Anterior Surgery in Multilevel Stenosis of the Lower Cervical Spine: Technical Indications and Personal Experience. 12 Years Follow-Up

OBJECTIVE Both unchanged upper cervical lordosis combined with decreased lower cervical lordosis and decreased upper cervical lordosis combined with decreased lower cervical lordosis have been reported to occur after correction surgery for adult spinal deformity. However, variations in cervical alignment after correction surgery in patients with ankylosing spondylitis (AS) have not been investigated. The current study aimed to investigate the variations in cervical alignment following the correction surgery in AS patients with thoracolumbar kyphosis. METHODS Patients with AS who underwent pedicle subtraction osteotomy (PSO) for thoracolumbar kyphosis from June 2016 to June 2019 with a minimum of 1-year follow-up were reviewed. Patients were grouped according to the presence (ossified group) and absence (non-ossified group) of total ossification of the anterior longitudinal ligament (ALL) in the lower cervical spine. Radiographic parameters, including thoracolumbar, craniocervical, and global radiographic parameters, were measured on lateral sitting EOS images. RESULTS Thirty-two patients (27 males and 5 females) with a mean follow-up of 1.5 years were identified. There were 21 patients in the non-ossified group and 11 patients in the ossified group. After PSO, both groups showed a decrease in the occiput–C7 angle (p < 0.001 for both). In the non-ossified group, the C2–7 angle decreased significantly (p < 0.001), while the occiput–C2 angle remained unchanged (p = 0.570). In the ossified group, the occiput–C2 angle decreased significantly (p < 0.001), while C2–7 angle remained unchanged (p = 0.311). In addition, the change in occiput–C2 was correlated with the osteotomy angle in the ossified group (R = 0.776, p = 0.005). CONCLUSIONS The variation patterns of cervical alignment following correction surgery for AS-related thoracolumbar kyphosis were different based on patients with or without total ossification of ALL in the lower cervical spine. When planning PSO for patients in the ossified group, restoration of the physiological upper cervical lordosis angle could be achieved by adjusting the osteotomy angle.

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Result of the arc of movement of lower cervical spine after seven years of arthroplasty

Coluna/Columna ◽

10.1590/s1808-18512014130300446 ◽

2014 ◽

Vol 13 (3) ◽

pp. 185-187

Author(s):

Luis Claudio de Velleca e Lima ◽

Fernando Gritsch Sanchis

Keyword(s):

Cervical Spine ◽

Cervical Disc ◽

Lower Cervical Spine ◽

Lateral Bending ◽

Disc Disease ◽

Cervical Disc Replacement ◽

The Right ◽

Lost To Follow Up ◽

Surgery Center

OBJECTIVE: To quantify the mobility of the lower cervical spine after seven years of total cervical disc replacement at two levels. METHOD: This clinical study was designed randomly and prospectively at the spine surgery center at the Hospital Nossa Senhora das Graças, in Canoas, RS-Brazil and at the Hospital Don João Becker, in Gravataí, RS-Brazil. Seventeen patients were included in the study that was designed to compare the data obtained from annual and sequential manner until the end of seven years. A comparison was made with the prior range of motion (ROM) of each patient. All patients were diagnosed with not tractable symptomatic cervical degenerative disc disease with two adjacent levels between C-3 and C-7. RESULTS: A total of patients underwent TDR in two levels and at the end of seven years, only one patient was lost to follow-up. The pre and postoperative ROM was the same in the first three years however after the fourth year there was a gradual decline with a loss of 12% of preoperative ROM in flexion, 21% in extension and 23% in the right and left lateral bending at the end of seven years. CONCLUSIONS: The clinical outcome of this study is evidence level IV in evaluating the ROM for Moby-C(r) for TDR in two adjacent levels at the lower cervical spine. These results show that the ROM is maintained during the first three years, gradually declining after that.

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Anterior Surgery for Unstable Lower Cervical Spine Injuries

Clinical Orthopaedics and Related Research ◽

10.1097/01.blo.0000068185.83581.cf ◽

2003 ◽

Vol 411 ◽

pp. 61-69 ◽

Cited By ~ 15

Author(s):

Elias Lambiris ◽

Panayotis Zouboulis ◽

Minos Tyllianakis ◽

Elias Panagiotopoulos

Keyword(s):

Cervical Spine ◽

Lower Cervical Spine ◽

Cervical Spine Injuries ◽

Anterior Surgery ◽

Spine Injuries

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Results of Long Term Follow-up of Lower Cervical Spine Fusions in 60 Cases

Cervical Spine II ◽

10.1007/978-3-7091-9055-5_18 ◽

1989 ◽

pp. 109-117 ◽

Cited By ~ 1

Author(s):

M. Arand ◽

O. Woersdoerfer

Keyword(s):

Cervical Spine ◽

Lower Cervical Spine ◽

Long Term Follow Up

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Listening to the Voices of Individuals with Disabilities

Families in Society The Journal of Contemporary Social Services ◽

10.1606/1044-3894.1818 ◽

1998 ◽

Vol 79 (2) ◽

pp. 188-196 ◽

Cited By ~ 13

Author(s):

Stephen French Gilson ◽

John C. Bricout ◽

Frank R. Baskind

Keyword(s):

Social Work ◽

Exploratory Study ◽

Personal Experience ◽

Work Practice ◽

Social Work Practice ◽

Fundamental Rights ◽

Individuals With Disabilities ◽

Research And Practice ◽

The Social

Social work literature, research, and practice on disabilities has lagged behind other topical areas dealing with oppressed groups. The social work literature remains “expert focused” and generally fragmented into discussions of specific disabilities or subpopulations. A viable general model that deals with the personal experience of disability is not available. This exploratory study presents a social work literature search and analysis as well as interviews with six individuals with disabilities about their experiences with social workers. Individuals with disabilities assert that they were treated as though they had categorically fewer aspirations, abilities, and perhaps even fundamental rights than did nondisabled people. This study provides a base for follow-up research on models of consumer-focused social work practice in the area of disability.

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Surgical Treatment of Diffuse Idiopathic Skeletal Hyperostosis (DISH) Involving the Cervical Spine: Technical Nuances and Outcome of a Multicenter Experience

Global Spine Journal ◽

10.1177/2192568220988272 ◽

2021 ◽

pp. 219256822098827

Author(s):

Giorgio Lofrese ◽

Alba Scerrati ◽

Massimo Balsano ◽

Roberto Bassani ◽

Michele Cappuccio ◽

...

Keyword(s):

Cervical Spine ◽

Clinical Outcome ◽

Waiting Times ◽

Diffuse Idiopathic Skeletal Hyperostosis ◽

Surgical Techniques ◽

Rare Condition ◽

Surgical Strategies ◽

Bone Removal ◽

Mild Dysphagia

Study Design: Retrospective multicenter. Objectives: diffuse idiopathic skeletal hyperostosis (DISH) involving the cervical spine is a rare condition determining disabling aero-digestive symptoms. We analyzed impact of preoperative settings and intraoperative techniques on outcome of patients undergoing surgery for DISH. Methods: Patients with DISH needing for anterior cervical osteophytectomy were collected. Swallow studies and endoscopy supported imaging in targeting bone decompression. Patients characteristics, clinico-radiological presentation, outcome and surgical strategies were recorded. Impact on clinical outcome of duration and time to surgery and different surgical techniques was evaluated through ANOVA. Results: 24 patients underwent surgery. No correlation was noted between specific spinal levels affected by DISH and severity of pre-operative dysphagia. A trend toward a full clinical improvement was noted preferring the chisel ( P = 0.12) to the burr ( P = 0.65), and whenever C2-C3 was decompressed, whether hyperostosis included that level ( P = 0.15). Use of curved chisel reduced the surgical times ( P = 0.02) and, together with the nasogastric tube, the risk of complications, while bone removal involving 3 levels or more ( P = 0.04) and shorter waiting times for surgery ( P < 0.001) positively influenced a complete swallowing recovery. Early decompressions were preferred, resulting in 66.6% of patients reporting disappearance of symptoms within 7 days. One and two recurrences respectively at clinical and radiological follow-up were registered 18-30 months after surgery. Conclusion: The “age of DISH” counts more than patients’ age with timeliness of decompression being crucial in determining clinical outcome even with a preoperative mild dysphagia. Targeted bone resections could be reasonable in elderly patients, while in younger ones more extended decompressions should be preferred.

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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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P97. Correlation of UIV and cervical spine surgery to functional outcomes in AIS: a minimum 40-years follow-up

The Spine Journal ◽

10.1016/j.spinee.2020.05.495 ◽

2020 ◽

Vol 20 (9) ◽

pp. S193

Author(s):

Aron Sulovari ◽

Adan Omar ◽

Emmanuel N. Menga ◽

Paul T. Rubery ◽

James Sanders ◽

...

Keyword(s):

Cervical Spine ◽

Spine Surgery ◽

Functional Outcomes ◽

Cervical Spine Surgery

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Occipitocervicothoracic stabilization in pediatric patients

Journal of Neurosurgery Pediatrics ◽

10.3171/2011.4.peds10450 ◽

2011 ◽

Vol 8 (1) ◽

pp. 57-62 ◽

Cited By ~ 10

Author(s):

Kyle M. Fargen ◽

Richard C. E. Anderson ◽

David H. Harter ◽

Peter D. Angevine ◽

Valerie C. Coon ◽

...

Keyword(s):

Cervical Spine ◽

Thoracic Spine ◽

Pediatric Patients ◽

Pathological Condition ◽

Case Series ◽

Neurological Function ◽

Spinal Reconstruction ◽

Spine Deformities ◽

Distal Fixation

Object Although rarely encountered, pediatric patients with severe cervical spine deformities and instability may occasionally require occipitocervicothoracic instrumentation and fusion. This case series reports the experience of 4 pediatric centers in managing this condition. Occipitocervical fixation is the treatment of choice for craniocervical instability that is symptomatic or threatens neurological function. In children, the most common distal fixation level with modern techniques is C-2. Treated patients maintain a significant amount of neck motion due to the flexibility of the subaxial cervical spine. Distal fixation to the thoracic spine has been reported in adult case series. This procedure is to be avoided due to the morbidity of complete loss of head and neck motion. Unfortunately, in rare cases, the pathological condition or highly aberrant anatomy may require occipitocervical constructs to include the thoracic spine. Methods The authors identified 13 patients who underwent occipitocervicothoracic fixation. Demographic, radiological, and clinical data were gathered through retrospective review of patient records from 4 institutions. Results Patients ranged from 1 to 14 years of age. There were 7 girls and 6 boys. Diagnoses included Klippel-Feil, Larsen, Morquio, and VATER syndromes as well as postlaminectomy kyphosis and severe skeletal dysplasia. Four patients were neurologically intact and 9 had myelopathy. Five children were treated with preoperative traction prior to instrumentation; 5 underwent both anterior and posterior spinal reconstruction. Two patients underwent instrumentation beyond the thoracic spine. Allograft was used anteriorly, and autologous rib grafts were used in the majority for posterior arthrodesis. Follow-up ranged from 0 to 43 months. Computed tomography confirmed fusion in 9 patients; the remaining patients were lost to follow-up or had not undergone repeat imaging at the time of writing. Patients with myelopathy either improved or stabilized. One child had mild postoperative unilateral upper-extremity weakness, and a second child died due to a tracheostomy infection. All patients had severe movement restriction as expected. Conclusions Occipitocervicothoracic stabilization may be employed to stabilize and reconstruct complex pediatric spinal deformities. Neurological function can be maintained or improved. The long-term morbidity of loss of cervical motion remains to be elucidated.

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