Application of a new integrated low-profile anterior plate and cage system in single-level cervical spondylosis: a preliminary retrospective study

Background Although ACDF has been widely used in treating cervical spondylosis and related diseases, the complications along with this anterior surgical technique have hindered its application and affected the postoperative outcome of the patients. Here, we investigated the clinical and radiological outcomes of a new integrated low-profile anterior plate and cage system for anterior cervical discectomy and fusion (ACDF) in treating cervical spondylosis. Methods A total of 96 cervical spondylosis patients who underwent single-level ACDF between 2018 to 2020 in our institute were enrolled. There were 28 patients using the new implants and 68 patients using the zero-profile (Zero-P) implants. The Japanese Orthopedic Association (JOA) score and the visual analog scale (VAS) were used to evaluate the clinical outcomes. The cervical and segmental Cobb angle and range of motion (ROM) were used to assessed the radiological outcomes. Incidence of complications were also recorded. All data were recorded at pre-operation, 6-month and 12-month post-operation. Results All patients were followed-up for at least 1-year, the mean follow-up time was over one year. The fusion rate was similar in the two groups. There was no significant difference in the postoperative JOA score recovery rate, postoperative VAS score of neck and arm pain, postoperative ROM, and incidence of complications between two groups (P > 0.05). However, postoperative cervical and segmental Cobb angle were better maintained in the new low-profile implant group compared to Zero-P group. Conclusions The clinical outcomes of the new low-profile implant were satisfactory and comparable to that of zero-profile system. It may have advantages in improving and maintaining the cervical lordosis, and can be an alternative device for single-level cervical spondylosis treated with ACDF.

CLINICAL EFFICACY OF DASHMOOL KWATH NASYA IN THE MANAGEMENT OF MANYASTAMBHA WITH SPECIAL REFERENCE TO CERVICAL SPONDYLITIS

Background: Nasya is an essential therapeutic procedure as many of the courses of Ayurvedic treatment. It comes under the Panchashodhana karmas. It is necessary in all Urdhwa jathru vikaras. Nasya is effective for inducing immediate results and serves as a permanent cure. Cervical spondylotic change is frequently found in many asymptomatic adults, with 25 the age of 40, 50% of adults over the age of 40 and 85% of adults over the age of 60 showing evidence of disc degeneration. Cervical spondylosis can be compared with Manyastambha based on signs & symptoms. Nasya is the simple techniques and ingredients are readily available & economical. Also, these are indicated in the management of Manyastambha and have no proven adverse effects. This study was intended to assess the efficacy of the Dashmool Kwath Nasya in the management of this disease. Method: Randomly, 30 patients of Manyastambha were selected and paired “t” test was used. Result: Statistically significant improvement was found in this study on post-follow-up. Conclusion: Dashmool Kwath Nasya is having a prolonged action as it is having highly significant results post follow up of treatment as compared to after treatment.

Monitoring of neck activity for early warning of cervical spondylosis

<abstract> <p>Wireless body area networks (WBANs) is a new research hotspot with great development prospects. The non-contact sensing based on radio frequency signal can solve the issues of personal comfort and privacy. Detection of cervical motion range and cervical strain in time are important in diagnosis and prevention of cervical spondylosis. In this paper, channel state information is used to achieve smart perception and monitoring, timely and efficient detection of different postures and abnormal bending of the neck. It provides an efficient way for protecting cervical health, and also some help for doctors to understand the causes of cervical vertebral disease in a timely manner. The classification accuracy of the four activities reached 99.4%, 99.7%, 99.5% and 99.3%, respectively.</p> </abstract>

Efficacy and Safety of Anterior Cervical Discectomy and Fusion (ACDF) Through Mini-Incision and Posterior Laminoplasty (LAMP) For Treatment of Long-Level Cervical Spondylosis

Background: The efficacy and safety of anterior cervical discectomy and fusion (ACDF) through mini-incision and posterior laminoplasty for long-level cervical spondylosis were investigated. Method: From January 2018 to September 2019, clinical patients data with 3-4 segments (C3-7) cervical spondylotic radiculopathy, cervical spondylotic myelopathy, or mixed cervical spondylosis who received ACDF (42 cases) throughwith mini-incision or LAMP (36 cases) treatment were retrospectively collected and analyzed. The operative time, bleeding volume, incisive length, and hospital stay were recorded. Moreover, the intervertebral height, functional segment height, cervical lordosis, cervical hyperextension and hyperflexion range-of-motion (ROM) and ROM in all directions of the cervical spine before and after the operation were measured. Additionally, all relevant postoperative complications were also recorded. Then, the therapeutic effects of both surgical methods were investigated.Results: Patients in the ACDF group had less bleeding, shorter incision, and fewer hospitalization days than the LAMP group. Postoperative intervertebral height and functional segment height in the ACDF group were significantly higher than those before the operation, and postoperative functional segment height of the ACDF group was significantly higher than that of the LAMP group. Moreover, the postoperative cervical lordosis angle in the ACDF group was significantly larger than the LAMP group. There was no significant difference between preoperative and postoperative ROM in all directions of the cervical spine for the two groups.Conclusions: Both ACDF through mini-incision and LAMP are effective treatments for long-level cervical spondylosis. However, ACDF through mini-incision shows minor trauma, less bleeding, fast recovery, and it is beneficial for cervical lordosis reconstruction.

Cervical Spinal Alignment Change Accompanying Spondylosis Exposes Harmonization Failure with Total Spinal Balance: A Japanese Cohort Survey Randomly Sampled from a Basic Resident Registry

The relationship between spinal posture and quality of life has garnered considerable attention with the increase in older community-dwelling residents. However, details of this association remain insufficient. A recent Japanese population cohort epidemiological locomotion survey (the Obuse study) revealed that the C2–C7 cervical sagittal vertical axis (CSVA) began to increase in males from their 60s, but not in females. This study aimed to clarify the pathology of these cervical spondylotic changes. A total of 411 participants (202 male and 209 female) aged between 50 and 89 years were selected by random sampling from a cooperating town’s resident registry. All participants underwent lateral X-ray photography in a standing position for the measurement of several sagittal spinal alignment parameters, including CSVA, C2–C7 cervical lordosis (CL), T1 slope (T1S), and sagittal vertical axis (SVA). The presence of cervical spondylotic changes was also recorded. Associations of cervical sagittal spinal alignment with cervical spondylosis and between cervical and total sagittal spinal alignment were examined. The prevalence of cervical spondylosis was significantly higher in males (81%) than in females (70%) (p = 0.01). CL was significantly smaller in cervical spondylosis subjects when adjusted by age (3.4 degrees less; p = 0.01). T1S minus CL displayed a moderate positive correlation with CSVA in both males and females (r = 0.49 and 0.48, respectively, both p < 0.01). In males only, CSVA and CL showed weak positive correlations with SVA (r = 0.31 and 0.22, respectively, both p < 0.01) independently of age. Cervical spinal misalignment was more clearly associated with diminished SF-8TM scores in females than in males. In community-dwelling elderly residents, cervical sagittal spinal alignment change accompanying cervical spondylosis manifested as hypofunction to compensate for whole-spine imbalance.

Pseudochoreoathetosis secondary to progressive spondylotic cervical myelopathy

Pseudochoreoathetosis is a rare movement disorder associated with loss of proprioception. Culprit lesions may occur at any point between the cerebral cortex and the peripheral nerve. Seldom is the underlying cause reversible or prone to improvement. An elderly man presented to our tertiary centre with choreoathetoid movements secondary to spondylotic subaxial cervical myelopathy. His myelopathy fulminated and he was emergently treated with posterior decompressive neurosurgery. Unexpectedly, his choreoathetoid movements improved significantly post-operatively. There are a multitude of reports of pseudochoreoathetosis secondary to lesions of various aetiologies; however, few have reported this disorder secondary to cervical spondylosis. To our knowledge, there is only one other report in the medical literature. Herein, we report a second case, for the purposes of raising awareness of this disorder, and to highlight relevant clinical pearls for clinicians who encounter this rare pathology.