Preoperative and Intraoperative Skull Traction Combined with Anterior-Only Cervical Operation in the Treatment of Severe Cervical Kyphosis (>50 Degrees)

2019 ◽  
Vol 130 ◽  
pp. e915-e925
Author(s):  
Xiaolong Shen ◽  
Huiqiao Wu ◽  
Changgui Shi ◽  
Yang Liu ◽  
Ye Tian ◽  
...  
Keyword(s):  
Cervical Kyphosis ◽  
Skull Traction

Total uncinectomy of the cervical spine with an osteotome: technical note and intraoperative video

2019 ◽  
Vol 31 (6) ◽  
pp. 831-834 ◽  
Author(s):  
Anand H. Segar ◽  
Alexander Riccio ◽  
Michael Smith ◽  
Themistocles S. Protopsaltis
Keyword(s):  
Vertebral Artery ◽  
High Speed ◽  
Thermal Injury ◽  
Technical Note ◽  
Uncinate Process ◽  
Foraminal Stenosis ◽  
Cervical Kyphosis ◽  
Kyphosis Correction ◽  
Direct Injury ◽  
High Speed Burr

Total uncinate process resection or uncinectomy is often required in the setting of severe foraminal stenosis or cervical kyphosis correction. The proximity of the uncus to the vertebral artery, nerve root, and spinal cord makes this a challenging undertaking. Use of a high-speed burr or ultrasonic bone dissector can be associated with direct injury to the vertebral artery and thermal injury to the surrounding structures. The use of an osteotome is a safe and efficient method of uncinectomy. Here the authors describe their technique, which is illustrated with an intraoperative video.

Anterior Cervical Discectomy With Fusion and Plating for Correction of Degenerative Cervical Kyphosis: 2-Dimensional Operative Video

2020 ◽  
Author(s):  
Jeremy M V Guinn ◽  
Brenton Pennicooke ◽  
Joshua Rivera ◽  
Praveen V Mummaneni ◽  
Dean Chou
Keyword(s):  
Spinal Cord ◽  
Informed Consent ◽  
Bone Density ◽  
Surgical Intervention ◽  
Anterior Cervical Discectomy ◽  
Cervical Kyphosis ◽  
Nerve Roots ◽  
Cervical Discectomy ◽  
Cervical Plate ◽  
Sequential Induction

Abstract This surgical video demonstrates the technique for correcting degenerative cervical kyphosis using an anterior cervical discectomy and fusion (ACDF). Degenerative cervical kyphosis can cause radiculopathy, myelopathy, and difficulty holding up one's head. The goal of surgical intervention is to alleviate pain, improve the ability for upright gaze, and decompress the spinal cord or nerve roots. Posterior-only approaches and anterior corpectomies are alternative treatments to address cervical kyphosis. However, an ACDF allows for sequential induction of lordosis via distraction over multiple segments and for further lordosis induction by sequential screw tightening, pulling the spine towards a lordotic cervical plate.1 This video shows 2 cases demonstrating a technique of correcting severe cervical degenerative kyphosis. The video illustrates our initial kyphotic Caspar pin placement coupled with sequential anterior distraction to correct kyphosis. The technique is most useful in patients who have good bone density, nonankylosed facets, and degenerative cervical kyphosis. We have received informed consent of this patient to submit this video.

Posterior and Anterior Fusion for Severe Cervical Kyphosis in a Patient with Chondrodysplasia Punctata

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shuzo Kato ◽  
Nobuyuki Fujita ◽  
Satoshi Suzuki ◽  
Osahiko Tsuji ◽  
Narihito Nagoshi ◽  
...  
Keyword(s):  
Chondrodysplasia Punctata ◽  
Anterior Fusion ◽  
Cervical Kyphosis

Review of surgical correction of cervical kyphosis

2017 ◽  
Vol 29 (4) ◽  
pp. 192-196
Author(s):  
Theodore J. Steelman ◽  
Daniel G. Kang ◽  
Jonathan G. Seavey ◽  
Tushar Ch. Patel
Keyword(s):  
Surgical Correction ◽  
Cervical Kyphosis

Brain abscess following insertion of skull traction

1988 ◽  
Vol 90 (4) ◽  
pp. 361-363 ◽  
Author(s):  
B.S. Sharma ◽  
V.K. Khosla ◽  
A. Pathak ◽  
S.N. Mathuriya ◽  
V.K. Kak
Keyword(s):  
Brain Abscess ◽  
Skull Traction

scholarly journals The impact of cervical sagittal parameters on axial neck pain in patients with cervical kyphosis

2020 ◽  
Author(s):  
Jia Li ◽  
Di Zhang ◽  
Yong Shen
Keyword(s):  
Risk Factors ◽  
Neck Pain ◽  
Sagittal Alignment ◽  
Multivariate Logistic Regression Analysis ◽  
Cervical Disc ◽  
Multivariate Logistic Regression ◽  
Cervical Kyphosis ◽  
T1 Slope ◽  
Sagittal Parameters ◽  
Axial Neck Pain

Abstract Background:Cervical sagittal alignment is closely related with cervical disc degeneration and impacts the spinal function and quality of life, especially for cervical kyphosis (CK). The purpose of this study was to evaluate the influence of cervical sagittal parameters on the axial neck pain (ANP) in patients with CK.Methods: A retrospective analysis was performed of data from 263 patients who underwent to the authors’ department of this institution between January 2012 and December 2018. Radiographic evaluations were performed at authors’ department, including CK types, C2-7 sagittal vertical axis (SVA), thoracic inlet angle (TIA), T1 slope, neck tilt (NT), cranial tilt and cervical tilt. Sagittal alignment of the cervical spine was classified into 2 types: global and regional type. Multivariate logistic regression analysis was performed to evaluate these parameters as the risk factors for ANP.Results: Patients in this study were divided into 2 groups according to ANP. There were 92 patients in ANP group and 171 patients in Non-ANP group. There was no significant difference in age (P=0.196), gender (P=0.516), TIA(P=0.139), NT (P=0.676), CK types (P=0.533), cranial tilt (P=0.332), cervical tilt (P=0.585) and cervical disc degeneration (P=0.695) between the two groups. T1 slope, C2-7 SVA in the ANP group was significantly higher than in the Non-ANP group (P < 0.05). After multivariate logistic regression analysis, C2-7 SVA (P=0.003, OR 2.318, 95% CI 1.373-4.651) and T1 slope (P=0.028, OR 2.563, 95% CI 1.186-4.669) were the two risk factors for the ANP.Conclusions: Based on this study, cervical sagittal parameters have a significant effect on the happening of axial neck pain in patients with CK. A higher T1 slope and larger C2-7 SVA are closely lead to the development of neck pain.

Prospective assessment of patient morbidity from prone sacral positioning

2012 ◽  
Vol 16 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Courtney E. Sherman ◽  
Peter S. Rose ◽  
Lori L. Pierce ◽  
Michael J. Yaszemski ◽  
Franklin H. Sim
Keyword(s):  
Morbid Obesity ◽  
Morbidly Obese ◽  
Reconstructive Procedures ◽  
Patient Morbidity ◽  
Ulnar Nerve Palsy ◽  
Prospective Assessment ◽  
Pressure Injury ◽  
Average Operative Time ◽  
Hemorrhage Risk ◽  
Skull Traction

Object Sacrectomy positioning must balance surgical exposure, localization, associated operative procedures, and patient safety. Poor positioning may increase hemorrhage, risk of blindness, and skin breakdown. Methods The authors prospectively identified positioning-related morbidity in 17 patients undergoing 19 prone sacral procedures from September 2008 to August 2009 following institution of a standardized positioning protocol. Key elements include skull traction/head suspension, an open radiolucent frame, and wide draping for associated closure and reconstructive procedures. Results Tumors included 5 chordomas, 4 high-grade sarcomas, 1 chondrosarcoma, 2 presacral extradural myxopapillary ependymomas, and 5 others. Mean patient age was 49.9 years (range 17–74 years); mean body mass index was 27.6 kg/m2 (range 19.3–43.9 kg/m2). Mean preoperative Braden skin integrity score was 21.1 (range 17–23). Average operative time was 501 minutes (range 158–1136 minutes). Prone surgery was a part of staged anterior/posterior resections in 8 patients. Localization was conducted using fluoroscopy in 13 patients and intraoperative CT in 4 patients. All imaging studies were successful. One patient developed a transient ulnar nerve palsy attributed to positioning. Three patients (two of whom were morbidly obese) developed Stage I pressure injuries to the chest and another developed Stage II pressure injury following a 1136-minute procedure. Morbidity was only observed in patients with morbid obesity or with procedures lasting in excess of 10 hours. Conclusions A positioning protocol using head suspension on an open radiolucent frame facilitates oncological sacral surgery with reasonable patient morbidity. Morbid obesity and procedure times in excess of 10 hours are risk factors for positioning-related complications. To the authors' knowledge, this is the first report of surgical positioning morbidity in this patient population.

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