Dynamic Cervical Spinal Canal Stenosis: Identifying Imaging Risk Factors in Extended Positions.

Study Design: A retrospective study at a single academic institution.

Purpose: This study aimed to identify imaging risk factors for stenosis in extended neck positions undetectable in preoperative neutral magnetic resonance imaging (MRI) and improving decompression strategies for cervical spine disorders.

Overview Of Literature: Cervical disorders are influenced by various dynamic factors, with spinal stenosis appearing during neck extension.

Assessment of the Necessity of Osteoporosis Treatment for Patients with Low Bone Density in Diffuse Idiopathic Skeletal Hyperostosis.

Introduction: Although patients with diffuse idiopathic skeletal hyperostosis (DISH) do not have low bone density, it is a risk factor for spine fractures associated with DISH. We investigated the characteristics and bone metabolism markers of patients with DISH having low bone density to assess whether osteoporosis medication is necessary to prevent fractures.

Methods: A cross-sectional study was conducted between April 1, 2008, and March 31, 2019.

Disc Height Narrowing Could Not Stabilize the Mobility at the Level of Cervical Spondylolisthesis: A Retrospective Study of 83 Patients with Cervical Single-Level Spondylolisthesis.

Study Design: A retrospective study at a single academic institution.

Purpose: We aimed to understand the pathogenesis of cervical spondylolisthesis by analyzing whether narrowing of the disc height stabilizes the slipped disc level according to the degenerative cascade.

Overview Of Literature: According to Kirkaldy-Willis' degenerative cascade, the narrowing of the disc height at slipped level contributes to intervertebral stability in lumbar spondylolisthesis.

Cervical Spinous Process and Its Attached Muscles Maintain Lower Disk Lordosis: A Retrospective Study of 155 Patients Who Underwent Muscle-Preserving Double Laminectomies.

Study Design: A retrospective study conducted at a single academic institution.

Purpose: This study compared the postoperative alignment of consecutive double laminectomies according to their decompression levels and investigated the influence of the extension unit of the spinous process and its attached muscles on postoperative alignment.

Overview Of Literature: Many reports have investigated bony and soft tissue factors as the causes of postoperative cervical alignment disorders.

Adjacent Segment Stenosis after Muscle-Preserving Selective Laminectomy: A Retrospective Study of Patients with a Minimum 10-Year Follow-Up.

Introduction: The present study aimed to understand the characteristics of adjacent segment stenosis post-surgery by examining the status of adjacent segment stenosis in patients with long-term follow-up after muscle-preserving selective laminectomy (SL).

Methods: We examined 43 patients who underwent muscle-preserving SL at a single academic institution and were followed up for >10 years. The C2-C7 angle, C2-C7 sagittal vertical axis, range of motion, and C7 slope were measured using an X-ray lateral view.

Atlantoaxial stenosis after muscle-preserving selective laminectomy.

There are few reports of degenerative atlantoaxial stenosis and new stenosis after cervical decompression. We experienced four cases of atlantoaxial stenosis after muscle-preserving selective laminectomy. We compared these four cases with no stenosis cases after long-term follow-up of selective laminectomy, as well as healthy subjects.

Maximum number of bone cross-linked vertebrae: an index for BMD in diffuse idiopathic skeletal hyperostosis.

Introduction: The maximum number of vertebral bodies with bony bridges between adjacent vertebrae (max VB) helps assess the risk of fracture in diffuse idiopathic skeletal hyperostosis (DISH). In addition to max VB, the maximum thickness of bone cross-bridges (max TB) may be an index of bone mineral density (BMD). Therefore, this study investigated the relationship among max VB, max TB, and BMD.

Surgical Outcomes of Selective Laminectomy for Patients With Cervical Kyphosis: A Retrospective Study of 379 Cases.

Study Design: A retrospective study.

Objectives: This study aimed to investigate the impact of cervical kyphosis on patients with cervical spondylotic myelopathy (CSM) following selective laminectomy (SL) regarding posterior spinal cord shift (PSS), and a number of SLs.

Methods: We evaluated 379 patients with CSM after SL.

Association of Continuous Vertebral Bone Bridges and Bone Mineral Density with the Fracture Risk in Patients with Diffuse Idiopathic Skeletal Hyperostosis.

Study Design: Cross-sectional study.

Purpose: To examine whether the number of continuous vertebral bone bridges and bone mineral density (BMD) influence the fracture risk in diffuse idiopathic skeletal hyperostosis (DISH) patients.

Overview Of Literature: Bone bridges connecting through the intervertebral body in DISH create long lever arms that can increase the risk of fractures from minor trauma.

Baseline severity of myelopathy predicts neurological outcomes after posterior decompression surgery for cervical spondylotic myelopathy: a retrospective study.

Study Design: Retrospective multicenter study.

Objectives: To identify the usefulness of the baseline severity of myelopathy for predicting surgical outcomes for cervical spondylotic myelopathy (CSM).

Setting: Seventeen institutions in Japan.

Clinical Effects of Anterior Cervical Spondylolisthesis on Cervical Spondylotic Myelopathy After Posterior Decompression Surgery: A Retrospective Multicenter Study of 732 Cases.

Study Design: Multicenter retrospective study.

Objectives: We aim to investigate features of cervical spondylotic myelopathy (CSM) associated with anterior cervical spondylolisthesis (ACS) during posterior decompression surgery.

Methods: A total of 732 patients with CSM were enrolled, who underwent posterior decompression surgery between July 2011 and November 2015 at 17 institutions.

Does K-line (-) in the Neck-flexed Position Predict Surgical Outcome of Cervical Spondylotic Myelopathy?: Results of a Multivariate Analysis After Muscle-preserving Selective Laminectomy.

Study Design: A retrospective single-center study.

Objective: The aim of this study was to investigate the influence of the K-line in the neck-flexed position (flexion K-line) on the surgical outcome after muscle-preserving selective laminectomy (SL) for cervical spondylotic myelopathy (CSM).

Summary Of Background Data: Development of CSM is associated with dynamic factors and cervical alignment.

Analysis of the impact of spinopelvic radiographic parameters on the severity of cervical spondylotic myelopathy.

Background: The correlation between spinal radiographic parameters and severity of cervical spondylotic myelopathy (CSM) is controversial. This study aimed to investigate the associations between spinal radiographic parameters and CSM severity, as well as between cervical and other spinopelvic radiographic parameters.

Methods: Patients diagnosed with CSM (N = 118; 77 men) at our hospital from March 2013 to February 2017 were included.

Ossified Posterior Longitudinal Ligament Existing at an Intervertebral Level Limits Compensatory Mechanism of Cervical Lordosis after Muscle-Preserving Selective Laminectomy.

Introduction: As C7 slope increases, lordotic change of C2-C7 angle compensates for adjustments in cervical sagittal balance. However, ossification of the posterior longitudinal ligament (OPLL) may affect the compensatory mechanism of the cervical spine. This study aims to evaluate the impact of OPLL on cervical lordotic compensation after muscle-preserving selective laminectomy (SL).

K-line (-) in the neck-flexed position affects surgical outcomes in patients with ossification of the posterior longitudinal ligament after muscle-preserving selective laminectomy.

Background: Posterior cervical decompression results in favorable outcomes for K-line (+) ossification of the posterior longitudinal ligament (OPLL) patients. However, even for patients with K-line (+) in the neck neutral position, K-line (-) in the neck-flexed position (flexion K-line (-)) may affect surgical outcomes. We investigated the influence of flexion K-line (-) on surgical outcomes after muscle-preserving selective laminectomy using multivariate analysis.

The Dural Tube Continues to Expand after Muscle-Preserving Cervical Laminectomy.

Introduction: The purpose of this study was to elucidate the duration for which the dural tube continues to expand after muscle-preserving cervical laminectomy and the extent to which the expansion affects surgical outcomes.

Methods: We analyzed 83 patients with cervical myelopathy who underwent muscle-preserving selective laminectomy of three consecutive laminae between C4 and C6. On the lateral radiographs, parameters considered were C2-7 Cobb angles, range of flexion-extension neck motions, and C2-7 sagittal vertical axis.

Upper cervical lordosis compensates lower cervical kyphosis to maintain whole cervical lordosis after selective laminectomy.

After lower-cervical-level spinal-cord tumor resection, compensatory upper cervical lordosis with lower cervical kyphosis was observed. However, no studies examined this compensation following posterior decompression surgery for cervical compressive myelopathy (CCM). The purpose of this study was to evaluate the compensatory mechanism after muscle-preserving selective laminectomy (SL) and to assess the clinical outcomes following such compensation.

Extremely high preoperative C7 slope limits compensatory cervical lordosis after muscle-preserving selective laminectomy.

Purpose: A high C7 slope induces C2-C7 lordosis to compensate for cervical sagittal balance adjustments. A muscle-preserving selective laminectomy (SL) can maintain this compensation postoperatively. This study evaluated the effect of an extremely high C7 slope on C2-C7 lordotic compensation following SL.

Narrow width of muscle-preserving selective laminectomy demonstrated sufficient surgical outcomes and reduced surgical invasiveness.

Sufficient width of laminectomy or laminoplasty is considered a criterion for successful surgical outcomes following posterior cervical decompression. No previous study has focused on surgical outcomes achieved by wide versus narrow decompression. This study examined whether narrow laminectomy width (LW) affected surgical outcomes in cervical compressive myelopathy (CCM).

Posterior spinal cord shift does not affect surgical outcomes after muscle-preserving selective laminectomy.

Postoperative posterior spinal cord shift (PSS) has been considered a required radiographic endpoint of posterior decompression procedures. To achieve PSS, laminoplasty for cervical compressive myelopathy (CCM) has been consecutively performed on four or more laminae (C2-C7, C3-C7, or C3-C6). However, the clinical significance of PSS remains controversial.

Characteristic findings on imaging of cervical spondylolisthesis: Analysis of computed tomography and X-ray photography in 101 spondylolisthesis patients.

Introduction: The characteristics of cervical spondylolisthesis are not currently fully understood, because of the shortage of reports covering the large population of patients with cervical spondylolisthesis. The purpose of this study was to elucidate the characteristics of cervical spondylolisthesis by examining a relatively large number of cases.

Methods: We analyzed 101 cases with more than 2 mm of vertebral listhesis as determined from X-ray or computed tomography (CT) images among 731 patients who underwent surgery at a single institute.

Presence of Modic type 1 change increases risk of postoperative pyogenic discitis following decompression surgery for lumbar canal stenosis.

Study Design: Multicenter retrospective study.

Background: Postoperative surgical site infection is one of the most serious complications following spine surgery. Previous studies do not appear to have investigated pyogenic discitis following lumbar laminectomy without discectomy.

Muscle-Preserving Selective Laminectomy Maintained the Compensatory Mechanism of Cervical Lordosis After Surgery.

Study Design: A retrospective single-center study.

Objective: The aim of this study was to evaluate the compensatory mechanism of cervical lordosis (CL), the changes in cervical sagittal alignment, and range of motion (ROM) after muscle-preserving selective laminectomy (SL).

Summary Of Background Data: CL increases as a compensatory mechanism for the adjustment of cervical sagittal balance or horizontal gaze.

Cervical laminectomy of limited width prevents postoperative C5 palsy: a multivariate analysis of 263 muscle-preserving posterior decompression cases.

Purpose: Between 2006 and 2010, we performed wide laminectomy (wide LAM) alone, with decompression performed between the bilateral medial margin of the zygapophyseal joints, or double-door laminoplasty (DL) combined with wide LAM for cervical compressive myelopathy (CCM). From 2010, instead of wide LAM and DL, we began to perform narrow LAM, where the laminectomy width was no more than 2-3 mm wider than the spinal cord width (SW). This study aimed to elucidate the risk factors for C5 palsy by reviewing surgical outcomes.

Comparison of shoulder internal rotation test with the elbow flexion test in the diagnosis of cubital tunnel syndrome.

Purpose: To compare the shoulder internal rotation test-a new, provocative test-with the elbow flexion test in the diagnosis of cubital tunnel syndrome (CubTS).

Methods: Twenty-five patients with CubTS were examined before and after surgery with 10 seconds each of the elbow flexion and shoulder internal rotation tests. Fifty-four asymptomatic individuals and 14 neuropathy patients with a diagnosis other than CubTS were also examined as control cases.