068b30aAuthors: Ying, Zhang MD; Xinwei, Wang MD; Jing, Zhang MD; Shengming, Xu MD; Bitao, Lv MD; Tao, Zhang MD; Wen, Yuan MD (Source: Spine)

Biomechanical Comparison of Instrumented and Uninstrumented Multilevel Cervical Discectomy Versus Corpectomy.

Spine — Mon, 14 May 2007 05:34:07 +0100

Spinal stability after multilevel corpectomy or discectomy was compared after bone graft insertion, after anterior plating, and after combined anterior and posterior instrumentation. There was little difference in stability among the techniques. An anterior plate effectively stabilized both types of decompression. Adding posterior instrumentation further reduced motion significantly.Page: 1220DOI: 10.1097/01.brs.0000270104.95045.24Authors: Galler, Robert M. DO; Dogan, Seref MD; Fifield, Mary S. BSE; Bozkus, Hakan MD; Chamberlain, Robert H. MS +; Sonntag, Volker K. H. MD; Crawford, Neil R. PhD (Source: Spine)

Implantation of a distractible titanium cage after cervical corpectomy: technical experience in 20 consecutive cases, by M. Payer, Volume 148, Issue 11, November 2006, Pages 1173–1180

Acta Neurochirurgica — Sat, 03 Feb 2007 09:54:18 +0100

Content TypeJournal Article JournalActa NeurochirurgicaOnline ISSN 0942-0940Print ISSN 0001-6268 Journal VolumeVolume 149 Journal IssueVolume 149, Number 2 / February, 2007 (Source: Acta Neurochirurgica)

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[High cervical spine injuries: classification, therapeutic indications, and surgical approaches: 286 consecutive cases]

Neurocirugia — Sun, 01 Oct 2006 04:00:00 +0100

Authors: Martín-Ferrer S Around 60% of all cervical fractures occur in the high cervical segment (C0-C1-C2); 4-15% occurs in C1, and between 15-25% in the axis. Nowadays, with high resolution imaging, we can see both anatomic and functional aspects of the fractures, as well as understand the mechanisms of injury. This can also allow us to study the evolution of the soft tissue lesions and fractures. The classification of traumatic injuries in C0-C1-C2 is basic in order to understand the mechanism of injury and natural history of these lesions. This also allow us to choose the correct or most adequate form of treatment. In the cases where surgery is indicated we must: a) release of the cord or nerves, using standard techniques such as laminectomy, discectomy or corpectomy; b) align...

Intraoperative Technique to Define the Safe Lateral Limits of Anterior Cervical Corpectomy: A Cadaveric Study.

Journal of Spinal Disorders & Techniques — Sat, 26 Aug 2006 17:39:01 +0100

(Source: Journal of Spinal Disorders & Techniques)

Implantation of a distractible titanium cage after cervical corpectomy: technical experience in 20 consecutive cases

Acta Neurochirurgica — Wed, 23 Aug 2006 06:34:26 +0100

Summary Background. This prospective observational study was undertaken to investigate the advantages, the safety, and the drawbacks of reconstructing a cervical corpectomy with a distractible corpectomy cage. According to the author’s literature search, this is the second clinical report on a distractible cervical corpectomy cage. Method. 20 consecutive patients underwent a single- or multi-level cervical corpectomy for spondylotic myelopathy, traumatic fracture, or tumor. The corpectomy defect was reconstructed by means of a distractible titanium cage, and local bone from the corpectomy was layed around the cage for fusion. An anterior cervical plate and/or a posterior lateral mass or pedicle screw fixation was added in all patients. The average follow-up was 14 months, a...

Successful outcome of six-level cervicothoracic corpectomy and circumferential reconstruction: case report and review of literature on multilevel cervicothoracic corpectomy

European Spine Journal — Tue, 22 Aug 2006 07:13:22 +0100

Abstract The authors report the successful outcome of a six-level corpectomy across the cervico-thoracic spine with circumferential reconstruction in a patient with extensive osteomyelitis of the cervical and upper thoracic spine. To the authors’ knowledge, this is the first report of a corpectomy extending across six levels of the cervico-thoracic spine. Clinical relevance: the authors recommend anterior cage and plate-assisted reconstruction and additional posterior instrumentation using modern spinal surgical techniques and implants. Content TypeJournal Article JournalEuropean Spine JournalOnline ISSN 1432-0932Print ISSN 0940-6719 (Source: European Spine Journal)

Anterior Cervical Fixation: Analysis of Load-Sharing and Stability with Use of Static and Dynamic Plates

JBJS [Am] — Mon, 03 Jul 2006 06:00:00 +0100

Conclusions: Although all of the tested anterior cervical plating systems provide similar load-sharing and stiffness following initial placement of the interbody spacer, the static plate system lost its ability to share load and limit motion following simulated subsidence of the interbody spacer. Both dynamic plate systems maintained load-sharing and stiffness despite simulated subsidence. Clinical Relevance: This study provides an improved understanding of the immediate performance of anterior cervical fusion surgery with plate fixation. (Source: JBJS [Am])

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Fusion rate of anterior cervical plating after corpectomy.

Journal of Orthopaedic Surgery — Wed, 14 Dec 2005 07:00:00 +0100

CONCLUSION: The use of anterior cervical plating after anterior corpectomy and fusion with autologous bone graft greatly enhances arthrodesis. The improved fusion rate and low complication rate associated with anterior cervical plating may justify its use in the treatment of cervical spondylotic myelopathy. PMID: 16365483 [PubMed - indexed for MEDLINE] (Source: Journal of Orthopaedic Surgery)

Dynamic anterior cervical plates for multilevel anterior corpectomy and fusion with simultaneous posterior wiring and fusion: efficacy and outcomes

Spinal Cord — Tue, 29 Nov 2005 07:00:00 +0100

(Source: Spinal Cord)

Clinical outcomes of multilevel anterior corpectomy and fusion as a revision surgery of the cervical spine: report of seven cases

Spinal Cord — Tue, 29 Nov 2005 07:00:00 +0100

(Source: Spinal Cord)