Clinical effect of combined anterior and posterior approach surgery for cervical spondylotic myelopathy

Objective: To evaluate the clinical efficacy of combined anterior and posterior approach surgery for patients with spinal type. Methods: 96 patients with cervical spondylosis were randomly selected among all patients admitted in our hospital from January 2013 to December 2015. They were evenly assigned to A, B or C group, 32 patients each. Patients in Group A suffered from cervical myelopathy and were treated by combined anterior and posterior approach. Patients in Group B group suffered from cervical vertebra disease and accepted a cervical corpectomy decompression and a bone graft fusion internal fixation surgery. Patients in Group C accepted conventional posterior decompression and fusion surgery for lateral mass screw fixation. Postoperative follow-up, X-ray intervertebral stability and fusion, neurological function JOA score and clinical efficacy of the effective date were compared. Results: JOA scores of all three groups were improved after 6 months. After a year, patients in Group A, B and C scored (16.3 ± 1.83), (15.7 ± 1.15) and (15.59 ± 1.21), respectively. The pairwise score differences between any two groups were statistically significant (P < 0.05). After one year’s follow-up, the bone graft and internal fixation material had no signs of loosening, displacement or subsidence. The fusion rates of Group A, B and C reached 90.6%, 53.1% and 56.25%, respectively. Similarly, the pairwise differences in fusion rate between any two groups were statistically significant (P < 0.05). The clinical effectiveness was classified as apparent, effective, fair and invalid. The effective rates of Group A, B and C were 87.5%, 50% and 56.2%, respectively. The pairwise differences between any two groups were statistically significant (P < 0.05). Conclusion: Combined anterior and posterior approach surgery significantly improved the clinical efficacy than the other two surgeries.

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Clinical effect of combined anterior and posterior approach surgery for cervical spondylotic myelopathy

Advanced Emergency Medicine ◽

10.18686/aem.v6.84 ◽

2018 ◽

Vol 6 (2) ◽

Author(s):

Yanzhou Jiang ◽

Liancong Fu ◽

Yunshan Mu

Keyword(s):

Internal Fixation ◽

Bone Graft ◽

Clinical Efficacy ◽

Posterior Approach ◽

Cervical Vertebra ◽

Clinical Effectiveness ◽

Fusion Rate ◽

Effective Rate ◽

The Difference

<p>Objective: To evaluate the clinical efficacy of combined anterior and posterior approach surgery for patients with spinal type. Methods: Randomly selected from January 2013 to December 2015 in our hospital 96 cases of cervical spondylosis patients treated in our hospital from January 2013 to December 2015 , the technical way of the operation of these 96 cases of loyalty if they were randomly divided into A, B, C three groups. A group of 32 cases were treated by combined anterior and posterior approach in treatment of cervical myelopathy. B group of 32 cases patients with anterior cervical corpectomy decompression and bone graft fusion internal fixation surgery to treat cervical vertebra disease, C treatment group of 32 patients used conventional posterior decompression and fusion surgery for lateral mass screw fixation. Postoperative follow-up, the three groups of X-ray intervertebral stability and fusion, neurological function JOA score and clinical efficacy of the effective date were compared. Results: three group of patients after half a year, the JOA scores were improved, the patients of the A group after a year of score(16.3±1.83)，the scores of B and C two groups were respectively (15.7±1.15）、（15.59±1.21）, there was statistically differences between the three groups （ P ＜ 0.05). After one year’s follow-up, the bone graft and internal fixation material had no loosening, displacement and subsidence, the fusion rate of A group reached 90.6%, the fusion rate of B group was 53.1%, the fusion rate of C group was 56.25%, and the difference was statistically significant (P＜0.05）. For clinical effectiveness is divided into apparent, effective, fair, invalid. the effective rate of group A was 87.5%, and the effective rate was 50% in group B, the difference was statistically significant（P＜0.05）. Conclusion: the treatment effect of A group was better than that of B and C two groups before and after operation, and the effect was significant.</p>

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Change in the postoperative intervertebral space height and its impact on clinical and radiological outcomes after ACDF surgery using a zero-profile device: a single-Centre retrospective study of 138 cases

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04432-0 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Haimiti Abudouaini ◽

Chengyi Huang ◽

Hao Liu ◽

Ying Hong ◽

Beiyu Wang ◽

...

Keyword(s):

Clinical Efficacy ◽

Fusion Rate ◽

Clear Correlation ◽

Cervical Lordosis ◽

Single Centre ◽

Intervertebral Space ◽

Imaging Parameters ◽

Group A ◽

Group B

Abstract Background The effects of postoperative intervertebral height (IH) changes on the clinical and radiological outcomes after anterior cervical decompression and fusion (ACDF) surgery using a zero-profile device remain unclear. Methods We retrospectively reviewed patients who had undergone ACDF using a zero-profile device from March 2012 to February 2016 at our institution. Based on the postoperative IH variation, the patients were divided into group A with postoperative IH 0 to 2 mm, group B with postoperative IH 2 to 4 mm, and group C with postoperative IH greater than 4 mm. Clinical efficacy was evaluated using JOA, VAS, and NDI scores in the groups. Imaging parameters including the IH, cervical lordosis, fusion rate, intervertebral foramen (IVF) diameter and complications such as subsidence, dysphagia, and ASD were also compared across the three groups. Results The average IH increased significantly from 6.72 mm preoperatively to 10.46 mm 1 week after surgery, and then gradually decreased to 7.48 mm at the final follow-up. The fusion rate was 61.90% in group A, 63.23% in group B, 53.57% in group C at 3 months, 73.81% in group A, 79.41% in group B, 67.86% in group C at 6 months, 90.48% in group A, 95.59% in group B, 92.86% in group C 1 year after surgery, and at the last follow-up, the fusion rate of three groups was all 100%. The IVF diameter was 6.52 ± 1.80 mm in group A, 9.55 ± 2.36 mm in group B, and 9.34 ± 1.62 mm in group C. ASD at the superior and inferior levels affected 11.90 and 16.67% patients in group A, 5.88 and 7.38% in group B, and 14.28 and 10.71% in group C. Regarding the 3 groups, the subsidence rates were 7.14, 4.41, and 14.29%, respectively. Conclusions No clear correlation was found between IH changes and clinical efficacy within a year of surgery. However, the IH may affect various complications after ACDF. If postoperative IH changes are maintained at 2 to 4 mm after a year, a satisfactory imaging parameters and relatively low complications may be achieved after ACDF surgery using a zero-profile device.

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Efficacy and Sagittal Parameters of Debridement and Bone Grafting using Internal Fixation in the Treatment of Kyphotic Cervical Tuberculosis: A Case Series

10.21203/rs.3.rs-965602/v1 ◽

2021 ◽

Author(s):

Haopeng Luan ◽

Kai Liu ◽

Qiang Deng ◽

Weibin Sheng ◽

Maierdan Maimaiti ◽

...

Keyword(s):

Internal Fixation ◽

Bone Grafting ◽

Case Series ◽

Cervical Vertebra ◽

Fixation Group ◽

Post Operation ◽

Group A ◽

Sagittal Parameters ◽

Radiographic Data

Abstract Background: To evaluate the efficacy of debridement and bone grafting using internal fixation in the treatment of kyphotic cervical tuberculosis, and analyze the changes of pre-operation and post-operation sagittal parameters, which related to the surgical indications.Methods: Clinical and radiographic data of patients with kyphotic cervical TB treated by debridement and BGIF at our hospital from January 2010 to December 2017 were analyzed retrospectively. The sagittal parameters of the cervical vertebra at the pre-operation, post-operation, and last follow-up were documented and were compared. Results: Eighteen patients of simple anterior approach debridement and fusion with internal fixation (group A), and 5 patients underwent anterior debridement and fusion, combined with posterior internal fixation (group AP). In the comparison of preoperative sagittal parameters, significant improvement after surgery was observed in both groups, included Cobb angle, SCA, C2-C7SVA, and CG-SVA (P < 0.05). There were no significant differences in T1 Slope, NT, and TIA (P > 0.05).Conclusions: In the treatment of kyphotic cervical TB, the characteristics of the lesion, the degree of kyphosis and spinal cord nerve compression damage can be presented clearly by the radiographic sagittal parameters, which does a favor to individualize the choice of surgical approach safely and effectively.

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One-stage anterior focus debridement, interbody graft using titamium mesh cages, and anterior instrumentation and fusion in the surgical treatment of short segment thoracic tuberculosis with paraplegia

10.21203/rs.3.rs-22042/v1 ◽

2020 ◽

Author(s):

huijun zhang ◽

zenghui lu ◽

lin wei ◽

chao ding ◽

junsong yang

Keyword(s):

Internal Fixation ◽

Bone Graft ◽

Clinical Manifestations ◽

Short Segment ◽

Anterior Debridement ◽

Bone Fusion ◽

Thoracic Spinal ◽

Imaging Results ◽

Thoracic Tuberculosis

Abstract Purpose The purpose of this study was to evaluate the clinical efficacy of primary anterior debridement, bone graft fusion and internal fixation in the treatment of short segmental thoracic tuberculosis with paraplegia.Methods We performed a retrospective analysis of 16 adult patients with short segment thoracic spinal TB with paraplegia who underwent surgery between September 2013 to March 2017. All the 16 patients were treated using a single primary anterior debridement, bone graft fusion and internal fixation. Clinical manifestations, laboratory, neurological symptoms,bone fusion and imaging results were subjected to statistical analysis.Results All patients underwent operation successfully. The preoperative ESR and CRP level of all patients were 72.6 ± 27.5 mm/h and 75.7 ± 25.9 mg/L, which decreased to 15.9 ± 4.6 mm/h and 4.7 ± 2.0 mg/L at the final follow-up, respectively. The preoperative thoracic kyphosis angle were 30.7 ± 7.1°respectively. The corresponding postoperative angles were ameliorated significantly to 9.1 ±1.9°. During the follow-up, spinal paraplegia was significantly improved in all patients.The symptoms of chest and back pain were alleviated and disappeared at 1–6 months postoperatively.Patients were followed up for 24–48months (average, 35.6 ±9.6 months). Among 16 patients, no recurrence, and bone fusion was achieved at the final follow-up.Conclusion The clinical results of primary anterior debridement, bone graft fusion and internal fixation in the treatment of segmental thoracic tuberculosis with paraplegia were satisfactory.

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Partial uncinatectomy combined with anterior cervical discectomy and fusion for the treatment of one-level cervical radiculopathy: analysis of clinical efficacy and sagittal alignment

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04680-0 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Haimiti Abudouaini ◽

Tingkui Wu ◽

Hao Liu ◽

Beiyu Wang ◽

Hua Chen ◽

...

Keyword(s):

Clinical Efficacy ◽

Sagittal Alignment ◽

Cervical Radiculopathy ◽

Fusion Rate ◽

Uncinate Process ◽

Anterior Cervical Discectomy ◽

Cervical Discectomy ◽

Cervical Sagittal Alignment ◽

Uncovertebral Joint

Abstract Background Biomechanical studies have demonstrated that uncovertebral joint contributes to segment mobility and stability to a certain extent. Simultaneously, osteophytes arising from the uncinate process are a common cause of cervical spondylotic radiculopathy (CSR). For such patients, partial uncinatectomy (UT) may be required. However, the clinical efficacy and sagittal alignment of partial UT during anterior cervical discectomy and fusion (ACDF) have not been fully elucidated. Methods A total of 87 patients who had undergone single level ACDF using a zero-profile device from July 2014 to December 2018 were included. Based on whether the foraminal part of the uncovertebral joint was resected or preserved, the patients were divided into the ACDF with UT group (n = 37) and the ACDF without UT group (n = 50). Perioperative data, radiographic parameters, clinical outcomes, and complications were compared between the two groups. Results The mean follow-up was 16.86 ± 5.63 and 18.36 ± 7.51 months in the ACDF with UT group and ACDF without UT group, respectively (p > 0.05). The average preoperative VAS arm score was 5.89 ± 1.00 in the ACDF with UT group and 5.18 ± 1.21 in the ACDF without UT group (p = 0.038). However, the average VAS arm score was 4.22 ± 0.64, 4.06 ± 1.13 and 1.68 ± 0.71, 1.60 ± 0.70 at 1 week post operation and at final follow up, respectively, (p > 0.05). We also found that the C2-7 SVA and St-SVA at the last follow-up and their change (last follow-up value − preoperative value) in the ACDF with UT group were significantly higher than ACDF without UT group (p < 0.05). No marked differences in the other cervical sagittal parameters, fusion rate or complications, including dysphagia, ASD, and subsidence, were observed. Conclusions Our result indicates that ACDF using a zero-p implant with or without partial UT both provide satisfactory clinical efficacy and acceptable safety. However, additional partial UT may has a negative effect on cervical sagittal alignment.

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Fractures of the Second Cervical Vertebra

Neurosurgery ◽

10.1227/00006123-197709000-00007 ◽

1977 ◽

Vol 1 (2) ◽

pp. 125-127 ◽

Cited By ~ 11

Author(s):

James H. Salmon

Keyword(s):

Internal Fixation ◽

Neurological Deficit ◽

Operative Mortality ◽

Cervical Vertebra ◽

Initial Evaluation ◽

Follow Up Studies

Abstract Fractures of the 2nd cervical vertebra are frequently undetected on initial evaluation. Tomography may be necessary to delineate the fracture. This is a report of 20 patients treated by internal fixation using interlaminar wiring. There was no operative mortality. Follow-up studies, an average of 25 months after operation, demonstrated satisfactory results and no evidence of delayed neurological deficit.

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Biomechanical Study of Cortical Bone Trajectory Screws in Intervertebral Fixation of Lumbar Tuberculosis

10.21203/rs.3.rs-680733/v1 ◽

2021 ◽

Author(s):

Chen-Wei Zhang ◽

Shi-Yuan Shi ◽

De-Xin Hu ◽

Shen-Ping Hu ◽

Jin-Ping Hu ◽

...

Keyword(s):

Lumbar Spine ◽

Internal Fixation ◽

Bone Graft ◽

Lateral Bending ◽

Flexion Extension ◽

Group A ◽

Group B ◽

Group D ◽

State 1 ◽

Screw Group

Abstract BackgroundWe aimed to explore the biomechanical stability and advantages of cortical bone trajectory (CBT) screws in the treatment of lumbar spine tuberculosis and provide biomechanical basis for the choice of clinical fixation methods. Methods16 pig spine specimens (T12-L5) were selected to simulate the lumbar spine(L2-L3) tuberculosis bone destruction model in vitro. The 16 specimens were randomly divided into 4 groups, and short segments (pedicle screws of the diseased vertebrae) were assigned respectively. Fixation (group A), short-segment fixation (group B), fixation with pedicle screw (group C), fixation with CBT screw (group D), 4 specimens in each group , Each specimen in each group was subjected to biomechanical testing in the state of complete specimen (state 1) and L2-3 spinal tuberculosis model bone graft fusion and internal fixation (state 2). Load each specimen on the spine 3D exercise machine, respectively apply moments of 2N·m, 2.5N·m, 1N·m, 3N·m, meanwhile record the movement of the specimens in the four directions of flexion，extension，lateral bending and torsion ROM, compare Simultaneously analyze each group of ROM. ResultsThe ROMs of flexion, extension, lateral bending, and torsion in group A in state 1 and state 3 modes were （8.47±1.76）°、（7.01±1.10）°、（5.03±0.92）°、（4.48±0.41）°and （4.78±0.07）°、（2.91±0.16）°、（2.66±0.09）°、（2.23±0.05）°; the ROMs of flexion, extension, lateral bending and torsion in group B in state 1 and state 3 modes were （7.32±0.75）°、（5.35±0.69）°、（3.44±0.51）°、（3.36±1.02）°and（3.51±0.29）°、（1.74±0.04）°、（1.53±0.31）°、（1.23±0.08）°; The ROMs of flexion, extension, lateral bending, and torsion in group C in state 1 and state 3 modes were （10.01±0.39）°、（9.05±0.25）°、（7.42±1.06）°、（6.92±1.15）°and （7.21±0.17）°、（5.07±0.02）°、（5.12±0.74）°、（4.58±0.01）°; The ROMs of flexion, extension, lateral bending, and torsion in group D in state 1 and state 3 modes were （9.20±1.37）°、（7.38±0.88）°、（6.89±1.22）°、（6.00±0.52）°and （6.06±0.16）°、（3.99±0.02）°、（3.85±0.08）°、（3.47±0.10）°. The ROM value of each fixed mode group under the state of bone graft fusion and internal fixation was lower than that of the intact state, and the difference was statistically significant (P<0.05)，The t values are 4.531, 5.346, 6.008, 4.149; 9.481, 16.181, 11.814, 4.769; 4.349, 8.002, 4.473, 4.800; 5.041, 4.146, 12.232, 10.58. ConclusionCBT screw disease intervertebral fixation can not only provide sufficient mechanical stability, but also provide stronger stability when using the same fixed segment, and The fixed segments are minimized.

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Protocol on Comparative Clinical Efficacy of Tryushanadi Guggul and Navaka Guggul in Sthoulya (Overweight)

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i30a31628 ◽

2021 ◽

pp. 169-175

Author(s):

Ashvini Dineshrao Pardhekar ◽

Sadhana Misar(Wajpeyi) ◽

Vinod Ade

Keyword(s):

Clinical Efficacy ◽

The Body ◽

Control Group ◽

Arm Circumference ◽

Before And After ◽

Group A ◽

Excessive Intake ◽

Group B ◽

Excessive Accumulation

Background: Sthoulya is Medovaha Strotodushtijanya vyadhi, which includes abnormal and excessive accumulation of Medodhatu in the body. This is caused by lack of physical and mental activity, daytime sleep, excessive intake of madhur (sweet), snigdha ahar (oily diet) results in increase Kaphadosha and meda which results in Sthoulya (overweight) having symptoms of mild dysponea, thirst, drowsiness, excess sleep, appetite, offensive smell from the body, incapability to work and incapability to participate in sexual intercourse. Aim: Comparative clinical efficacy of Tryushanadi Guggul and Navaka Guggul in Sthoulya (overweight). Materials and methods: Total 60 patients of Sthoulya will enrolled and will divided into two groups (each group contains 30). Patients in group A (experimental group) will be given 1 gram Tryushanadi Guggul two times a day after meal with honey and in group B (control group)1 gram Navaka Guggul will administered two times a day after meal with honey for 30 days. Dietary changes and walking (30 minutes) will be advised to patients of both groups. Follow up will be taken on 15th day and 30th day. Assessment of subjective parameters like kshudrashwasa (exertional dyspnoea), swedadhikya (perspiration), atikshudha (increased appetite), nidradhikya (increased sleep) and objective parameters like body weight, B.M.I., mid arm circumference, waist-hip ratio and lipid profile will be done before and after treatment. Results: Subjective and objectives outcomes will be assessed by statistical analysis. Conclusion: It will be drawn from the result obtained.

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A Comparison of the Bridge-type ROI-C Interbody Fusion Cage System and Titanium Mesh Graft With Titanium Plate Fixation in 2-level Anterior Cervical Discectomy and Fusion With Plating and Cage System: A Retrospective Study

10.21203/rs.3.rs-48049/v1 ◽

2020 ◽

Author(s):

Shuangjun He ◽

Zhangzhe Zhou ◽

Xiaofeng Shao ◽

Changhao Zhang ◽

Xinfeng Zhou ◽

...

Keyword(s):

Interbody Fusion ◽

Operation Time ◽

Fusion Rate ◽

Cage System ◽

Significant Difference ◽

Group A ◽

Bridge Type ◽

Group B ◽

Fusion Cage

Abstract Objective To explore the clinical efficacy and radioactive results of the bridge-type ROI-C interbody fusion cage (ROI-C) and anterior cervical discectomy and fusion with plating and cage system (ACDF) for cervical spondylopathy. Methods From January 2014 to January 2018, 45 patients undergoing ACDF were retrospectively analyzed, including 24 cases of ROI-C (group A) and 21 cases of ACDF (group B). The operation time, blood loss, Neck Disability Index (NDI), Japanese Orthopaedic Association score (JOA), postoperative complications, imaging results including cervical Cobb angle and fusion were compared between groups. Results All patients were successfully treated with surgery, and no cerebrospinal fluid leakage, esophageal fistula, or hoarseness occurred after surgery. The operation time and blood loss in group A were lower than those in group B (P < 0.05). During the follow-up period, JOA score increased and NDI score decreased after operation (P < 0.05), but there was no significant difference between the groups (P > 0.05). The incidence of dysphagia in group A was lower than that in group B at 1 month and 3 months after operation (P < 0.05), but the final follow-up results showed that there was no significant difference in the incidence of dysphagia between the two groups (P > 0.05). In group A, the fusion rate was 83.3% 3 months after surgery and 100% at the last follow-up. The rate of adjacent level ossification development was 12.5%. In group B, the fusion rate was 85.7% 3 months after surgery and 100% at the last follow-up. The rate of adjacent level ossification development was 23.8%. Conclusion Both ROI-C and ACDF can achieve satisfactory results, but ROI-C has shorter operation time, less bleeding and lower incidence of dysphagia in the short term.

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How to select the fusion and fixation range of thoracolumbar and lumbar tuberculosis: A retrospective clinical study

10.21203/rs.3.rs-22774/v1 ◽

2020 ◽

Author(s):

Yang zong qiang ◽

Liu chang hao ◽

Niu ning kui ◽

Tang jing ◽

Sayed Abdulla Jami ◽

...

Keyword(s):

Bone Graft ◽

Clinical Efficacy ◽

Clinical Data ◽

Spinal Tuberculosis ◽

Operation Time ◽

Adjacent Vertebral Body ◽

Surgery Group ◽

Surgical Methods ◽

Retrospective Clinical Study

Abstract Purpose To investigate the clinical data of thoracolumbar and lumbar spinal tuberculosis with diseased and non-diseased intervertebral surgery, evaluate the clinical efficacy of the two surgical methods, and explore how to choose the fusion of fixation range. Methods Among 221 patients with thoracolumbar and lumbar tuberculosis were categorized into two groups. 118 patients were in the diseased intervertebral surgery group (lesion vertebral pedicle fixation, group A) and there were 103 patients in the non-diseased intervertebral surgery group (1 or 2 vertebral fixation groups at the above and below levels of the affected vertebra, group B). Both groups of patients were treated with primary or staging, anterior combined complete lesion removal, bone graft fusion, and internal fixation. By analyzing of clinical data and the clinical efficacy of the two surgical methods in thoracolumbar and lumbar tuberculosis was evaluated. Results The mean follow-up duration was 65months (range 50–68 months). There were no significant differences in laboratory examination, VAS scores, and the Cobb angle correction rate and the angle loss, however, significant differences between the two groups in operation time, blood loss, drainage volume, and transfusion, the diseased intervertebral surgery group was significantly better than the non-diseased intervertebral surgery group. Meanwhile, the bone graft was fused entirely at the last follow-up. Conclusion Under the conditions of strictly grasping the indications for surgery, intervertebral surgery for thoracolumbar and lumbar tuberculosis is safe, effective, and feasible, and it can effectively restore its physiological curvature and reduce the degeneration of the adjacent vertebral body.

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