Does the postoperative cervical lordosis angle affect the cervical rotational range of motion after cervicothoracic multilevel fusion?

2021 ◽  
Vol 90 ◽  
pp. 105484
Author(s):  
Christoph Scholz ◽  
Marc Hohenhaus ◽  
Ulrich Hubbe ◽  
Waseem Masalha ◽  
Yashar Naseri ◽  
...  
2020 ◽  
Author(s):  
Tingkui Wu ◽  
Hao Liu ◽  
Chen Ding ◽  
Xin Rong ◽  
Jun-bo He ◽  
...  

Abstract BackgroundCervical disc arthroplasty (CDA) has been demonstrated in clinical trials as an effective and safe treatment for patients diagnosed with radiculopathy and/or myelopathy. However, the current CDA indication criteria based on the preoperative segmental range of motion (ROM), comprise a wide range of variability. Although the arthroplasty level preserved ROM averaged 7°-9° after CDA, there are no clear guidelines on preoperatively limited or excessive ROM at the index level, that could be considered as suitable for CDA in any given trials.MethodsPatients who underwent CDA between January 2008 to October 2018 using Prestige-LP discs in our hospital, were reviewed retrospectively. They were divided into the small-ROM (≤5.5°) and the large-ROM (> 12.5°) groups according to preoperatively index-level ROM. Clinical outcomes, including the Japanese Orthopedics Association (JOA), Neck Disability Index (NDI), and Visual Analogue Scale (VAS) scores, were evaluated. Radiological parameters, including cervical lordosis, disc angle (DA), global and segmental ROM, disc height (DH), and complications were measured.ResultsOne hundred and twenty-six patients, with a total of 132 arthroplasty segments were analyzed. There were 64 patients in the small-ROM and 62 in the large-ROM group. There are more patients diagnosed with cervical spondylosis in the small-ROM than in the large-ROM group (P=0.046). Patients in both groups had significantly improved in JOA, NDI, and VAS scores after surgery, but the intergroup difference was not significant. Patients in the small-ROM group increased dramatically in cervical lordosis, global and segmental ROM postoperatively (P < 0.001). However, global and segmental ROM paradoxically decreased in the large-ROM group postoperatively (P < 0.001). Patients in the small-ROM group had lower DH preoperatively (P=0.012), and a higher rate of heterotopic ossification (HO) postoperatively (P=0.037).ConclusionPatients with preoperatively limited or excessive segmental ROM could achieve satisfactory clinical outcomes at 3 years postoperatively. Patients with limited segmental ROM had more, and severe HO and significantly increased segmental mobility, which decreased in patients with excessive segmental ROM after surgery.


2002 ◽  
Vol 7 (4) ◽  
pp. 8-10
Author(s):  
Christopher R. Brigham ◽  
Leon H. Ensalada

Abstract Recurrent radiculopathy is evaluated by a different approach in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, compared to that in the Fourth Edition. The AMA Guides, Fifth Edition, specifies several occasions on which the range-of-motion (ROM), not the Diagnosis-related estimates (DRE) method, is used to rate spinal impairments. For example, the AMA Guides, Fifth Edition, clarifies that ROM is used only for radiculopathy caused by a recurrent injury, including when there is new (recurrent) disk herniation or a recurrent injury in the same spinal region. In the AMA Guides, Fourth Edition, radiculopathy was rated using the Injury Model, which is termed the DRE method in the Fifth Edition. Also, in the Fourth Edition, for the lumbar spine all radiculopathies resulted in the same impairment (10% whole person permanent impairment), based on that edition's philosophy that radiculopathy is not quantifiable and, once present, is permanent. A rating of recurrent radiculopathy suggests the presence of a previous impairment rating and may require apportionment, which is the process of allocating causation among two or more factors that caused or significantly contributed to an injury and resulting impairment. A case example shows the divergent results following evaluation using the Injury Model (Fourth Edition) and the ROM Method (Fifth Edition) and concludes that revisions to the latter for rating permanent impairments of the spine often will lead to different results compared to using the Fourth Edition.


2001 ◽  
Vol 6 (1) ◽  
pp. 1-3
Author(s):  
Robert H. Haralson

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, was published in November 2000 and contains major changes from its predecessor. In the Fourth Edition, all musculoskeletal evaluation and rating was described in a single chapter. In the Fifth Edition, this information has been divided into three separate chapters: Upper Extremity (13), Lower Extremity (14), and Spine (15). This article discusses changes in the spine chapter. The Models for rating spinal impairment now are called Methods. The AMA Guides, Fifth Edition, has reverted to standard terminology for spinal regions in the Diagnosis-related estimates (DRE) Method, and both it and the Range of Motion (ROM) Method now reference cervical, thoracic, and lumbar. Also, the language requiring the use of the DRE, rather than the ROM Method has been strengthened. The biggest change in the DRE Method is that evaluation should include the treatment results. Unfortunately, the Fourth Edition's philosophy regarding when and how to rate impairment using the DRE Model led to a number of problems, including the same rating of all patients with radiculopathy despite some true differences in outcomes. The term differentiator was abandoned and replaced with clinical findings. Significant changes were made in evaluation of patients with spinal cord injuries, and evaluators should become familiar with these and other changes in the Fifth Edition.


Swiss Surgery ◽  
2003 ◽  
Vol 9 (6) ◽  
pp. 275-282
Author(s):  
Ott ◽  
Rikli ◽  
Babst

Einleitung: Kombinierte Verletzungen des Capitulum humeri und des Radiusköpfchens sind selten. Meist sind neben den osteocartilaginären Schäden am Gelenk auch Verletzungen der Kollateralbänder assoziiert. Behandlungsempfehlungen für diese seltenen schwerwiegenden Ellenbogenverletzungen fehlen. Studientyp: In einer retrospektiven Analyse werden fünf Fälle untersucht, bei denen die osteocartilaginären Verletzungen des Capitulum humeri durch den gleichen Zugang, der zur Versorgung des Radiusköpfchens verwendet wurde, versorgt wurden. Die Osteosynthese erfolgte mit Mini-Titanimplantaten z.T. kombiniert mit resorbierbaren Pins. Patienten und Methode: Zwischen 1996-1999 wurden fünf Patienten (vier Männer, eine Frau) mit einer Kombinationsverletzung von Radiuskopf und Capitulum humeri operativ stabilisiert. Das Durchschnittsalter beträgt 34 Jahre (31-40 Jahre). Alle Frakturen wurden über einen direkten radialen Zugang mittels 1.5mm oder 2.0mm Zugschrauben, zum Teil mit resorbierbaren Pins stabilisiert. Anschliessend wurden die Patienten radiologisch und klinisch gemäss dem Mayo-elbow-performance Score beurteilt. Resultate: Alle Patienten konnten persönlich durch einen nicht in die Initialtherapie involvierten Untersucher nach durchschnittlich 12.8 Monaten (8-24 Monate) nachuntersucht werden. 4/5 Patienten konnten bezüglich ihrer subjektiven Einschätzung befragt werden. Radiologische Zeichen einer Nekrose des Capitulum humeri oder Arthrosezeichen fanden sich nicht. Bei drei Patienten fanden sich periartikuläre Verkalkungen. Der range of motion beträgt durchschnittlich 124 Grad (Extension 5-30 Grad, Flexion 110-145 Grad) in drei von fünf Fällen waren Sekundäreingriffe zu Mobilitätsverbesserung nötig. Der Mayo-elbow-performance Score beträgt im Mittel 85 Punkte (range 70-100 Punkte). Schlussfolgerung: Die direkte Verschraubung mit Miniimplantaten zum Teil in Kombination mit resorbierbaren Pins ermöglicht eine stabile anatomische Rekonstruktion des Capitulum humeri durch den gleichen Zugang wie er für die Stabilisierung des Radiusköpfchens notwendig ist. Die transartikuläre Fixation der kleinen Schalenfragmente des Capitulum humeri erlaubt eine sichere interfragmentäre Kompression und damit eine frühfunktionelle Rehabilitation. Sekundäreingriffe zur Verbesserung der Gelenkbeweglichkeit waren in drei von fünf Fällen nötig.


Author(s):  
Tomoyuki Kato ◽  
Taku Suzuki ◽  
Makoto Kameyama ◽  
Masato Okazaki ◽  
Yasushi Morisawa ◽  
...  

Abstract Background Previous study demonstrated that distal radioulnar joint (DRUJ) plays a biomechanical role in extension and flexion of the wrist and suggested that fixation of the DRUJ could lead to loss of motion of the wrist. Little is known about the pre- and postoperative range of motion (ROM) after the Sauvé–Kapandji (S-K) and Darrach procedures without tendon rupture. To understand the accurate ROM of the wrist after the S-K and Darrach procedures, enrollment of patients without subcutaneous extensor tendon rupture is needed. Purpose This study aimed to investigate the pre- and postoperative ROM after the S-K and Darrach procedures without subcutaneous extensor tendon rupture in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Methods This retrospective study included 36 patients who underwent the S-K procedure and 10 patients who underwent the Darrach procedure for distal radioulnar joint disorders without extensor tendon rupture. Pre- and postoperative ROMs after the S-K and Darrach procedures were assessed 1 year after the surgery. Results In the S-K procedure, the mean postoperative ROM of the wrist flexion (40 degrees) was significantly lower than the mean preoperative ROM (49 degrees). In wrist extension, there were no significant differences between the mean preoperative ROM (51 degrees) and postoperative ROM (51 degrees). In the Darrach procedure, the mean postoperative ROM of the wrist flexion and extension increased compared with the mean preoperative ROM; however, there were no significant differences. Conclusion In the S-K procedure, preoperative ROM of the wrist flexion decreased postoperatively. This study provides information about the accurate ROM after the S-K and Darrach procedures. Level of Evidence This is a Level IV, therapeutic study.


2018 ◽  
Vol 4 (4) ◽  
pp. 519-522
Author(s):  
Jeyakumar S ◽  
Jagatheesan Alagesan ◽  
T.S. Muthukumar

Background: Frozen shoulder is disorder of the connective tissue that limits the normal Range of motion of the shoulder in diabetes, frozen shoulder is thought to be caused by changes to the collagen in the shoulder joint as a result of long term Hypoglycemia. Mobilization is a therapeutic movement of the joint. The goal is to restore normal joint motion and rhythm. The use of mobilization with movement for peripheral joints was developed by mulligan. This technique combines a sustained application of manual technique “gliding” force to the joint with concurrent physiologic motion of joint, either actively or passively. This study aims to find out the effects of mobilization with movement and end range mobilization in frozen shoulder in Type I diabetics. Materials and Methods: 30 subjects both male and female, suffering with shoulder pain and clinically diagnosed with frozen shoulder was recruited for the study and divided into two groups with 15 patients each based on convenient sampling method. Group A patients received mobilization with movement and Group B patients received end range mobilization for three weeks. The outcome measurements were SPADI, Functional hand to back scale, abduction range of motion using goniometer and VAS. Results: The mean values of all parameters showed significant differences in group A as compared to group B in terms of decreased pain, increased abduction range and other outcome measures. Conclusion: Based on the results it has been concluded that treating the type 1 diabetic patient with frozen shoulder, mobilization with movement exercise shows better results than end range mobilization in reducing pain and increase functional activities and mobility in frozen shoulder.


Author(s):  
Andri Setyorini ◽  
Niken Setyaningrum

Background: Elderly is the final stage of the human life cycle, that is part of the inevitable life process and will be experienced by every individual. At this stage the individual undergoes many changes both physically and mentally, especially setbacks in various functions and abilities he once had. Preliminary study in Social House Tresna Wreda Yogyakarta Budhi Luhur Units there are 16 elderly who experience physical immobilization. In the social house has done various activities for the elderly are still active, but the elderly who experienced muscle weakness is not able to follow the exercise, so it needs to do ROM (Range Of Motion) exercise.   Objective: The general purpose of this research is to know the effect of Range Of Motion (ROM) Active Assitif training to increase the range of motion of joints in elderly who experience physical immobility at Social House of Tresna Werdha Yogyakarta unit Budhi Luhur.   Methode: This study was included in the type of pre-experiment, using the One Group Pretest Posttest design in which the range of motion of the joints before (pretest) and posttest (ROM) was performed  ROM. Subjects in this study were all elderly with impaired physical mobility in Social House Tresna Wreda Yogyakarta Unit Budhi Luhur a number of 14 elderly people. Data analysis in this research use paired sample t-test statistic  Result: The result of this research shows that there is influence of ROM (Range of Motion) Active training to increase of range of motion of joints in elderly who experience physical immobility at Social House Tresna Wredha Yogyakarta Unit Budhi Luhur.  Conclusion: There is influence of ROM (Range of Motion) Active training to increase of range of motion of joints in elderly who experience physical immobility at Social House Tresna Wredha Yogyakarta Unit Budhi Luhur.


Author(s):  
Garrett S. Bullock ◽  
Edward C. Beck ◽  
Gary S. Collins ◽  
Stephanie R. Filbay ◽  
Kristen F. Nicholson

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