Consideration of Pathology in the Selection of Operative Methods—Anterior Surgery or Posterior Surgery for Cervical Radiculopathy—

OBJECTIVE Previous studies have demonstrated that Lenke lumbar modifier A contains 2 distinct types (AR and AL), and the AR curve pattern is likely to develop adding-on (i.e., a progressive increase in the number of vertebrae included within the primary curve distally after posterior surgery). However, the results of anterior surgery are unknown. The purpose of this study was to present the surgical results in a cohort of patients undergoing scoliosis treatment for type 1AR curves and to compare anterior and posterior surgeries to consider the ideal indications and advantages of anterior surgery for type 1AR curves. METHODS Patients with a Lenke type 1 or 2 and lumbar modifier AR (L4 vertebral tilt to the right) and a minimum 2-year postoperative follow-up were included. The incidence of adding-on and radiographic data were compared between the anterior and posterior surgery groups. The numbers of levels between the end, stable, neutral, and last touching vertebra to the lower instrumented vertebra (LIV) were also evaluated. RESULTS Forty-four patients with a mean follow-up of 57 months were included. There were 14 patients in the anterior group and 30 patients in the posterior group. The main thoracic Cobb angle was not significantly different between the groups preoperatively and at final follow-up. At final follow-up, the anterior group had significantly less tilting of the LIV than the posterior group (−0.8° ± 4.5° vs 3° ± 4°). Distal adding-on was observed in no patient in the anterior group and in 6 patients in the posterior group at final follow-up (p = 0.025). In the anterior group, no LIV was set below the end vertebra, and all LIVs were set above last touching vertebra. The LIV was significantly more proximal in the anterior group than in the posterior surgery patients without adding-on for all reference vertebrae (p < 0.001). CONCLUSIONS This is the first study to investigate the surgical results of anterior surgery for Lenke type 1AR curve patterns, and it showed that anterior surgery for the curves could minimize the distal extent of the instrumented fusion without adding-on. This would leave more mobile disc space below the fusion.

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Twenty Four Thumb Replantations

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681(84)90028-7 ◽

1984 ◽

Vol 9 (1) ◽

pp. 98-102 ◽

Cited By ~ 29

Author(s):

M. J. EARLEY ◽

J. S. WATSON

Keyword(s):

Functional Results ◽

Primary Operation ◽

Operative Methods ◽

Selection Of Patients ◽

Selection Of

Of 40 patients with amputated thumbs referred for replantation to the Manchester Microsurgical Unit over five and a half years, 10 (25%) were not considered to be feasible replants, 6(15%) were abandoned at the primary operation, and 24 were replanted. Mode of selection of patients for replantation and operative methods are considered. The 14 thumb replants that survived were studied in detail and functional results are presented. Only one patient had a result that prevented normal activities, the remainder having returned to former occupations.

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Selection of Operative Methods for Common Bile Duct Stones after Cholecystectomy

Hans Journal of Surgery ◽

10.12677/hjs.2021.104011 ◽

2021 ◽

Vol 10 (04) ◽

pp. 63-68

Author(s):

世利臧

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Common Bile Duct Stones ◽

Bile Duct Stones ◽

Operative Methods ◽

Selection Of

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Physical Function Outcome in Cervical Radiculopathy Patients After Physiotherapy Alone Compared With Anterior Surgery Followed by Physiotherapy

Spine ◽

10.1097/brs.0b013e31826d2cbb ◽

2013 ◽

Vol 38 (4) ◽

pp. 300-307 ◽

Cited By ~ 30

Author(s):

Anneli Peolsson ◽

Anne Söderlund ◽

Markus Engquist ◽

Bengt Lind ◽

Håkan Löfgren ◽

...

Keyword(s):

Physical Function ◽

Cervical Radiculopathy ◽

Anterior Surgery

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Meta-Analysis of Anterior Surgery versus Posterior Surgery for Thoracolumbar Burst Fractures

Journal of Computational and Theoretical Nanoscience ◽

10.1166/jctn.2016.4859 ◽

2016 ◽

Vol 13 (1) ◽

pp. 678-687

Author(s):

YuWen Jiang ◽

Hong Xia ◽

HaiFeng Liu ◽

QiuGen Hu ◽

Guang Zheng ◽

...

Keyword(s):

Meta Analysis ◽

Anterior Surgery ◽

Thoracolumbar Burst Fractures ◽

Posterior Surgery ◽

Burst Fractures

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Comparison of anterolateral and posterior approaches in the management of thoracolumbar burst fractures

Journal of Neurosurgery Spine ◽

10.3171/spi.2006.5.2.117 ◽

2006 ◽

Vol 5 (2) ◽

pp. 117-125 ◽

Cited By ~ 66

Author(s):

Patrick W. Hitchon ◽

James Torner ◽

Kurt M. Eichholz ◽

Stephanie N. Beeler

Keyword(s):

Angular Deformity ◽

Intergroup Difference ◽

Total Cost ◽

Thoracolumbar Burst Fractures ◽

Posterior Surgery ◽

Burst Fractures ◽

Posterior Group ◽

The Mean ◽

Selection Of

Object The authors undertook a retrospective cohort study of patients with T11–L2 thoracolumbar burst fractures who underwent decompression and the placement of instrumentation via the anterolateral or posterior approach. Methods There were 63 thoracolumbar burst fractures in 45 male and 18 female patients. The instrumentation was placed posteriorly in 25 patients and anterolaterally in 38. The mean follow-up duration after discharge from the hospital was 1.8 years (range 6 months–8 years). The mean preoperative Frankel scores in the anterolateral and posterior groups were 3.7 ± 1.1 and 3.5 ± 1.4, respectively (p = 0.4155). Preoperative angular deformity in the anterolateral and posterior groups measured 11.9 ± 9.7 and 4.1 ± 7.1°, respectively (p = 0.0007). Postoperatively, angular deformity had been corrected to 2.0 ± 7.9 and 3.4 ± 7.5° in both groups, respectively (p = 0.565). The follow-up Frankel scores had improved to 4.2 ± 0.8 and 4.0 ± 1.4 (p = 0.461). At the latest follow-up examination, angular deformity had progressed to 4.5 ± 9.3° in the anterolateral group and to 9.8 ± 9.4° in the posterior group (p = 0.024). Although surgeons’ fees were significantly (p = 0.0024) higher for patients who underwent anterolateral procedures ($27,940 ± 4390) than for those who underwent posterior surgery ($18,270 ± 6980), there was no intergroup difference in total cost of hospitalization. Conclusions Rigid guidelines for the selection of anterior or posterior approaches are lacking. Evaluation of the authors’ results and those of others shows that angular deformity is more successfully corrected and maintained when the anterior approach is used.

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Vertebroplasty-augmented short-segment posterior fixation of osteoporotic vertebral collapse with neurological deficit in the thoracolumbar spine: comparisons with posterior surgery without vertebroplasty and anterior surgery

Journal of Neurosurgery Spine ◽

10.3171/2010.5.spine09813 ◽

2010 ◽

Vol 13 (5) ◽

pp. 612-621 ◽

Cited By ~ 51

Author(s):

Kenzo Uchida ◽

Hideaki Nakajima ◽

Takafumi Yayama ◽

Tsuyoshi Miyazaki ◽

Takayuki Hirai ◽

...

Keyword(s):

Neurological Deficit ◽

Posterior Fixation ◽

Vertebral Collapse ◽

Kyphotic Angle ◽

Short Segment ◽

Anterior Surgery ◽

Posterior Surgery ◽

Group B ◽

Osteoporotic Vertebral Collapse

Object The surgical approach and treatment of thoracolumbar osteoporotic vertebral collapse with neurological deficit have not been documented in detail. Anterior surgery provides good decompression and solid fusion, but the surgery-related risk is relatively higher than that associated with the posterior approach. In posterior surgery, the major problem after posterior correction and instrumentation is failure to support the anterior spinal column, leading to loss of correction of kyphosis. The aim of this study was to evaluate the efficacy of reinforcing short-segment posterior fixation with vertebroplasty and to compare the outcome with those of posterior surgery without vertebroplasty and anterior surgery, retrospectively. Methods The authors studied 83 patients who underwent surgical treatment for a single thoracolumbar osteoporotic vertebral collapse with neurological deficit. Twenty-eight patients treated by posterior surgery combined with vertebroplasty (Group A), 25 patients treated by posterior surgery without vertebroplasty (Group B), and 30 patients treated by anterior surgery (Group C) were followed up for a mean postoperative period of 4.4 years. Neurological outcome, visual analog scale pain score, and radiographic results were compared in the 3 groups. Results Postoperative (4–6 weeks) and follow-up neurological outcome and visual analog scale scores were not significantly different among the 3 groups. Postoperative kyphotic angle was significantly reduced in Group B compared with Group C (p = 0.007), whereas the kyphotic angle was not significantly different among the 3 groups at follow-up. The mean ± SD loss of correction at follow-up was 4.6° ± 4.5°, 8.6° ± 6.2°, and 4.5° ± 5.9° in Groups A, B, and C, respectively. The correction loss at follow-up in Group B was significantly higher compared with Groups A and C (p = 0.0171 and p = 0.0180, respectively). Conclusions The results suggest that additional reinforcement with vertebroplasty reduces the kyphotic loss and instrumentation failure, compared with patients without the reinforcement of vertebroplasty. Vertebroplasty-augmented short-segment fixation seems to offer immediate spinal stability in patients with thoracolumbar osteoporotic vertebral collapse; the effect seems equivalent to that of anterior reconstruction.

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Cognitive gadgets and cognitive priors

Behavioral and Brain Sciences ◽

10.1017/s0140525x19000992 ◽

2019 ◽

Vol 42 ◽

Author(s):

Gian Domenico Iannetti ◽

Giorgio Vallortigara

Keyword(s):

Cognitive Neuroscience ◽

Selection Of

Abstract Some of the foundations of Heyes’ radical reasoning seem to be based on a fractional selection of available evidence. Using an ethological perspective, we argue against Heyes’ rapid dismissal of innate cognitive instincts. Heyes’ use of fMRI studies of literacy to claim that culture assembles pieces of mental technology seems an example of incorrect reverse inferences and overlap theories pervasive in cognitive neuroscience.

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