Accuracy of cervical pedicle screw placement with a robotic guidance system via the open midline approach.

Objective: An increasing number of studies have shown that a robotic guidance system (RGS) can provide accurate cervical pedicle screw (CPS) placement. The accuracy of CPS placement with an RGS has mostly been evaluated according to the magnitude of pedicular cortical violation. However, an RGS assists in pedicle screw (PS) placement by directly indicating the preplanned trajectory in the operative field.

Influence of cranium orientation on cervical sagittal alignment during radiographic examination: a radiographic analysis.

Background Context: During the radiographic examination, the cranium orientation varies not only individually but also within the same subject, in different imaging sessions. Knowing how changes in the orientation of the cranium influences cervical sagittal alignment during the radiographic examination of the cervical spine can aid clinicians in the accurate evaluation for cervical sagittal alignment in clinical practice.

Purpose: To radiographically examine the influence of cranium orientation on cervical sagittal alignment during radiographic examination in an asymptomatic cohort.

Comparison of Cervical Pedicle Screw Placement Accuracy With Robotic Guidance System Versus Image Guidance System Using Propensity Score Matching.

Study Design: A retrospective study.

Objective: To compare the accuracy of cervical pedicle screw (CPS) placement using a robotic guidance system (RGS) with that of using an image guidance system (IGS; navigation system) through propensity score matching.

Background: The RGS may provide accurate CPS placement, which may outperform IGS.

Ultrasonographic Evaluation of Upper Esophageal Sphincter for Dysphagia During the Acute Postoperative Phase of Anterior Cervical Surgery.

Study Design: A retrospective study.

Objective: To verify the pathophysiology of dysphagia during the acute postoperative phase of anterior cervical surgery and to identify its predictive features, using ultrasonographic (US) examination for upper esophageal sphincter (UES).

Summary Of Background Data: There are no clinical studies investigating dysphagia after anterior cervical surgery, using US examination for UES.

Clinical outcome of surgical management of mild cervical compressive myelopathy based on minimum clinically important difference.

Background Context: Cervical compressive myelopathy (CCM), caused by cervical spondylosis (cervical spondylotic myelopathy [CSM]) or ossification of the posterior longitudinal ligament (OPLL), is a common neurological disorder in the elderly. For moderate/severe CCM, surgical management has been the first-line therapeutic option. Recently, surgical management is also recommended for mild CCM, and a few studies have reported the surgical outcome for this clinical population.

Studies in the Falls Efficacy Scale-International for patients with cervical compressive myelopathy: Reliability, validity, and minimum clinically important difference.

Context: Patients with cervical compressive myelopathy (CCM) often complain of body balance problems, such as fear of falling and bodily unsteadiness. However, no accepted patient-reported outcome measures (PROMs) for this symptomatology exist. The Falls Efficacy Scale-International (FES-I) is one of the most widely used PROMs for evaluating impaired body balance in various clinical fields.

Segmental cervical instability does not drive the loss of cervical lordosis after laminoplasty in patients with cervical spondylotic myelopathy.

Background/context: Kyphotic deformity after cervical laminoplasty (CLP) often leads to unfavorable neurological recovery due to insufficient indirect decompression of the spinal cord. Existing literature has described that segmental cervical instability is a contraindication for CLP because it is a potential risk factor for kyphotic changes after surgery; however, this has never been confirmed in any clinical studies.

Purpose: To confirm whether segmental cervical instability was an independent risk factor for postoperative kyphotic change and to examine whether segmental cervical instability led to poor neurological outcomes after CLP for cervical spondylotic myelopathy (CSM).

Morphology of cervical periradicular fibrous sheath and nerve roots in relation to postoperative C5 palsy.

Background Context: C5 palsy is a major complication of cervical spine surgery, however, its exact pathogenesis remains unclear. Some studies have shown that the superficial layer of the posterior longitudinal ligament extends laterally and forms the periradicular fibrous sheath (PFS), and envelopes the nerve roots. However, the anatomical relationship between the PFS and nerve root at each cervical level has not been fully revealed.

An Experimental Rat Model of C5 Palsy Following Posterior Decompression Surgery of the Cervical Spine.

Study Design: Basic in vivo research.

Objectives: The aim of this study was to establish an animal model that is appropriate for analyzing the mechanisms of C5 palsy (C5P) and to clarify the structural and functional alterations of cervical roots following posterior decompression.

Summary Of Background Data: Although C5P is one of the major complications of cervical surgery, the exact pathogenesis of C5P remains unclear partly because of the lack of an appropriate animal model.

Impact of morphological restoration of the spinal cord from the preoperative to early postoperative periods on C5 palsy development.

Objective: C5 palsy (C5P) is a known complication of cervical decompression surgery. The tethering effect of the C5 nerve root following the posterior shift of the spinal cord is the most accepted pathologic mechanism for C5P development; however, this mechanism cannot fully explain C5P by itself in clinical practice. Separately, some studies have suggested that preoperative severe spinal cord compression and postoperative morphological changes in the spinal cord affect C5P development; however, no previous study has quantitatively addressed these possibilities.

Usefulness of Percutaneous Ultrasonography for Deciding the Need of Surgical Evacuation of Epidural Hematoma After Cervical Double-door Laminoplasty.

Study Design: This was a retrospective study.

Objective: The objective of this study was to investigate the diagnostic utility of percutaneous ultrasonography (PUS) for postoperative epidural hematoma (EH) as a postoperative complication.

Summary Of Background Data: We investigated the usefulness of PUS for determining the need of surgical evacuation of postoperative EH by comparing the postoperative magnetic resonance imaging (MRI) and PUS of the spinal cord.

Gap between flexion and extension ranges of motion: a novel indicator to predict the loss of cervical lordosis after laminoplasty in patients with cervical spondylotic myelopathy.

Objective: Kyphotic deformity resulting from the loss of cervical lordosis (CL) is a rare but serious complication after cervical laminoplasty (CLP), and it is essential to recognize the risk factors. Previous studies have demonstrated that a greater flexion range of motion (fROM) and smaller extension ROM (eROM) in the cervical spine are associated with the loss of CL after CLP. Considering these facts together, one can hypothesize that an indicator representing the gap between fROM and eROM (gROM) is highly useful in predicting postoperative CL loss.

Significance of flexion range of motion as a risk factor for kyphotic change after cervical laminoplasty.

Kyphotic deformity is a rare but serious complication after cervical laminoplasty (CLP), and several studies have investigated its predictors. In these studies, a kyphotic Cobb angle of 0°-5° between C2 and C7 at a certain postoperative time-point was often used to detect kyphotic deformity. However, studies considering the amount of cervical lordosis loss compared to the preoperative measurement are scarce.

Impact of Multifidus Muscle Swelling on C5 Palsy After Cervical Laminoplasty.

Study Design: Retrospective radiological analysis OBJECTIVE.: The aim of this study was to identify the effects of posterior cervical muscle swelling on C5 palsy (C5P) by evaluating early postoperative magnetic resonance (MR) images.

Summary Of Background Data: Cervical laminoplasty is an established technique, but the risk of C5P after surgery has not been fully resolved.

The Evaluation of Indirect Neural Decompression After Lateral Lumbar Interbody Fusion Using Intraoperative Computed Tomography Myelogram.

Background: The effect of indirect decompression after lateral lumbar interbody fusion (LLIF) is widely acknowledged; however, its details remain unclear. This study aimed to evaluate the immediate effects of indirect decompression just after LLIF cage placement but just before posterior instrumentation, using intraoperative computed tomography myelogram (iCTM).

Methods: Fifty-three levels from 28 patients undergoing LLIF with iCTM, were included in this retrospective study.