Radiological and Clinical Significance of Cervical Dynamic Magnetic Resonance Imaging for Cervical Spondylotic Myelopathy.

Objective: The study compared the morphometric changes of the cervical spinal cord using dynamic magnetic resonance imaging (MRI) in patients with cervical spondylotic myelopathy (CSM) and assessed the correlation with kinematic changes, cord cross-sectional area (CSA), and high signal intensity (SI) on T2-weighted imaging (T2WI).

Methods: Patients with CSM were evaluated through dynamic MRI for sagittal and axial CSA changes of the cervical cord, cerebrospinal fluid (CSF) reserve ratio, degree of cord impingement, cord compression rate, range of motion (ROM), and severity of SI on T2WI. The degree of cord impingement was evaluated using the Muhle grading system.

Surgical Versus Conservative Management for Treating Unstable Atlas Fractures: A Multicenter Study.

Objective: This multicenter study compared radiological parameters and clinical outcomes between surgical and nonsurgical management and investigated treatment characteristics associated with the successful management of unstable atlas fractures.

Methods: We retrospectively evaluated 53 consecutive patients with unstable atlas fracture who underwent halo-vest immobilization (HVI) or surgical fixation. Clinical outcomes were assessed using neck visual analogue scale and disability index.

Radiological Changes in Adjacent and Index Levels after Cervical Disc Arthroplasty.

Purpose: The purpose of this retrospective study was to evaluate radiological and clinical outcomes in patients undergoing cervical disc arthroplasty (CDA) for cervical degenerative disc disease. The results may assist in surgical decision-making and enable more effective and safer implementation of cervical arthroplasty.

Materials And Methods: A total of 125 patients who were treated with CDA between 2006 and 2019 were assessed.

Laminectomy with instrumented fusion vs. laminoplasty in the surgical treatment of cervical ossification of the posterior longitudinal ligament: A multicenter retrospective study.

Laminectomy with instrumented fusion (LF) has demonstrated better prevention of ossification of posterior longitudinal ligament (OPLL) growth compared to laminoplasty (LP). There remains uncertainty, however, as to which surgical approach is more beneficial with respect to clinical outcomes and complications. We retrospectively reviewed 273 cervical OPLL patients of more than 3 levels, from the two institutions' databases, who underwent LF or LP between January 1998 and January 2016.

Cervical disc arthroplasty: What we know in 2020 and a literature review.

Cervical disc arthroplasty (CDA) is a safe and effective option to improve clinical outcomes (e.g., NDI, VAS, and JOA) in degenerative cervical disc disease and compressive myelopathy.

Preoperative Radiological Parameters to Predict Clinical and Radiological Outcomes after Laminoplasty.

Many studies have focused on pre-operative sagittal alignment parameters which could predict poor clinical or radiological outcomes after laminoplasty. However, the influx of too many new factors causes confusion. This study reviewed sagittal alignment parameters, predictive of clinical or radiological outcomes, in the literature.

A Prospective, Multi-Center, Double-Blind, Randomized Study to Evaluate the Efficacy and Safety of the Synthetic Bone Graft Material DBM Gel with rhBMP-2 versus DBM Gel Used during the TLIF Procedure in Patients with Lumbar Disc Disease.

Objective: This study is to evaluate the efficacy and safety of demineralized bone matrix (DBM) gel versus DBM gel with recombinant human bone morphogenetic protein-2 (rhBMP-2) used in transforaminal lumbar interbody fusion (TLIF).

Methods: This study was designed as a prospective, multi-center, double-blind method, randomized study. All randomized subjects underwent TLIF with DBM gel with rhBMP-2 group (40 patients) as an experimental group or DBM gel group (36 patients) as a control group.

Predictors of neurologic outcome after surgery for cervical ossification of the posterior longitudinal ligament differ based on myelopathy severity: a multicenter study.

Objective: The purpose of this retrospective multicenter study was to compare prognostic factors for neurological recovery in patients undergoing surgery for cervical ossification of the posterior longitudinal ligament (OPLL) based on their presenting mild, moderate, or severe myelopathy.

Methods: The study included 372 consecutive patients with OPLL who underwent surgery for cervical myelopathy between 2006 and 2016 in East Asian countries with a high OPLL prevalence. Baseline and postoperative clinical outcomes were assessed using the Japanese Orthopaedic Association (JOA) myelopathy score and recovery ratio.

Surgical Strategies for Cervical Deformities Associated With Neuromuscular Disorders.

Neuromuscular disorders (NMDs) are diseases involving the upper and lower motor neurons and muscles. In patients with NMDs, cervical spinal deformities are a very common issue; however, unlike thoracolumbar spinal deformities, few studies have investigated these disorders. The patients with NMDs have irregular spinal curvature caused by poor balance and poor coordination of their head, neck, and trunk.

Comparison of Adjacent Segment Degeneration, Cervical Alignment, and Clinical Outcomes After One- and Multilevel Anterior Cervical Discectomy and Fusion.

Objective: This study aimed to assess the influence of a fused segment on cervical range of motion (ROM) and adjacent segmental kinematics and determine whether increasing number of fusion levels causes accelerated adjacent segment degeneration (ASD) after anterior cervical discectomy and fusion (ACDF).

Methods: A total of 165 patients treated with ACDF were recruited for assessment, and they were divided into 3 groups based on the number of fusion levels. Radiological measurements and clinical outcomes included visual analogue scale (VAS) and Neck Disability Index (NDI) assessed preoperatively and at ≥2 years of follow-up.

Epidemiology of C5 Palsy after Cervical Spine Surgery: A 21-Center Study.

Objective: C5 palsy is a severe complication after cervical spine surgery, the pathophysiology of which remains unclear. This multicenter study investigated the incidence of C5 palsy following cervical spine surgery in Korea.

Methods: We conducted a retrospective multicenter study involving 21 centers from the Korean Cervical Spine Study Group.

Comparison of clinical and radiological outcomes in cervical laminoplasty versus laminectomy with fusion in patients with ossification of the posterior longitudinal ligament.

This study aimed to comparatively assess cervical sagittal alignment, progression of ossification of the posterior longitudinal ligament (OPLL), and health-related quality of life (HRQOL) outcomes between patients who underwent cervical laminoplasty (CL) and those who underwent cervical laminectomy with fusion (LF) for cervical OPLL at more than three levels. We retrospectively evaluated consecutive 91 patients with cervical OPLL undergoing CL (n = 49) or LF (n = 42) who were followed up for at least 24 months (mean 38.6 months).

Epidemiology of Iatrogenic Vertebral Artery Injury in Cervical Spine Surgery: 21 Multicenter Studies.

Background: The overall incidence of iatrogenic vertebral artery injury (IVAI) in cervical spine surgeries (CSSs) is reported to be 0.07%-1.4%.

Comparison of radiological and clinical outcomes after surgical reduction with fixation or halo-vest immobilization for treating unstable atlas fractures.

Background: Unstable atlas fractures with concomitant transverse atlantal ligament (TAL) injury may be conservatively managed by halo-vest immobilization (HVI) or surgically treated by various fixation techniques. Many surgeons prefer surgical management due to complications, nonunion, and further dislocations with HVI. There are no comparative studies on surgical and nonsurgical management of unstable atlas fractures.

Pharmacological target therapy of neuropathic pain and patient-reported outcomes in patients with chronic low back pain in Korea: Results from the NLBP Outcomes Research.

A number of studies have demonstrated an association of neuropathic pain and chronic low back pain (CLBP), but the outcome difference in each medical management is poorly understood. This study is aimed to investigate treatment patterns of neuropathic pain in CLBP patients and to explore patient-reported outcomes (PROs) including quality of life (QoL) and functional disability by treatment patterns.Data were extracted from the neuropathic low back pain (NLBP) outcomes research.

Cerebellar infarction after posterior direct reduction and fixation to treat an unstable Jefferson fracture: a case report.

A 42-year-old man had an unstable Jefferson type IV atlas fracture with unilateral vertebral artery occlusion after a diving accident. We performed C1-ring reconstruction with a crosslink rod and C2 fixation to directly reduce the fracture fissure. Within 6 h, cerebellar hemisphere infarction developed.

Prevalence of Neuropathic Pain and Patient-Reported Outcomes in Korean Adults with Chronic Low Back Pain Resulting from Neuropathic Low Back Pain.

Study Design: A noninterventional, multicenter, cross-sectional study.

Purpose: We investigated the prevalence of neuropathic pain (NP) and patient-reported outcomes (PROs) of the quality of life (QoL) and functional disability in Korean adults with chronic low back pain (CLBP).

Overview Of Literature: Among patients with CLBP, 20%-55% had NP.

Influence of plate fixation on cervical height and alignment after one- or two-level anterior cervical discectomy and fusion.

Purpose: To evaluate the efficacy of plate fixation on cervical alignment after anterior cervical discectomy and fusion (ACDF) using a stand-alone cage (ACDF-CA), compared to ACDF performed using a cage and plate fixation (ACDF-CP) and ACDF using autologous iliac bone graft and plate fixation (ACDF-AP), for the treatment of one- or two-level cervical degenerative disease. A second objective was to assess the clinical and radiological outcomes between the groups.

Methods: A total of 247 patients underwent ACDF and were divided into three groups: those who underwent ACDF-CA (n = 76), ACDF-CP (n = 82) or ACDF-AP (n = 89).

Surgical treatment of a broken neuroplasty catheter in the epidural space: a case report.

Background: Percutaneous epidural neuroplasty with a Racz catheter is widely used to treat radicular pain caused by spinal stenosis or a herniated intervertebral disc. The breakage or shearing of an epidural catheter, particularly a percutaneous epidural neuroplasty catheter, is reported as a rare complication. There has been a controversy over whether surgical removal of a shorn epidural catheter is needed.

Signal intensity ratio on magnetic resonance imaging as a prognostic factor in patients with cervical compressive myelopathy.

Patients with intramedullary signal intensity (SI) changes have a poor prognosis after surgical decompression in cervical compressive myelopathy (CCM); however, some patients show no clear relationship between the SI and postsurgical prognosis. This discrepancy may be because no comprehensive and proper quantitative evaluation exists to assess SI on magnetic resonance imaging (MRI). The purpose of this study was prospectively to evaluate the correlation between the clinical features, neurological outcome of patients with CCM, and the quantitative assessment of SI changes preoperatively and postoperatively, and the correlation with SI severity.

Prognostic factors for surgical outcome in spinal cord injury associated with ossification of the posterior longitudinal ligament (OPLL).

Background: Ossification of the posterior longitudinal ligament (OPLL) may increase the risk of spinal cord injury (SCI) with various neurological deficits after minor trauma. However, few studies have investigated the influence of OPLL on neurological outcome after acute cord injury. We examined whether severe spinal canal stenosis caused by OPLL affects neurological outcome after SCI based on intramedullary signal intensity (SI) changes on magnetic resonance imaging (MRI).

Combination treatment for rapid growth of a saccular aneurysm on the internal carotid artery dorsal wall: case report.

Aneurysms arising from non-branching sites of the supraclinoid internal carotid artery (ICA) are considered rare, accounting for only 0.9-6.5% of all ICA aneurysms.

Does intramedullary signal intensity on MRI affect the surgical outcomes of patients with ossification of posterior longitudinal ligament?

Objectives: Patients with cervical ossification of posterior longitudinal ligament (OPLL) are susceptible to cord injury, which often develops into myelopathic symptoms. However, little is known regarding the prognostic factors that are involved in minor trauma. We evaluated the relationship between minor trauma and neurological outcome of OPLL and investigated the prognostic factors with a focus on compressive factors and intramedullary signal intensity (SI).

Biomechanical analysis of disc pressure and facet contact force after simulated two-level cervical surgeries (fusion and arthroplasty) and hybrid surgery.

Objective: The objective of this study was designed to compare 2-level cervical disc surgery (2-level anterior cervical discectomy and fusion [ACDF] or disc arthroplasty) and hybrid surgery (ACDF/arthroplasty) in terms of postoperative adjacent-level intradiscal pressure (IDP) and facet contact force (FCF).

Methods: Twenty-four cadaveric cervical spines (C3-T2) were tested in various modes, including extension, flexion, and bilateral axial rotation, to compare adjacent-level IDP and FCF after specified treatments as follows: 1) C5-C6 arthroplasty using ProDisc-C (Synthes Spine, West Chester, Pennsylvania, USA) and C6-C7 ACDF, 2) C5-C6 ACDF and C6-C7 arthroplasty using ProDisc-C, 3) 2-level C5-C6/C6-C7 disc arthroplasties, and 4) 2-level C5-C6/C6-C7 ACDF. IDPs were recorded at anterior, central, and posterior disc portions.