scholarly journals Transcorporeal cervical foraminotomy: description of technique and results

2014 ◽  
Vol 13 (3) ◽  
pp. 180-184
Author(s):  
Guilherme Pereira Corrêa Meyer ◽  
Gun Choi ◽  
Amit Bandharkar ◽  
Pil Sun Choi ◽  
Sang Ho Lee ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Analogue Scale ◽  
Neck Disability Index ◽  
Clinical Results ◽  
Disc Height ◽  
Significant Clinical Improvement ◽  
Clinical Records ◽  
Neck Disability ◽  
Cervical Foraminotomy

OBJECTIVE: Retrospective analyses of 216 patients undergoing foraminal decompression with transcorporeal approach and review of the surgical technique. METHOD: 216 patients with minimum follow-up of 2 years and an average of 41.8 months were included in the study. The clinical records of these patients were reviewed for complications, NDI (neck disability index) and VAS (visual analogue scale). Pre and post-operative radiographs were used to evaluate the disc height. RESULTS: At the end of follow-up patients had significant clinical improvement with reduction of NDI of 88.3% and 86.5% and 68.3% of the VAS for neck and upper limb, respectively (p<0.05). A reduction of 8.8% of the disc height was observed without other complications associated (p<0.05). CONCLUSION: Radicular decompression through a transcorporeal approach is an alternative that provides good clinical results without the need for a fusion and with few complications.

scholarly journals Posterior endoscopic cervical foramiotomy and discectomy: clinical and radiological computer tomography evaluation on the bony effect of decompression with 2 years follow-up

2020 ◽  
Author(s):  
Pang Hung Wu ◽  
Hyeun Sung Kim ◽  
Yeon Jin Lee ◽  
Dae Hwan Kim ◽  
Jun Hyung Lee ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Clinical Outcomes ◽  
Analogue Scale ◽  
Neck Disability Index ◽  
Cervical Radiculopathy ◽  
3D Ct ◽  
Retrospective Evaluation ◽  
Neck Disability ◽  
Cervical Foraminotomy

Abstract Purpose Cervical radiculopathy is a common disabling cervical spine condition. Open anterior and posterior approaches are the conventional surgical treatment approaches with good clinical outcomes. However, the soft tissue damage in these procedures can lead to increase perioperative morbidity. Endoscopic spine surgery provides more soft tissue preservation than conventional approaches. We investigate the radiological and clinical outcomes of posterior endoscopic cervical foraminotomy and discectomy. Methods A prospective clinical and radiological study with retrospective evaluation were done for 25 patients with 29 levels of cervical radiculopathy who underwent posterior endoscopic cervical discectomy from November 2016 to December 2018. Clinical outcomes of Visual Analogue Scale, Neck Disability Index and MacNab’s score were evaluated at pre-operative, post-operative 1 week, 3 months and final follow-up. Preoperative and post-operative final follow-up flexion and extension roentgenogram were evaluated for cervical stability assessment. Pre-operative and post-operative computer tomography cervical spine evaluation of foraminal length in ventro-dorsal, cephalad-caudal dimensions, sagittal foraminal area and using 3D CT reconstruction coronal decompression area were done. Results Twenty-nine levels of cervical radiculopathy underwent posterior endoscopic cervical decompression. The mean follow-up was 29.6 months, and the most common levels affected were C5/6 and C6/7. There was a complication rate of 12% with 2 cases of neurapraxia and one case of recurrent of prolapsed disc. There was no revision surgery in our series. There was significant clinical improvement in Visual Analogue Scale and Neck Disability Index. Prospective comparative study between preoperative and final follow-up mean improvement in VAS score was 5.08 ± 1.75, and NDI was 45.1 ± 13.3. Ninety-two percent of the patients achieved good and excellent results as per MacNab’s criteria. Retrospective evaluation of the radiological data showed significant increments of foraminal dimensions: (1) sagittal area increased 21.4 ± 11.2 mm2, (2) CT Cranio Caudal length increased 1.21 ± 1.30 mm and (3) CT ventro-dorsal length increased 2.09 ± 1.35 mm and (4) 3D CT scan reconstruction coronal decompression area increased 536 ± 176 mm2, p < 0.05. Conclusion Uniportal posterior endoscopic cervical foraminotomy and discectomy are safe, efficient and precise choreographed set of technique in the treatment of cervical radiculopathy. It significantly improved clinical outcomes and achieved the objective of increasing in the cervical foramen size in our cohort of patients.

scholarly journals Follow-up of a new titanium-coated polyetheretherketone cage for the cervical spine

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Ricardo Arregui ◽  
José Aso Escario ◽  
José-Vicente Martínez Quiñones ◽  
Cristina Sebastián ◽  
Fabián Consolini ◽  
...  
Keyword(s):  
Modulus Of Elasticity ◽  
Neck Disability Index ◽  
Clinical Results ◽  
Poly Ether Ether Ketone ◽  
Clinical And Radiological Outcome ◽  
The One ◽  
Neck Disability ◽  
Polyetheretherketone Cage ◽  
Anterior Cervical Discectomy Fusion

Poly-ether-ether-ketone (PEEK) cages have lower modulus of elasticity when compared with Titanium (TTN) cages. This suggests that PEEK-cages could show a lower rate of subsidence after anterior cervical discectomy-fusion (ACDF) and might lead to a lower loss of correction. We investigated the one to five year-results of standalone PEEK-TTN-porous coated cages in a patient cohort from 2014 to 2017. The patients underwent single-level ACDF for disc herniation and degenerative discopathy. Clinical and radiological outcome were assessed in 50 eligible patients after a mean of 27 months. Results: Solid arthrodesis was found in 84%. Neck disability index (NDI), and visual analogue scale (VAS) of neck and arm show comparable results to the literature. Conclusions: Clinical and radiological outcomes of ACDF with PEEK-body-cages with a porous coated surface show good bony integration. The modulus of elasticity, design, shape, size, cage surface architecture, as well as bone density, endplate preparation, radical microdiscectomy and distraction during surgery should be considered as important factors influencing the clinical results. One main advantage, over titanium cages, is the absence of MRI artifacts, allowing an excellent postoperative follow-up.

P76 Skip laminectomy versus cervical laminectomy, an analysis of patient reported outcomes, spinal alignment and re-operation rates: the leeds spinal unit experience (2008–2016)

2019 ◽  
Vol 90 (3) ◽  
pp. e42.1-e42
Author(s):  
JMW Robins ◽  
L Luo ◽  
F Mallallah ◽  
J Timothy ◽  
D Pal ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Patient Reported Outcomes ◽  
Sagittal Alignment ◽  
Neck Disability Index ◽  
Cervical Laminectomy ◽  
Patient Reported ◽  
Neck Disability ◽  
Skip Laminectomy

ObjectivesTo compare clinical, radiological and complication results between skip laminectomy and cervical laminectomy for posterior cervical decompression for cervical spondylotic myelopathy.DesignRetrospective single institution cohort study.SubjectsSubjects underwent primary skip or cervical laminectomy between 2008–2016.MethodsStatistical analysis compared pre- and post-operative differences in Visual Analogue Scale, Neck Disability Index and radiological differences in sagittal alignment of the vertebral bodies. Analysis of re-operation rates was performed.ResultsA total of 42 and 29 patients had skip and cervical laminectomy respectively. Median follow up was 32±23.1 (Range: 1–325) weeks. Post-operatively there was no difference in patient reported outcomes namely Visual Analogue Scale and Neck Disability Index between skip laminectomy and cervical laminectomy groups compared to pre-operatively (p=0.64, p=0.75). No difference was seen in sagittal alignment between both groups following surgery (p=0.65). Three patients (7.1%) in the skip laminectomy group and two patients (6.9%) in the cervical laminectomy group required revision surgery to the cervical spinal region at a different level to the original surgery. No patients needed further instrumentation.ConclusionsBoth skip laminectomy and cervical laminectomy appear to deliver similar outcomes with regards to patient reported outcomes, preserving sagittal alignment and re-operation rates over this short follow-up period.

scholarly journals A Long-Term Control Study of the Treatment of Cervical Radiculopathy by Percutaneous Endoscopic Posterior Cervical Discectomy and Anterior Cervical Decompression, Bone Graft Fusion and Internal Fixation

2020 ◽  
Author(s):  
Xiaodong Huang ◽  
Weiheng Wang ◽  
Qingxi Meng ◽  
Jiangming Yu ◽  
Xiaojian Ye
Keyword(s):  
Clinical Symptoms ◽  
Neck Disability Index ◽  
Cervical Radiculopathy ◽  
Clinical Results ◽  
Cervical Discectomy ◽  
Anterior Cervical Decompression ◽  
Intermediate Outcomes ◽  
Significant Difference ◽  
Neck Disability

Abstract BackgroundCervical spondylotic radiculopathy (CSR) is very common all over the world. However, there are only a few reports about the efficacy of percutaneous endoscopic posterior cervical discectomy (PEPCD) in the treatment of CSR. Anterior cervical decompression and fusion (ACDF) and PEPCD which is a better way to treat CSR need further study.MethodsFrom January 2015 to December 2016. A retrospective study of 70 patients undergoing surgery for CSR (33 using PEPCD and 37 using ACDF). The intra-operative parameters, neck disability index (NDI), neck and arm visual analog scale (VAS) score were used to assessed clinical outcome. Radiological outcomes were assessed by measuring cervical 2-7 (C2-7) lordosis, disc height index (DHI), and degree of degenerative changes at the corresponding level.ResultsThe mean follow-up period was 48.5 month (36 –66 months). Two groups can significantly improve the clinical symptoms. There was no significant difference between the two groups in clinical results (VAS, NDI). Compared with preoperative, the lordosis of C2-7 increased significantly at the last follow-up. At the last follow-up, C2-7 lordosis in the ACDF group was significantly higher than that in the PEPCD group. In PEPCD, compared with preoperative, there was no significant difference in the DHI, but the degree of disc degeneration was significantly increased at the last follow-up.ConclusionFor patients with CSR, PEPCD had similar clinical early and intermediate outcomes when compared with ACDF, with the advantages of minimally invasive. PEPCD is a sufficient and safe supplement and alternative to conventional surgery.

A Novel Virtual Reality Technique (Cervigame®) Compared to Conventional Proprioceptive Training to Treat Neck Pain: A Randomized Controlled Trial

2019 ◽  
Vol 9 (3Jun) ◽  
Author(s):  
I Rezaei ◽  
M Razeghi ◽  
S Ebrahimi ◽  
S Kayedi ◽  
A Rezaeian Zadeh
Keyword(s):  
Virtual Reality ◽  
Visual Analogue Scale ◽  
Neck Pain ◽  
Analogue Scale ◽  
Controlled Trial ◽  
Neck Disability Index ◽  
Repeated Measure ◽  
Balance Test ◽  
Proprioceptive Training ◽  
Neck Disability

Background: Despite the potential benefits of virtual reality technology in physical rehabilitation, only a few studies have evaluated the efficacy of this type of treatment in patients with neck pain.Objective: The aim of this study was to compare the effects of virtual reality training (VRT) versus conventional proprioceptive training (CPT) in patients with neck pain.Methods: Forty four participants with nonspecific chronic neck pain were randomly assigned to VRT or CPT in this assessor-blinded clinical trial. A novel videogame called Cervigame® was designed for VRT. It comprises of 50 stages divided into unidirectional and two-directional stages ordered from easy to hard. CPT consisted of eye-follow, gaze stability, eye-head coordination and position and movement sense training. Both groups completed 8 training sessions over 4 weeks. Visual analogue scale score, neck disability index and Y-balance test results were recorded at baseline, immediately after and 5 weeks post-intervention. Mixed repeated measure ANOVA was used to analyze differences between mean values for each variable at an alpha level of 0.05.Results: There were significant improvements in all variables in both groups immediately after and 5 weeks after the intervention. Greater improvements were observed in the visual analogue scale and neck disability index scores in VRT group, and the results for all directions in Y-balance test were similar in both groups. No side effects were reported.Conclusion: Improvements in neck pain and disability were greater in VRT than CPT group. Cervigame® is a potentially practical tool for rehabilitation in patients with neck pain.

scholarly journals Results of a novel surgical technique for iridodialysis repair using segments

2021 ◽  
Author(s):  
Ugur Unsal ◽  
Huri Sabur ◽  
Mehmet Soyler
Keyword(s):  
Surgical Technique ◽  
Minimally Invasive ◽  
Clinical Results ◽  
Study Data ◽  
Invasive Technique ◽  
Minimally Invasive Surgical ◽  
Corrected Distance Visual Acuity ◽  
History Of ◽  
Surgical Manipulation

Abstract Purpose: To describe a novel surgical technique for iridodialysis repair using iris retractor segments and report its clinical results.Methods: 53 eyes of 53 patients who underwent surgery for iridodialysis repair were enrolled in this retrospective study. Data recorded from patient files consisted of age, sex, history of trauma, surgical indications and type of surgery, preoperative and postoperative corrected distance visual acuity (CDVA), intraocular pressure (IOP), complications, and follow-up time. The novel, minimally invasive surgical technique was explicitly described in detail.Results: Mean follow-up time was 34.4 (range 12-84) months. The subjects were 29 (54.7%) men and 26 (45.3%) women, and the mean age was 56.6±14.0 years. Iridodialysis repair performed using one segment in 37 (69.8%) eyes, two segments in 15 (28.3%) eyes, and three segments in 1 (1.9%) eye. Pupilloplasty was performed in 17 eyes due to wide pupil diameter. The iridodialysis repair was combined with lens removal in 48 eyes, and anterior vitrectomy was performed in 10 eyes. CDVA significantly improved after surgery (p<0.001). Post-traumatic IOP rise was the most common complication, and six patients needed medical therapy for glaucoma control.Conclusion: Iridodialysis repair using iris retractor segment is a minimally invasive technique and found to be safe and effective, providing less surgical manipulation and surgical time than other techniques.

scholarly journals A Novel Virtual Reality Technique (Cervigame®) Compared to Conventional Proprioceptive Training to Treat Neck Pain: A Randomized Controlled Trial

2018 ◽  
Author(s):  
I Rezaei ◽  
M Razeghi ◽  
S Ebrahimi ◽  
S Kayedi ◽  
A Rezaeian Zadeh
Keyword(s):  
Virtual Reality ◽  
Visual Analogue Scale ◽  
Neck Pain ◽  
Analogue Scale ◽  
Controlled Trial ◽  
Neck Disability Index ◽  
Repeated Measure ◽  
Balance Test ◽  
Proprioceptive Training ◽  
Neck Disability

Background: Despite the potential benefits of virtual reality technology in physical rehabilitation, only a few studies have evaluated the efficacy of this type of treatment in patients with neck pain.Objective: The aim of this study was to compare the effects of virtual reality training (VRT) versus conventional proprioceptive training (CPT) in patients with neck pain.Methods: Forty four participants with nonspecific chronic neck pain were randomly assigned to VRT or CPT in this assessor-blinded clinical trial. A novel videogame called Cervigame® was designed for VRT. It comprises of 50 stages divided into unidirectional and two-directional stages ordered from easy to hard. CPT consisted of eye-follow, gaze stability, eye-head coordination and position and movement sense training. Both groups completed 8 training sessions over 4 weeks. Visual analogue scale score, neck disability index and Y-balance test results were recorded at baseline, immediately after and 5 weeks post-intervention. Mixed repeated measure ANOVA was used to analyze differences between mean values for each variable at an alpha level of 0.05.Results: There were significant improvements in all variables in both groups immediately after and 5 weeks after the intervention. Greater improvements were observed in the visual analogue scale and neck disability index scores in VRT group, and the results for all directions in Y-balance test were similar in both groups. No side effects were reported.Conclusion: Improvements in neck pain and disability were greater in VRT than CPT group. Cervigame® is a potentially practical tool for rehabilitation in patients with neck pain.

scholarly journals Motion-Preserving Navigated Primary Internal Fixation of Unstable C1 Fractures

2020 ◽  
Vol 14 (4) ◽  
pp. 466-474
Author(s):  
Shanmuganathan Rajasekaran ◽  
Dilip Chand Raja Soundararajan ◽  
Ajoy Prasad Shetty ◽  
Rishi Mugesh Kanna
Keyword(s):  
Neck Disability Index ◽  
Optimal Placement ◽  
Range Of Movement ◽  
Ct Guided ◽  
Duration Of Surgery ◽  
The Mean ◽  
The Right ◽  
Neck Disability ◽  
Displaced Fracture

Study Design: Prospective observational study.Purpose: To assess the safety, efficacy, and benefits of computed tomography (CT)-guided C1 fracture fixation.Overview of Literature: The surgical management of unstable C1 injuries by occipitocervical and atlantoaxial (AA) fusion compromises motion and function. Monosegmental C1 osteosynthesis negates these drawbacks and provides excellent functional outcomes.Methods: The patients were positioned in a prone position, and cranial traction was applied using Mayfield tongs to restore the C0–C2 height and obtain a reduction in the displaced fracture fragments. An intraoperative, CT-based navigation system was used to enable the optimal placement of C1 screws. A transverse rod was then placed connecting the two screws, and controlled compression was applied across the fixation. The patients were prospectively evaluated in terms of their clinical, functional, and radiological outcomes, with a minimal follow-up of 2 years.Results: A total of 10 screws were placed in five patients, with a mean follow-up of 40.8 months. The mean duration of surgery was 77±13.96 minutes, and the average blood loss was 84.4±8.04 mL. The mean combined lateral mass dislocation at presentation was 14.6±1.34 mm and following surgery, it was 5.2±1.64 mm, with a correction of 9.4±2.3 mm (<i>p</i> <0.001). The follow-up CT showed excellent placement of screws and sound healing. There were no complications and instances of AA instability. The clinical range of movement at 2 years in degrees was as follows: rotation to the right (73.6°±9.09°), rotation to the left (71.6°±5.59°), flexion (35.4°±4.5°), extension (43.8°±8.19°), and lateral bending on the right (28.4°±10.45°) and left (24.8°±11.77°). Significant improvement was observed in the functional Neck Disability Index from 78±4.4 to 1.6±1.6. All patients returned to their occupation within 3 months.Conclusions: Successful C1 reduction and fixation allows a motion-preserving option in unstable atlas fractures. CT navigation permits accurate and adequate monosegmental fixation with excellent clinical and radiological outcomes, and all patients in this study returned to their preoperative functional status.

Effect of adding interferential current stimulation to exercise on outcomes in primary care patients with chronic neck pain: a randomized controlled trial

2019 ◽  
Vol 33 (9) ◽  
pp. 1458-1467
Author(s):  
Manuel Albornoz-Cabello ◽  
José Manuel Pérez-Mármol ◽  
Cristo Jesus Barrios Quinta ◽  
Guillermo A Matarán-Peñarrocha ◽  
Adelaida María Castro-Sánchez ◽  
...  
Keyword(s):  
Neck Pain ◽  
Analogue Scale ◽  
Outcome Measure ◽  
Controlled Trial ◽  
Neck Disability Index ◽  
Core Outcome ◽  
Randomized Controlled ◽  
Interferential Current ◽  
Core Outcome Measure ◽  
Neck Disability

Objective: To evaluate the effect of adding interferential current stimulation to exercise on pain, disability, psychological status and range of motion in patients with neck pain. Design: A single-blinded randomized controlled trial. Setting: Primary care physiotherapy units. Subjects: A total of 84 patients diagnosed with non-specific mechanical neck pain. This sample was divided into two groups randomly: experimental ( n = 42) versus control group ( n = 42). Interventions: Patients in both groups had a supervised therapeutic exercise programme, with the experimental group having additional interferential current stimulation treatment. Main measures: The main measures used were intensity of neck pain according to the Visual Analogue Scale; the degree of disability according to the Neck Disability Index and the CORE Outcome Measure; anxiety and depression levels according to the Goldberg scale; apprehension as measured by the Personal Psychological Apprehension scale; and the range of motion of the cervical spine. The sample was evaluated at baseline and posttreatment (10 sessions/two weeks). Results: Statistically significant differences between groups at posttreatment were observed for Visual Analogue Scale (2.73 ± 1.24 vs 4.99 ± 1.56), Neck Disability Index scores (10.60 ± 4.77 vs 18.45 ± 9.04), CORE Outcome Measure scores (19.18 ± 9.99 vs 35.12 ± 13.36), Goldberg total score (6.17 ± 4.27 vs 7.90 ± 4.87), Goldberg Anxiety subscale, Personal Psychological Apprehension Scale scores (28.17 ± 9.61 vs 26.29 ± 11.14) and active and passive right rotation. Conclusions: Adding interferential current stimulation to exercise resulted in better immediate outcome across a range of measures.

scholarly journals McKENZIE NECK EXERCISE LEBIH BAIK DALAM MENURUNKAN DISABILITAS LEHER DARIPADA DYNAMIC NECK EXERCISE PADA PENJAHIT DENGAN MYOFASCIAL PAIN SYNDROME OTOT UPPER TRAPEZIUS

2020 ◽  
Vol 8 (2) ◽  
pp. 41
Author(s):  
Boki Jaleha ◽  
I Putu Gede Adiatmika ◽  
Sugijanto Sugijanto ◽  
I Made Muliarta ◽  
Ketut Tirtayasa ◽  
...  
Keyword(s):  
Myofascial Pain ◽  
Neck Disability Index ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
T Test ◽  
Upper Trapezius ◽  
Paired Samples ◽  
Post Test ◽  
Neck Disability

Pendahuluan: Myofascial pain syndrome otot upper trapezius merupakan gangguan muskuloskeletal pada otot upper trapezius akibat penggunaan otot secara berlebihan, postur yang jelek, dan repetitif mikrotrauma sehingga menyebabkan nyeri, taut band, kelemahan otot dan disabilitas pada daerah leher. Tujuan Penelitian: Untuk mengetahui perbedaan efek kedua intervensi, Mckenzie Neck Exercise dan Dynamic Neck Exercise dalam menurunkan disabilitas leher pada penjahit dengan myofascial pain syndrome otot upper trapezius. Metode: Penelitian eksperimental ini menggunakan rancangan randomized pre and post test two group design. Sampel penelitian sebanyak 18 orang yang dibagi secara acak menjadi 2 kelompok, masing-masing kelompok berjumlah 9 orang. Kelompok I diberikan McKenzie Neck Exercise sedangkan Kelompok II diberikan Dynamic Neck Exercise. Perlakuan dilakukan 3 kali seminggu selama 6 minggu dengan evaluasi menggunakan kuesioner penilaian Neck Disability Index (NDI). Hasil: Hasil uji statistik menggunakan paired-samples t test pada Kelompok I dengan rerata skor sebelum intervensi (23,8±2,1)% dan sesudah intervensi yaitu (16,4±2,4)% dengan nilai (p < 0,05) dan Kelompok II dengan rerata skor sebelum intervensi (23,6±2,2)% dan sesudah intervensi (20,9±2,3)% dengan nilai (p < 0,05). Uji beda hipotesis antara Kelompok I dengan Kelompok II menggunakan independent-samples t test diperoleh nilai (p < 0,05). Simpulan: McKenzie Neck Exercise lebih baik dalam menurunkan disabilitas leher daripada Dynamic Neck Exercise dengan myofascial pain syndrome otot upper trapezius. Saran: Penelitian selanjutnya diharapkan dapat mengontrol aktivitas pekerja dilingkungan kerja maupun tempat tinggal dan diperlukan adanya tindak lanjut ataupun pengawasan (follow up) sampel penelitian setelah berakhirnya program penelitian pada masing-masing sampel, untuk mengetahui hasil intervensi yang diberikan dapat memberikan efek jangka panjang.  

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