Journal of Spinal Disorders and Techniques This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Crossing the Cervicothoracic Junction: A Review of the Current Literature
Abstract: The cervicothoracic junction (CTJ) is the site of transition in biomechanical, osseous, and alignment properties of the spine. The interface between the highly mobile, lordotic cervical spine and the rigid, kyphotic thoracic spine results increased the biomechanical stress experienced at this junction. The concentration of stress at this level has led to high rates of failure when instrumenting near or across the CTJ. The changes in osseous anatomy from the cervical spine to the thoracic spine present additional challenges in construct planning. For these reasons, a thorough understanding of the complexity of...
Source: Journal of Spinal Disorders and Techniques - December 1, 2022 Category: Surgery Tags: Current Concepts Diagnosis & Management—CSRS Supplement 2022 Source Type: research

Performing the 3-level Anterior Cervical Discectomy and Fusion (ACDF): Technical Pearls to Maximize Fusion Rates and Reduce Postoperative Complications
The anterior cervical discectomy and fusion is a common and effective treatment for degenerative cervical myelopathy, either with or without concomitant radiculopathy. In many cases, patients with degenerative cervical spondylosis can present with disease at multiple levels. With each additional level included in the procedure, rates of complication rate can increase—both due to the nature of the anterior cervical approach (dysphagia) as well as fusion across all levels. Here, we review several technical considerations with the goal of increasing efficiency and improving outcomes with the 3-level anterior cervical discec...
Source: Journal of Spinal Disorders and Techniques - December 1, 2022 Category: Surgery Tags: Current Concepts Diagnosis & Management—CSRS Supplement 2022 Source Type: research

Anterior Cervical Corpectomy and Fusion for Degenerative Cervical Spondylotic Myelopathy: Case Presentation With Surgical Technique Demonstration and Review of Literature
Anterior cervical corpectomy and fusion (ACCF) provides an extensive decompression and provides a large surface area for fusion in patients presenting with cervical spondylotic myelopathy. Unfortunately, this procedure is a more difficult spinal surgery to perform (compared with a traditional anterior cervical discectomy and fusion) and has a higher incidence of overall complications. In literature, ACCF has functional outcomes that seem clinically equivalent to those for multilevel anterior cervical discectomy and fusion, especially when contained to 1 vertebral body level, and in cases, for which both posterior and anter...
Source: Journal of Spinal Disorders and Techniques - December 1, 2022 Category: Surgery Tags: Current Concepts Diagnosis & Management—CSRS Supplement 2022 Source Type: research

Cervical Disk Arthroplasty: Surgical Technique
Conclusions: CDA presents a motion-sparing alternative to anterior cervical discectomy and fusion and has the potential to reduce adjacent segment disease, though further studies are needed to fully determine its benefits and expanding indications. Careful patient selection and proper surgical technique, as demonstrated here, remain crucial in optimizing outcomes. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2022 Category: Surgery Tags: Current Concepts Diagnosis & Management—CSRS Supplement 2022 Source Type: research

Technical Nuances of Cervical Laminoplasty: Supplemental Manuscript to Operative Video
Conclusions: Cervical laminoplasty provides more stability compared with laminectomy alone and a better range of motion compared with laminectomy with posterior spinal fusion. Understanding the nuances of laminoplasty may help surgeons to avoid complications. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2022 Category: Surgery Tags: Current Concepts Diagnosis & Management—CSRS Supplement 2022 Source Type: research

New Imaging Modalities for Degenerative Cervical Myelopathy
Discussion: Current imaging modalities, particularly magnetic resonance imaging and, to a lesser extent, radiographs/CT, offer important information to aid in decision making but are not ideal as stand-alone tools. Newer imaging modalities currently being studied in the literature include diffusion tensor imaging, MR spectroscopy, functional magnetic resonance imaging, perfusion imaging, and positron emission tomography. These newer imaging modalities attempt to more accurately evaluate the physical structure, intrinsic connectivity, biochemical and metabolic function, and perfusion of the spinal cord in DCM. Although ...
Source: Journal of Spinal Disorders and Techniques - December 1, 2022 Category: Surgery Tags: Current Concepts Diagnosis & Management—CSRS Supplement 2022 Source Type: research

Prognostic Factors Impacting Surgical Outcomes in Patients With Cervical Spondylotic Myelopathy
The purpose of surgical decompression in patients who have CSM is to stop the progression of symptoms and hopefully improve function. It is critical to understand prognostic factors that affect the outcome. Factors intrinsic to the patient that can adversely affect outcomes include diabetes, older age, tobacco use, the presence of mental health disease, and obesity. MRI imaging findings of T2 hyperintensity and clinical duration and severity of symptoms is also associated with poorer outcomes. Patients should be counseled regarding the efficacy of decompressive procedures for CSM and given realistic expectations based on t...
Source: Journal of Spinal Disorders and Techniques - December 1, 2022 Category: Surgery Tags: Current Concepts Diagnosis & Management—CSRS Supplement 2022 Source Type: research

Review of Prospective Trials for Degenerative Cervical Myelopathy
Degenerative cervical myelopathy (DCM) is the leading cause of spinal cord dysfunction in adults. DCM refers to a collection of degenerative conditions that cause the narrowing of the cervical canal resulting in neurological dysfunction. A lack of high-quality studies and a recent increase in public health awareness has led to numerous prospective studies evaluating DCM. Studies evaluating the efficacy of surgical intervention for DCM can be characterized by the presence (comparative) or absence (noncomparative) of a nonoperative control group. Noncomparative studies predominate due to concerns regarding treatment equipois...
Source: Journal of Spinal Disorders and Techniques - December 1, 2022 Category: Surgery Tags: Current Concepts Diagnosis & Management—CSRS Supplement 2022 Source Type: research

Electrodiagnostic Studies in Degenerative Cervical Myelopathy
The diagnosis of degenerative cervical myelopathy can generally be made with a thorough history, physical examination, and spinal imaging. Electrodiagnostic studies, consisting of nerve conduction studies and electromyography, are a useful adjunct when the clinical picture is inconsistent or there is concern for overlapping pathology. Electrodiagnostic studies may be particularly helpful in identifying cases of myeloradiculopathy, when there is combined nerve root and spinal cord injury, both with regards to prognosis and guiding surgical treatment. Electrodiagnostic studies are a useful adjunct for the spine surgeon and s...
Source: Journal of Spinal Disorders and Techniques - December 1, 2022 Category: Surgery Tags: Current Concepts Diagnosis & Management—CSRS Supplement 2022 Source Type: research

The Natural History of Degenerative Cervical Myelopathy
Degenerative cervical myelopathy (DCM) is the most frequent cause of spinal cord dysfunction and injury in the adult population and leads to significant loss of quality of life and economic impact from its associated medical care expenditures and loss of work. Surgical intervention is recommended for patients manifesting progressing neurological signs and symptoms of myelopathy, but the optimal management in individuals who have mild and clinically stable disease manifestations is controversial. Understanding the natural history of DCM is, thus, important in assessing patients and identifying those most appropriately indic...
Source: Journal of Spinal Disorders and Techniques - December 1, 2022 Category: Surgery Tags: Current Concepts Diagnosis & Management—CSRS Supplement 2022 Source Type: research

Radiographic Parameters in Cervical Myelopathy: Review of Current Literature
Conclusion: Utilization of key radiographic parameters in surgical planning and decision-making allows surgeons to optimize clinical outcomes for CSM. Level of Evidence: Level V. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2022 Category: Surgery Tags: Current Concepts Diagnosis & Management—CSRS Supplement 2022 Source Type: research

History of Prior Lumbar Surgery Does Not Impact Mental Health Outcomes Following Anterior Cervical Discectomy and Fusion
Conclusions: Anterior cervical discectomy and fusion patients with a past history of lumbar surgery demonstrated significant improvements in depression, neck and arm pain, disability, and physical function as those without a past lumbar surgical history. Prior surgery also did not impact MCID achievement for all outcomes. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 1, 2022 Category: Surgery Tags: Primary Research Source Type: research

Do Patients With Chronic Diabetes Have Worse Motor Outcomes After Cervical ASIA C Traumatic Spinal Cord Injury?
Conclusions: Patients with diabetes have increased wheelchair requirement and decreased ambulatory ability at 1 year after the injury as well as diminished recovery in motor scores after motor-incomplete cervical TSCI. These patients may be targets for aggressive diabetic screening and intervention to minimize negative outcomes. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 1, 2022 Category: Surgery Tags: Primary Research Source Type: research

Treatment Patterns and Health Care Resource Utilization of Iatrogenic Spinal Cerebrospinal Fluid Leaks in the United States
Conclusions: National treatment patterns and costs for CSF leaks were described. When used in the correct patient cohort, EBP has the lower failure rates and costs than comparable alternatives. EBP may be considered more often in situations where conservative management or lumbar drains are currently being used. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 1, 2022 Category: Surgery Tags: Primary Research Source Type: research

What PROMIS Scores Correlate With Severe Disability in Cervical Spine Surgery?
Study Design: Institutional Review Board-approved prospective cohort study. Objectives: To establish a conversion between Neck Disability Index (NDI) and Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference (PI). Summary of Background Data: As the National Institutes of Health (NIH) PROMIS is a global outcome measure, it can be difficult to interpret the clinical implications in patients with cervical spine surgery. To determine how a disease-specific legacy instrument (NDI) correlates with PROMIS PI and define levels of substantial and minimal disability, we developed a for...
Source: Journal of Spinal Disorders and Techniques - November 1, 2022 Category: Surgery Tags: Primary Research Source Type: research