Surgical and Functional Outcomes of Expansive Open-Door Laminoplasty for Patients With Mild Kyphotic Cervical Alignment

Objective: To evaluate the cervical dynamics, neurological function, pain, and quality of life in patients with mild cervical kyphotic alignment who underwent expansive unilateral open-door laminoplasty (ELAP).Methods: In this retrospective single-center study, we reviewed the surgical outcomes of 80 patients with cervical spondylotic myelopathy who were followed for at least 2 years. The patients were categorized into the preoperative kyphotic group (C2–7 angle < 0°) and nonkyphotic group (angle ≥ 0°). We compared clinical information, radiographic parameters, Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) scores, and cervical Japanese Orthopaedic Association (JOA) scores between the groups.Results: The kyphotic and nonkyphotic groups comprised 17 and 63 patients, respectively. The preoperative C2–7 angles were -3.7° in the kyphotic group and 15.4° in the nonkyphotic group (p < 0.01). In the kyphotic group, kyphotic alignment improved to lordosis at the final follow-up (2.6°, p = 0.01). The preoperative (16.4° vs. 24.1°, p < 0.01) and finalfollow-up (17.8° vs. 24.5°, p < 0.01) C7 slopes were significantly smaller in the kyphotic group. ELAP reduced pain in the arms or hands (p = 0.02) and improved the JOA scores (p < 0.01) in the kyphotic group. Patient-reported outcomes assessed using the JOACMEQ showed comparable effective rates in both groups.Conclusion: Patients with mild cervical kyphosis showed smaller C7 slopes as a compensatory mechanism. Kyphotic angles significantly improved to lordosis after ELAP, resulting in favorable clinical outcomes. ELAP is a useful surgical option for patients even if they present mild kyphotic cervical angles.

The Importance of Lamina Size Measurement and Proper Implants Selection before Laminoplasty : Two Case Reports

Open door laminoplasty using plates is a safe and effective procedure for multi-level cord compression. To achieve stable laminar arch, various types of plate have been developed and used. Now, we introduce two rare complications related to the laminar shelf of plate. In the first case, we used the wider laminar shelf plate because the elevated lamina did not fit well into the usual laminar shelf. During follow-up, cord compression due to laminar shelf was observed. And in the second case, the laminar shelf of plate did not fit into the elevated lamina, so we inserted it with a little bit of force. But the patient’s symptom was not improved. On CT image, the inner cortical bone of the lamina was fractured. To prevent these complications, surgeons need to consider the thickness of the lamina and the size of the laminar shelf before surgery.

Symbol of Door as Mary in Images of the Annunciation of the 14th-15th Centuries

The current article addresses the topic of the symbolic identification of the Virgin Mary as a door according to a double possibility, namely, as an open door and as a shut door. This implies designating Mary simultaneously as ianua coeli and as porta clausa. These two possibilities suggest very different, though complementary, doctrinal meanings. Through the textual analysis of various quotes from the Church Fathers and theologians and medieval liturgical hymns referring to one or other of these two metaphorical expressions, the Author will determine the doctrinal meanings inherent in each one. In the second instance, the iconographic analysis of seven images of the Annunciation from the 14th and 15th centuries that include some door in special conditions will allow us to validate the hypothesis that the intellectual authors of these seven paintings introduced that door into them as a visual metaphor capable of illustrating both textual metaphors of porta clausa and ianua coeli.

Współpraca wojskowa NATO z państwami Kaukazu od 1991 roku

NATO declares open door policy towards aspiring countries since 90s. States from South Caucasus region took the effort to adjust its defense and security systems to NAO standards. To become a fully-fledged NATO members the main obstacle remains the lack of political will to extend NATO commitment to collective defense. Additionally self-imposed limitations of some NATO members stemming form 1997 NATO-Russia Founding Act plays a vital role. It’s hard to assume that new Strategic Concept will grant an automatic membership to any of NATO partner countries. Georgia, Armenia nor Azerbaijan have been seriously considered as NATO member states. The door are barely open.

The Mob Rule Continued

In 1967, during a mutiny known as the Wuhan Incident, Zhou Enlai flexed his political muscles and pacified the insurgent commanders. Mao felt threatened. Yuan-tsung’s friend Courtier Yu, her direct link to Zhou, warned her that she had been caught in the crossfire of a huge power struggle between Zhou and Mao. Zhou wanted to reach an understanding with the West that would lead to the lifting of its trade sanctions against China. Mao, however, wanted to resuscitate the Great Leap Forward. Yuan-tsung’s best bet was Zhou. If Zhou prevailed, he would use Jack’s knowledge of English and Western culture to explain his open-door policy to the West. In return Jack and Yuan-tsung would get their exit visas. Courtier Yu arranged a meeting at a place near Badaling where Yuan-tsung could take her plea directly to Zhou.

Adebáyọ̀ Fálétí: The Passing of a Cultural Icon

Through the open door of the room next to the editing suite at the offices of Mainframe Productions, near Oshodi, Lagos, a figure dressed in colorful agbada is visible, hunched over papers and books. Back turned to the door, he scribbles away, oblivious to all movement around him. But it is not difficult to know who it is. The cap tipped to the right and the brief side glance cast in reaction to approaching motion are enough to give him away, even if, as in such situations, a few moments lapse before recognition registers. The sight is riveting, forbidding and disorienting all at once. In more than an hour of chattering about the problems of Nigeria, I have been unaware of the presence in the same building of one of the iconic figures of the arts in Nigeria, probably at work making things even more complicated. It is late in the evening. We greet him and quickly withdraw, careful not to disturb him further. Walking out the building with cultural critic Toyin Akinosho at the end of a visit with the filmmaker Tunde Kelani, I also find it quite chastening.

Surgical Treatment of Multilevel Degenerative Cervical Myelopathy: Open-Door Laminoplasty and Fixation via Unilateral Approach. A Feasibility Study

Objective We compared open-door laminoplasty via a unilateral approach and additional unilateral lateral mass screw fixation (uLP) with laminectomy and bilateral lateral mass screw fixation (LC) in the surgical treatment of multilevel degenerative cervical myelopathy (mDCM). Methods A retrospective cohort analysis of 46 prospectively enrolled patients (23 uLP and 23 LC). The minimum follow-up was 1 year. Neck and arm pains were evaluated with visual analog scales and disability with the Neck Disability Index (NDI). Myelopathy was rated with the modified Japanese Orthopaedic Association (mJOA) score. Cervical sagittal parameters were measured on plain and functional X-ray films with a specific software. The statistical significance was set at p < 0.05. Fusion was defined as <2 degrees of intersegmental motion on flexion/extension radiographs. Results The two groups were similar in age and comorbidities. The mean operation time and the mean hospital stay were shorter in the uLP group (p = 0.015). The intraoperative blood loss did not exceed 200 mL in both groups. At follow-up, the groups showed comparable clinical outcome data. The sagittal profile did not deteriorate in either group. Fusion rates were 67% in the uLP group and 92% in the LC group. No infections occurred in either group. In the LC group, one patient developed a transient C5 palsy. Revision surgery was required for a malpositioned screw (LC) and for one implant failure (uLP). Conclusion Laminoplasty and unilateral fixation via a unilateral approach achieved comparable clinical and radiologic results with laminectomy and bilateral fixation, despite a lower fusion rate. However, the surgical traumatization was less.