Comparison of Short-Term Clinical Results and Radiologic Changes Between Two Different Minimally Invasive Decompressive Surgical Methods for Lumbar Canal Stenosis: Lumbar Spinous Process Splitting Laminectomy and Trans-Interspinous Lumbar Decompression.

Study Design: A multicenter, retrospective study.

Objective: To clarify the clinical and radiological effects of removing interspinous contextures in lumbar decompression surgery for patients with lumbar spinal stenosis.

Summary Of Background Data: There have seldom been reports that have compared both clinical results and radiological changes among minimally invasive decompression methods.

Indications for prophylactic lumbar decompression at the L3/4 level in patients with L4/5 responsible lumbar spinal canal stenosis.

Introduction: Lumbar spinal canal stenosis (LSS) is a very common disease. When the responsible level is considered to be L4/5 despite the appearance of double-level (L3/4 and L4/5) stenosis on magnetic resonance imaging (MRI), it is difficult for spinal surgeons to decide whether prophylactic decompression should be performed at the L3/4 level. The purpose of this study was to investigate the relationship between the dural sac cross-sectional area (DCSA) at the L3/4 level and clinical symptoms in patients with double-level stenosis.

The relationship between the anatomy of the nuchal ligament and postoperative axial pain after cervical laminoplasty: cadaver and clinical study.

Study Design: A cadaver and clinical study investigated the attachment of the nuchal ligament to the cervical spinous process.

Objective: To investigate the anatomical details of the attachment of the nuchal ligament to the spinous process and the relationship between the morphology of the nuchal ligament and postoperative axial pain after laminoplasty.

Summary Of Background Data: The relationship between the length of the C6 spinous process and the morphology of the nuchal ligament and occurrence of postoperative axial pain has not been elucidated.

Simple foot tapping test as a quantitative objective assessment of cervical myelopathy.

Study Design: A clinical and cohort study.

Objective: The first purpose of this study was to investigate the standard value of a simple foot tapping test (FTT) in a large healthy population. The second purpose was to elucidate the validity of FTT as a quantitative assessment of lower extremity motor function for cervical compressive myelopathy.

Perioperative cardiopulmonary complications after cervical spine surgery in the prone position: the relationship between age and preoperative testing.

Background: Cardiac arrest during spine surgery in the prone position is difficult to manage as poor access makes cardiopulmonary resuscitation and defibrillation difficult. Advanced age is the maximal risk factor for cardiac arrest. Therefore, we wanted to determine the relationship between age and cardiac risk factors/pre-operating tests for cervical spine surgery in the prone position.

Surgical anatomy of the nuchal muscles in the posterior cervicothoracic junction: significance of the preservation of the C7 spinous process in cervical laminoplasty.

Study Design: An anatomic study investigated the attachment of the nuchal muscles to the spinous process.

Objective: To investigate the anatomic details of the attachment of the nuchal muscles to the spinous process, and which muscles are spared, and to what extent, when the C7 spinous process is preserved in the cervical laminoplasty.

Summary Of Background Data: In previous studies, it was reported that the incidence of postoperative axial pain was lower in C3-C6 laminoplasty than in C3-C7 laminoplasty, emphasizing the effectiveness of the former procedure where discission of the nuchal muscles that are attached to the C7 spinous process is avoided.

Cervical spinal motion before and after surgery in patients with Chiari malformation type I associated with syringomyelia.

Object: There have been few reports about the cervical spinal motion in patients with Chiari malformation Type I (CM-I) associated with syringomyelia. To investigate this phenomenon, the relationship between the preoperative cervical range of motion (ROM) and the stage of cerebellar tonsillar descent as well as the cervical ROM before and after foramen magnum decompression (FMD) were evaluated.

Methods: Thirty patients who had CM-I associated with syringomyelia and who underwent FMD participated in the study.

Surgical outcomes in adult patients with syringomyelia associated with Chiari malformation type I: the relationship between scoliosis and neurological findings.

Object: The clinical characteristics of pediatric scoliosis associated with syringomyelia have been reported in previous studies, but scoliosis associated with syringomyelia in adults is rarely treated, and there is a paucity of detailed studies. In the present study of adult syringomyelia associated with Chiari malformation Type I, the authors investigated the relationships among the syrinx, scoliosis, and neurological data.

Methods: The population was composed of 27 patients (> or = 20 years of age) who underwent foramen magnum decompression for the treatment of syringomyelia.

Postoperative changes at the lower end of cervical laminoplasty: for preservation of the C7 spinous process in laminoplasty.

Introduction: C3-C7 laminoplasty has been the standard treatment for cervical myelopathy, although several recent reports described C3-C6 laminoplasty for preserving the muscles inserting in C7 and reducing postoperative axial symptoms. However, postoperative changes at C6/C7 of the lower end of C3-C6 laminoplasty, especially regarding a possibility of postoperative spinal canal narrowing have not been measured. The purpose of this study was to clarify postoperative changes at the lower end of laminoplasty.

Axial symptoms after cervical laminoplasty with C3 laminectomy compared with conventional C3-C7 laminoplasty: a modified laminoplasty preserving the semispinalis cervicis inserted into axis.

Study Design: Results of C4-C7 laminoplasty with C3 laminectomy and C3-C7 laminoplasty were compared.

Objectives: To clarify prospectively whether the modified laminoplasty preserving the semispinalis cervicis inserted into C2 could reduce the axial symptoms compared with conventional laminoplasty reattaching the muscle to C2.

Summary Of Background Data: Intraoperative damage of the semispinalis cervicis is relevant to the development of axial symptoms after laminoplasty.

Anatomic study of the semispinalis cervicis for reattachment during laminoplasty.

Some patients who had cervical laminoplasty with subsequent substantial loss of cervical lordosis have shown failed healing of a repaired semispinalis cervicis. We also have identified some patients in whom it is difficult to repair the C2 spinous process during laminoplasty. We therefore quantitatively analyzed the morphologic features of the C2 insertion of the semispinalis cervicis and obtained data relevant to the repair of the muscle.

Inadvertent C2-C3 union after C1-C2 posterior fusion in adults.

Introduction: Some authors pointed out that there were more than a few patients with inadvertent C2-C3 union after C1-C2 posterior fusion, although few detailed studies of C2-C3 union have been reported. The purpose of this study was to clarify whether C2-C3 union accelerated adjacent C3-C4 disc degeneration after C1-C2 posterior fusion and to investigate the related factors for C2-C3 union.

Methods: Sixteen patients with rheumatoid arthritis (RA group) (4 males, 12 females, mean age 60 years, mean follow-up period 4 years and 3 months) and fifteen patients without RA (non-RA group) (11 males, 4 females, mean 52 years, mean follow-up period 3 years and 10 months) who underwent C1-C2 posterior fusion were radiologically assessed.