scholarly journals Anterior and Posterior Approach Results for Treatment of Cervical Myelopathy in the Elderly: A 10-Year Experience in a Mexican Institution

2021 ◽  
Vol 11 (07) ◽  
pp. 207-219
Author(s):  
Mauricio Daniel Sánchez-Calderón ◽  
María Elena Córdoba-Mosqueda ◽  
José Ramón Aguilar-Calderón ◽  
Carlos René Domínguez-Herz ◽  
Diego Ochoa-Cacique ◽  
...  
Keyword(s):  
Cervical Myelopathy ◽  
Posterior Approach ◽  
The Elderly

Biomechanical analysis of transverse acetabular fracture fixation in the elderly via the posterior versus the anterior approach with and without a total hip arthroplasty

2020 ◽  
Vol 234 (9) ◽  
pp. 966-974
Author(s):  
Joel Moktar ◽  
Alan Machin ◽  
Habiba Bougherara ◽  
Emil H Schemitsch ◽  
Radovan Zdero
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Acetabular Fracture ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Failure Load ◽  
The Elderly ◽  
Clinical Failure ◽  
Total Hip

This study provides the first biomechanical comparison of the fixation constructs that can be created to treat transverse acetabular fractures when using the “gold-standard” posterior versus the anterior approach with and without a total hip arthroplasty in the elderly. Synthetic hemipelvises partially simulating osteoporosis (n = 24) were osteotomized to create a transverse acetabular fracture and then repaired using plates/screws, lag screws, and total hip arthroplasty acetabular components in one of four ways: posterior approach (n = 6), posterior approach plus a total hip arthroplasty acetabular component (n = 6), anterior approach (n = 6), and anterior approach plus a total hip arthroplasty acetabular component (n = 6). All specimens were biomechanically tested. No differences existed between groups for stiffness (range, 324.6–387.3 N/mm, p = 0.629), clinical failure load at 5 mm of femoral head displacement (range, 1630.1–2203.9 N, p = 0.072), or interfragmentary gapping (range, 0.67–1.33 mm, p = 0.359). Adding a total hip arthroplasty acetabular component increased ultimate mechanical failure load for posterior (2904.4 vs. 3652.3 N, p = 0.005) and anterior (3204.9 vs. 4396.0 N, p = 0.000) approaches. Adding a total hip arthroplasty acetabular component also substantially reduced interfragmentary sliding for posterior (3.08 vs. 0.50 mm, p = 0.002) and anterior (2.17 vs. 0.29 mm, p = 0.024) approaches. Consequently, the anterior approach with a total hip arthroplasty may provide the best biomechanical stability for elderly patients, since this fixation group had the highest mechanical failure load and least interfragmentary sliding, while providing equivalent stiffness, clinical failure load, and gapping compared to other surgical options.

Clinical Features and Surgical Outcomes of Cervical Myelopathy in the Elderly

2006 ◽  
Vol 443 (&NA;) ◽  
pp. 140-145 ◽  
Author(s):  
Hideki Nagashima ◽  
Yasuo Morio ◽  
Hideki Yamashita ◽  
Koji Yamane ◽  
Ryota Teshima
Keyword(s):  
Clinical Features ◽  
Surgical Outcomes ◽  
Cervical Myelopathy ◽  
The Elderly

scholarly journals Combined Anterior and Posterior Decompression With Fusion for Cervical Ossification of the Posterior Longitudinal Ligament

2022 ◽  
Vol 8 ◽  
Author(s):  
Chao-Hung Kuo ◽  
Yi-Hsuan Kuo ◽  
Chih-Chang Chang ◽  
Hsuan-Kan Chang ◽  
Li-Yu Fay ◽  
...  
Keyword(s):  
Cervical Myelopathy ◽  
Functional Outcomes ◽  
Posterior Approach ◽  
Posterior Longitudinal Ligament ◽  
Wound Complications ◽  
Complication Rates ◽  
Continuous Type ◽  
Csf Leakage ◽  
Post Operation

Objective:Cervical myelopathy caused by ossification of the posterior longitudinal ligament (OPLL) is not uncommon among Asian ethnic groups. Despite reports comparing the pros and cons of anterior- and posterior-only approaches, the optimal management remains debatable. This study aimed to evaluate the outcomes of patients who underwent a combined anterior and posterior approach, simultaneous circumferential decompression and fixation, for cervical OPLL.Method:The study retrospectively reviewed patients with OPLL and who underwent circumferential decompression and fixation, combined anterior corpectomy and posterior laminectomy. The clinical outcomes were evaluated by the Visual Analog Scale of neck and arm pain, the Japanese Orthopedic Association scores, Neck Disability Index, and Nurick scores at each time-point of evaluation. Radiological evaluations included plain and dynamic radiographs and computed tomography for every patient within 2 years post-operation. Subgroup analyses were further performed between the groups, with and without intra-operative cerebrospinal fluid (CSF) leakage.Results:A total of 41 patients completed the follow-up for more than 2 years (mean = 39.8 months) and were analyzed. Continuous-type OPLL was the most common (44%), followed by segmental (27%), mixed (22%), and localized types (7%) in the cohort. Myelopathy and all other functional outcomes improved significantly at 2 years post-operation (all p < 0.05). There were 13 (32%) patients who had intra-operative CSF leakage. At 2 years post-operation, there were no differences in the demographics, functional outcomes, and complication rates between the CSF-leakage and no-leakage groups. The CSF-leakage group had more patients with continuous-type OPLL than the no-leakage group (77 vs. 29%, p = 0.004 < 0.05). During the follow-up, there was no secondary or revision surgery for pseudomeningocele, pseudarthrosis, or other surgery-related complications.Conclusions:Simultaneous circumferential decompression and fixation combine the surgical benefits of sufficient decompression by the posterior approach and direct decompression of OPLL by the anterior approach. It is an effective surgical option for patients with cervical myelopathy caused by OPLL, given that myelopathy unanimously improved without neurological complications in this study. The fusion rates were high, and reoperation rates were low. Despite higher rates of CSF leakage, there were no related long-term sequelae, and minimal wound complications.

scholarly journals Comparative studies between anterior approach and posterior approach for cervical myelopathy.

1985 ◽  
Vol 33 (4) ◽  
pp. 1011-1014
Author(s):  
Tadashi Sakamoto ◽  
Shinya Kawai ◽  
Tetsuo Imagama ◽  
Hirotsugu Oda ◽  
Akira Matsuoka ◽  
...  
Keyword(s):  
Comparative Studies ◽  
Cervical Myelopathy ◽  
Anterior Approach ◽  
Posterior Approach

scholarly journals Surgical Management of Odontoid Fracture in Elderly

2014 ◽  
Vol 52 (193) ◽  
pp. 732-734
Author(s):  
Muhammad Nadeem ◽  
Muhammad Jawad Noon ◽  
Rana Muhammad Omar Daraz Khan ◽  
Inayatullah Khan
Keyword(s):  
Posterior Approach ◽  
The Elderly ◽  
Motor Deficit ◽  
Type Ii ◽  
Short Term ◽  
Geriatric Population ◽  
Transoral Odontoidectomy ◽  
Occipitocervical Fixation ◽  
History Of

Odontoid type II fractures are associated with high mortality in the elderly. Their management can be done either conservatively or surgically, however, surgical treatment is technically demanding and relatively new. We report a case of 75 years old man who presented to our clinical setting, following a history of fall. The CT scan and MRI showed odontoid type II fracture. With time, the neurological deficit got marked and he underwent transoral odontoidectomy and occipitocervical fixation using rods and screws via posterior approach. Patient’s neurological condition improved dramatically and on the short term follow up, he had no motor deficit. Our experience suggests that occipitocervical fixation via posterior approach is a viable option for the management of odontoid type II fracture in the geriatric population.

A Comparison of the Anterior Approach and the Posterior Approach in Treating Multilevel Cervical Myelopathy

2017 ◽  
Vol 30 (2) ◽  
pp. 65-76 ◽  
Author(s):  
Zihao Chen ◽  
Bin Liu ◽  
Jianwen Dong ◽  
Feng Feng ◽  
Ruiqiang Chen ◽  
...  
Keyword(s):  
Cervical Myelopathy ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Multilevel Cervical Myelopathy
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