Clinical and radiological follow-up of single-level Prestige LP cervical disc replacement.

By London Spine
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Clinical and radiological follow-up of single-level Prestige LP cervical disc replacement.

Arch Orthop Trauma Surg. 2013 Feb 8;

Authors: Chen F, Yang J, Ni B, Guo Q, Lu X, Xie N

Abstract
OBJECTIVE: To evaluate the clinical outcomes and radiographic results of patients who underwent single-level cervical arthroplasty using the Prestige LP. METHOD: Thirty-one patients with single-level cervical disc disease received the Prestige LP disc replacement from June 2008 to December 2009. The neck disability index (NDI), Japanese Orthopedic Association score (JOA) and visual analogue scale (VAS) were used to assessed clinical outcomes pre-operatively and post-operatively at 24 months. The overall cervical alignment (C2-7 Cobb angle), the functional segmental unit (FSU) curvature, the range of motion (ROM) of treated and adjacent levels were measured, and the evidence of heterotopic ossification (HO) was observed from static and dynamic radiographs. RESULTS: There was a statistically significant improvement in the NDI from 20.2 ± 7.5 to 6.4 ± 3.5 (P < 0.000), JOA from 12.8 ± 2.2 to 16.6 ± 0.6 (P < 0.000), the neck VAS score from 4.1 ± 2.5 to 1.4 ± 1.1 (P < 0.000), the arm VAS score from 4.6 ± 2.5 to 0.7 ± 1.1 (P < 0.000). The post-operative overall cervical alignment (9.3° ± 7.2°), ROM of treated level (7.6°) and adjacent level (upper level 9.4° ± 3.1°, lower level 9.1° ± 3.5°) are well maintained. The FSU were 0.2° ± 5.4° and 1.9° ± 5.5° at pre-operation and final follow-up with statistical significance (P = 0.011). Heterotopic ossification was evidenced in five operated segment (16 %). CONCLUSIONS: The Prestige LP disc arthroplasty maintains favorable clinical outcomes, preserves the overall cervical alignment, FSU curvature, ROM of treated level and adjacent levels.

PMID: 23392650 [PubMed – as supplied by publisher]

Clinical evaluation of the stability of single-segment short pedicle screw fixation for the reconstruction of lumbar and sacral tuberculosis lesions.

By London Spine
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Clinical evaluation of the stability of single-segment short pedicle screw fixation for the reconstruction of lumbar and sacral tuberculosis lesions.

Arch Orthop Trauma Surg. 2012 Oct;132(10):1429-35

Authors: Jin W, Wang Z

Abstract
INTRODUCTION: The routine surgical approach to posterior reconstruction in spinal tuberculosis is short- or long-segment fixation and/or fusion. This method sacrifices movement at more than one vertebral level, limits normal movement of the spinal column, and leads to degeneration of the small joints of the adjacent levels. Surgical techniques that reduce the number of fixed vertebral levels and maximize the retention of movement of the spinal column are of current interest in the treatment of spinal tuberculosis.
MATERIALS AND METHODS: A total of 106 patients with lumbosacral tuberculosis were randomly divided into two groups: a single-segment fixation group and a short-segment fixation group. After posterior correction and internal fixation, all patients underwent anterior radical debridement and interbody fusion with bone grafting.
RESULTS: The mean postoperative follow-up period was 58.09 ± 17.01 months. The average bone graft healing time was 4.35 ± 1.04 months in the single-segment group and 4.47 ± 1.10 months in the short-segment group. In the single-segment group, correction of the Cobb angle was 14.47 ± 3.76° and the loss rate was 7.22 %, and in the short-segment group, correction of the Cobb angle was 16.20 ± 2.70° and the loss rate was 6.37 % (P < 0.05). Patients with operative time, blood loss, costs in the single-segment group were significantly reduced than the short-segment group (P < 0.05).
CONCLUSIONS: Single-segment pedicle screw fixation and correction surgery can fix and fuse the diseased segment in lumbar and sacral tuberculosis, retain normal movement in the adjacent spinal column, and promote functional recovery of the spinal column postoperatively. It was be regarded as a cost-effective means of treatment with lumbar and sacral tuberculosis.

PMID: 22736022 [PubMed – indexed for MEDLINE]

A single neurosurgical center’s experience of the resolution of cervical radiculopathy after dorsal foraminotomy and ventral discectomy.

By London Spine
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A single neurosurgical center’s experience of the resolution of cervical radiculopathy after dorsal foraminotomy and ventral discectomy.

J Clin Neurosci. 2011 Aug;18(8):1090-2

Authors: Schebesch KM, Albert R, Schödel P, Proescholdt M, Lange M, Brawanski A

Abstract
Monosegmental cervical disc herniation can be removed either by dorsal foraminotomy and sequesterectomy (Frykholm’s method) or by a ventral approach with extensive removal of the affected disc with subsequent segmental fusion (modified Cloward’s method). The choice of method largely depends on the surgeon’s individual preference and experience. We evaluated the neurological outcomes of both surgical methods in a retrospective series of 100 consecutive patients (50 male, 50 female; mean age=47.7 years) who underwent surgery within a 3-year period. Fifty-one patients (30 male, 21 female; mean age=50.1 years) underwent a dorsal foraminotomy and 49 patients (20 male, 29 female; mean age=45.3 years) underwent surgery by the ventral approach with consecutive segmental fusion. We identified demographic data and analysed the postoperative neurological performance (motor and sensory activity) and the resolution of the radiating and local pain during the in-hospital stay. Patients in the Cloward Group recovered significantly better from cervicobrachialgia (p=0.02), neck pain (p=0.01) and sensory deficits (p=0.003). Furthermore, the Cloward Group showed a trend towards better outcomes for paresis. Complete removal of the affected cervical disc via a ventral approach and segmental fusion results in a superior neurological performance in the short-term compared to a dorsal foraminotomy and nerve root decompression by sequestrectomy. However, assessment of the long-term outcome is required and further studies are required to confirm our results.

PMID: 21665478 [PubMed – indexed for MEDLINE]