Computer-Assisted Image-Guided Cervical Spine Surgery

OBJECT Rigid screw fixation may be technically difficult in the upper cervical spine of young children. Intraoperative stereotactic navigation may potentially assist a surgeon in precise placement of screws in anatomically challenging locations. Navigation may also assist in defining abnormal anatomy. The object of this study was to evaluate the authors’ initial experience with the feasibility and accuracy of this technique, both for resection and for screw placement in the upper cervical spine in younger children. METHODS Eight consecutive pediatric patients 10 years of age or younger underwent upper cervical spine surgery aided by image-guided navigation. The demographic, surgical, and clinical data were recorded. Screw position was evaluated with either an intraoperative or immediately postoperative CT scan. RESULTS One patient underwent navigation purely for guidance of bony resection. A total of 14 navigated screws were placed in the other 7 patients, including 5 C-2 pedicle screws. All 14 screws were properly positioned, defined as the screw completely contained within the cortical bone in the expected trajectory. There were no immediate complications associated with navigation. CONCLUSIONS Image-guided navigation is feasible within the pediatric cervical spine and may be a useful surgical tool for placing screws in a patient with small, often difficult bony anatomy. The authors describe their experience with their first 8 pediatric patients who underwent navigation in cervical spine surgery. The authors highlight differences in technique compared with similar navigation in adults.

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Application of Smith-Robinson approach for C2/3 cervical spine surgery

Academic Journal of Second Military Medical University ◽

10.3724/sp.j.1008.2012.01199 ◽

2013 ◽

Vol 32 (11) ◽

pp. 1199-1202

Author(s):

Ying ZHANG ◽

Jun MA ◽

Yuan-yuan CHEN ◽

Xin-wei WANG ◽

De-yu CHEN ◽

...

Keyword(s):

Cervical Spine ◽

Spine Surgery ◽

Cervical Spine Surgery

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Impact of Diabetes Mellitus on Cervical Spine Surgery for Ossification of the Posterior Longitudinal Ligament

Journal of Clinical Medicine ◽

10.3390/jcm10153375 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3375

Author(s):

Atsushi Kimura ◽

Katsushi Takeshita ◽

Toshitaka Yoshii ◽

Satoru Egawa ◽

Takashi Hirai ◽

...

Keyword(s):

Diabetes Mellitus ◽

Cervical Spine ◽

Postoperative Complications ◽

Spine Surgery ◽

Posterior Longitudinal Ligament ◽

Lower Extremity Function ◽

Cervical Spine Surgery ◽

The Impact

Ossification of the posterior longitudinal ligament (OPLL) is commonly associated with diabetes mellitus (DM); however, the impact of DM on cervical spine surgery for OPLL remains unclear. This study was performed to evaluate the influence of diabetes DM on the outcomes following cervical spine surgery for OPLL. In total, 478 patients with cervical OPLL who underwent surgical treatment were prospectively recruited from April 2015 to July 2017. Functional measurements were conducted at baseline and at 6 months, 1 year, and 2 years after surgery using JOA and JOACMEQ scores. The incidence of postoperative complications was categorized into early (≤30 days) and late (>30 days), depending on the time from surgery. From the initial group of 478 patients, 402 completed the 2-year follow-up and were included in the analysis. Of the 402 patients, 127 (32%) had DM as a comorbid disease. The overall incidence of postoperative complications was significantly higher in patients with DM than in patients without DM in both the early and late postoperative periods. The patients with DM had a significantly lower JOA score and JOACMEQ scores in the domains of lower extremity function and quality of life than those without DM at the 2-year follow-up.

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