Surgical outcomes after posterior lumbar interbody fusion using traditional trajectory screw fixation or cortical bone trajectory screw fixation: A comparative study between the polyetheretherketone cage and the same shape titanium-coated polyetheretherketone cage.

Objective: To investigate whether or not the fusion rate after posterior lumbar interbody fusion with cortical bone trajectory screw fixation (CBT-PLIF) is lower than after PLIF using traditional trajectory screw fixation (TT-PLIF) and whether or not the titanium-coated polyetheretherketone (PEEK) cage (TiP cage) improves fusion status compared to the same shape uncoated PEEK cage (P cage).

Methods: The subjects were 37 patients undergoing TT-PLIF using P cages (P-TT group), 24 patients undergoing CBT-PLIF using P cages (P-CBT group), 32 patients undergoing TT-PLIF using TiP cages (TiP-TT group), and 20 patients undergoing CBT-PLIF using TiP cages (TiP-CBT group). All patients from the 4 groups underwent our unified PLIF procedure (total facetectomy, subtotal discectomy, and the same bone graft technique using the same shape cages) except for the screw trajectories and the surface materials of the cages.

Early Fusion Status After Posterior Lumbar Interbody Fusion With Cortical Bone Trajectory Screw Fixation or Traditional Trajectory Screw Fixation: A Comparison Between the Titanium-coated Polyetheretherketone Cage and the Same Shape Polyetheretherketone Cage.

Study Design: A retrospective analysis of prospectively collected data.

Objective: The aim was to examine whether posterior lumbar interbody fusion with cortical bone trajectory screw fixation (CBT-PLIF) is inferior to PLIF using traditional trajectory screw fixation (TT-PLIF) regarding early fusion status and whether the titanium-coated polyetheretherketone (PEEK) cage (TP cage) improves early fusion status compared with the same shape pure PEEK cage (P cage).

Summary Of Background Data: We recently reported that the fusion rate was relatively lower after CBT-PLIF than after TT-PLIF, although no significant difference was found and that compared with the carbon PEEK cage, the TP cage significantly reduced the incidence of vertebral endplate cysts (cyst signs) and slightly improved the early fusion rate at 1 year after CBT-PLIF.

Does Atherosclerosis Have Negative Impacts on Early Adjacent Segment Degeneration After Posterior Lumbar Interbody Fusion?

Study Design: Retrospective study.

Objective: To examine whether atherosclerosis has negative impacts on early adjacent segment degeneration (ASD) after posterior lumbar interbody fusion using traditional trajectory pedicle screw fixation (TT-PLIF).

Methods: The subjects were 77 patients who underwent single-level TT-PLIF for degenerative lumbar spondylolisthesis.

Two-level Posterior Lumbar Interbody Fusion at the Lumbosacral Segment has a High Risk of Pseudarthrosis and Poor Clinical Outcomes: Comparison Between the Lumbar and Lumbosacral Segments.

Study Design: This was a retrospective study.

Objectives: The purposes of this study were to investigate the fusion rate and clinical outcomes of 2-level posterior lumbar interbody fusion (PLIF).

Summary Of Background Data: PLIF provides favorable clinical outcomes and a high fusion rate.

Early cephalad adjacent segment degeneration after posterior lumbar interbody fusion: a comparative study between cortical bone trajectory screw fixation and traditional trajectory screw fixation.

Objective: Cortical bone trajectory (CBT) screw insertion through a caudomedial starting point provides advantages in limiting dissection of the superior facet joints and reducing muscle dissection and the risk of superior-segment facet violation by the screw. These advantages of the cephalad CBT screw can result in lower rates of early cephalad adjacent segment degeneration (ASD) after posterior lumbar interbody fusion (PLIF) with CBT screw fixation (CBT-PLIF) than those after PLIF using traditional trajectory screw fixation (TT-PLIF). Here, the authors investigated early cephalad ASD after CBT-PLIF and compared these results with those after TT-PLIF.

Improvement of thoracic myelopathy following bariatric surgery in an obese patient.

Revision spine surgery is extremely challenging in super-super obese patients (body mass index (BMI) ≥60 kg/m). This is the first report describing how bariatric surgery was useful for a super-super obese patient with progressing myelopathy. A 44-year-old man with a BMI of 62.

Conventional JOA score for cervical myelopathy has a rater's bias -In comparison with JOACMEQ.

Background: The JOA (Japan Orthopaedic Association) score has been a standard outcome measure to evaluate cervical myelopathy in Japan. Despite its reliability and convenience, there can be a rating bias in the JOA score. The current study was conducted to delineate the rater's bias of the JOA score by comparing it with a new objective outcome measure.

Preoperative retrolisthesis as a predictive risk factor of reoperation due to delayed-onset symptomatic foraminal stenosis after central decompression for lumbar canal stenosis without fusion.

Background Context: For patients diagnosed with lumbar central canal stenosis with asymptomatic foraminal stenosis (FS), surgeons occasionally only decompress central stenosis and preserve asymptomatic FS. These surgeries have the potential risk of converting preoperative asymptomatic FS into symptomatic FS postoperatively by accelerating spinal degeneration, which requires reoperation. However, little is known about delayed-onset symptomatic FS postoperatively.

Clinical Outcomes After Posterior Lumbar Interbody Fusion: Comparison of Cortical Bone Trajectory and Conventional Pedicle Screw Insertion.

Study Design: This study is a retrospective cohort study using prospectively collected data.

Objective: To compare the effectiveness of posterior lumbar interbody fusion (PLIF) using the cortical bone trajectory (CBT) and conventional pedicle screw (PS) techniques.

Summary Of Background Data: There are few published studies to date comparing PLIF using CBT technique with PLIF using the conventional PS technique.

Preoperative retrolisthesis as a risk factor of postdecompression lumbar disc herniation.

Object: In this study, the authors aimed to identify specific risk factors for postdecompression lumbar disc herniation (PDLDH) in patients who have not undergone discectomy and/or fusion.

Methods: Between 2007 and 2012, 493 patients with lumbar spinal stenosis underwent bilateral partial laminectomy without discectomy and/or fusion in a single hospital. Eighteen patients (herniation group [H group]: 15 men, 3 women; mean age 65.

Vertebral osteolytic defect due to cellulose particles derived from gauze fibers after posterior lumbar interbody fusion.

Vertebral cystic lesions may be observed in pseudarthroses after lumbar fusion surgery. The authors report a rare case of pseudarthrosis after spinal fusion, accompanied by an expanding vertebral osteolytic defect induced by cellulose particles. A male patient originally presented at the age of 69 years with leg and low-back pain caused by a lumbar isthmic spondylolisthesis.

C3-6 laminoplasty for cervical spondylotic myelopathy maintains satisfactory long-term surgical outcomes.

Study Design Prospective cohort study. Objective To clarify long-term surgical outcomes of C3-6 laminoplasty preserving muscles attached to the C2 and C7 spinous processes in patients with cervical spondylotic myelopathy (CSM). Methods Twenty patients who underwent C3-6 open-door laminoplasty for CSM and who were followed for 8 to 10 years were included in this study.

Major surgical treatment of osteoporotic vertebral fractures in the elderly: a comparison of anterior spinal fusion, anterior-posterior combined surgery and posterior closing wedge osteotomy.

Study Design: A retrospective study.

Purpose: To clarify the differences among the three major surgeries for osteoporotic vertebral fractures based on the clinical and radiological results.

Overview Of Literature: Minimally invasive surgery like balloon kyphoplasty has been used to treat osteoporotic vertebral fractures, but major surgery is necessary for severely impaired patients.

Intramuscular pressure of the multifidus muscle and low-back pain after posterior lumbar interbody fusion: comparison of mini-open and conventional approaches.

Object: This randomized study was designed to elucidate the time course of the perioperative development of intramuscular multifidus muscle pressure after posterior lumbar interbody fusion (PLIF) and to investigate whether the route of pedicle screw insertion affects this pressure and resultant low-back pain. Although several studies have focused on intramuscular pressure associated with posterior lumbar surgery, those studies examined intramuscular pressure generated by the muscle retractors during surgery. No study has investigated the intramuscular pressure after PLIF.

The use of cooled saline during bone drilling to reduce the incidence of upper-limb palsy after cervical laminoplasty: clinical article.

Object: No previous hypothesis has attempted to fully account for the occurrence of upper-limb palsy (ULP) after cervical laminoplasty. The authors propose that friction-generated heat from a high-speed drill may cause thermal injury to the nerve roots close to the drilled bone, which may then lead to ULP. The authors investigated the effect of cooling the saline used for irrigation during the drilling on the incidence of upper-limb (C-5) palsy following cervical laminoplasty.

Finger-tapping motion analysis in cervical myelopathy by magnetic-sensor tapping device.

Study Design: Case-control study.

Objectives: The purpose of this study is to determine finger motion of patients with cervical myelopathy during finger-tapping cycles.

Summary Of Background Data: A major symptom of patients with compressive cervical myelopathy is finger clumsiness.

Postoperative 24-hour result of 15-second grip-and-release test correlates with surgical outcome of cervical compression myelopathy.

Study Design: A prospective follow-up study to detect the early neurological improvement after decompression surgery and to clarify its correlation with the late neurological outcome in patients with cervical compression myelopathy.

Objective: To reveal the suitability of a simple performance, 15-second grip-and-release test for postoperative neurological recovery in patients with cervical myelopathy.

Summary Of Background Data: Although various parameters have been advocated as prognostic factors, there still remain arguments against them.

Medium-term outcomes of C3-6 laminoplasty for cervical myelopathy: a prospective study with a minimum 5-year follow-up.

C3-6 laminoplasty preserving muscle insertions into the C7 spinous process is reportedly associated with a significantly decreased frequency of postoperative axial neck pain. However, no prospective study has reported medium-term outcomes of C3-6 laminoplasty. The purpose of this study was to elucidate medium-term outcomes after C3-6 laminoplasty.

Preservation of muscles attached to the C2 and C7 spinous processes rather than subaxial deep extensors reduces adverse effects after cervical laminoplasty.

Study Design: Prospective study.

Objective: To examine whether preservation of subaxial deep extensor muscles plays any significant role in reducing axial neck pain and unfavorable radiologic changes after cervical laminoplasty in patients with cervical spondylotic myelopathy and to confirm the benefits of preserving muscles attached to the C2 and C7 spinous processes.

Summary Of Background Data: Axial neck pain and unfavorable radiologic changes after cervical laminoplasty have been reported to mostly result from detachment of cervical extensor muscles, particularly muscles attached to the C2 and C7 spinous processes.

Induction of early degeneration of the adjacent segment after posterior lumbar interbody fusion by excessive distraction of lumbar disc space.

Object: Spinal fusion at the L4-5 disc space alters the normal biomechanics of the spine, and the loss of motion at the fused level is compensated by increased motion and load at the other unfused segments. This may lead to deterioration of the adjacent segments of the lumbar spine, called adjacent-segment disease (ASD). In this study, the authors investigate the distracted disc height of the fused segment, caused by cage or bone insertion during surgery, as a novel risk factor for ASD after posterior lumbar interbody fusion (PLIF).

Myelopathy hand: new evidence of the classical sign.

Study Design: Motion analysis on video files that captured grip and release cycles with fingers.

Objective: To reveal the kinematic characteristics of finger motion in cervical myelopathy.

Summary Of Background Data: Myelopathy patients are often unable to smoothly move their fingers in grip and release cycles.

Preservation of the nuchal ligament plays an important role in preventing unfavorable radiologic changes after laminoplasty.

Study Design: Prospective study.

Objective: To examine whether preservation of the funicular section of the nuchal ligament attached to the C6 and C7 spinous processes could prevent unfavorable radiologic changes such as kyphotic deformity and destabilization at the C6/7 segment, and to investigate possible correlations between adverse radiologic changes and neurologic recovery or incidence of axial neck pain after laminoplasty in patients with cervical spondylotic myelopathy.

Summary Of Background Data: Adverse radiologic changes after cervical laminoplasty have been reported to result from detachment of cervical extensor muscles.

The source of axial pain after cervical laminoplasty-C7 is more crucial than deep extensor muscles.

Study Design: Prospective study to investigate the incidence of axial pain in the 3 different procedures of laminoplasty.

Objective: To inquire which is more important in the development of axial pain after laminoplasty: C7 or deep extensor muscles.

Summary Of Background Data: The etiology of axial pain remains largely unknown.

Sagittal alignment of the subaxial cervical spine after C1-C2 transarticular screw fixation in rheumatoid arthritis.

Several articles reported the association between the development of subaxial kyphosis and the hyperlordotic fixation of C1-C2. However, their patients were heterogeneous in both primary disease and operative procedure. Transarticular screw fixation has become a popular procedure for C1-C2 arthrodesis instead of wiring techniques in which C1-C2 is difficult to fix in the intended alignment.

Kinematics of the lumbar spine in trunk rotation: in vivo three-dimensional analysis using magnetic resonance imaging.

In vivo three-dimensional (3D) kinematics of the lumbar spine has not been well evaluated by the conventional methods because of their methodological limitations, while 3D intervertebral motions have been quantitatively determined by cadaver studies. We thus developed a novel 3D analyzing system for the relative motions of individual vertebrae using 3D magnetic resonance imaging (MRI) and analyzed in vivo 3D intervertebral motions of the lumbar spine during trunk rotation. Ten healthy volunteers underwent 3D MRI of the lumbar spine in nine positions with 15 degrees increments during trunk rotation (0 degrees , 15 degrees , 30 degrees , 45 degrees , and maximum).