Objective: To develop and validate a computed tomography (CT)-based scoring system for evaluating the risk of dural defects (DDs) in anterior surgery for cervical ossification of the posterior longitudinal ligament (OPLL).
Methods: We retrospectively analyzed CT imaging features of 114 OPLL patients in our institute who received anterior decompression surgery. Intraoperative DDs were found in 16 patients.
In Klippel-Feil patients with atlantoaxial dislocation, narrow C2 pedicles are often encountered preventing pedicle screw placement. Alternative techniques, including translaminar screws, pars screws, and inferior process screws could not achieve 3-column rigid fixation, and have shown inferior biomechanical stability. The present study aimed to evaluate the feasibility, safety, and efficacy of C3 pedicle screws (C3PSs) as an option for atlantoaxial stabilization in Klippel-Feil patients, and to introduce a freehand technique, the "medial sliding technique," for safe and accurate C3PS insertion.
View Article and Find Full Text PDFPurpose: To introduce a novel surgical protocol for safe and accurate placement of C1 lateral mass screws in patients with atlas assimilation, basilar invagination and atlantoaxial instability, and to categorize the screw accuracy and perioperative complications regarding this technique in a large case series.
Methods: Between January 2015 and January 2020, patients who had atlas assimilation, basilar invagination and atlantoaxial instability, and underwent atlantoaxial fixation using C1 lateral mass screws were reviewed. C1 lateral mass screws were placed with a novel surgical protocol following a series key steps, including posterior para-odontoid ligament release, panoramic exposure of the invaginated lateral mass, and diligent protection of the abnormal VA.
Study Design: Retrospective case series.
Object: To evaluate the outcomes of a head frame reduction and atlantoaxial arthrodesis technique for the treatment of reducible basilar invagination (BI) and atlantoaxial dislocation (AAD).
Methods: Seventy-two reducible BI and AAD cases who were treated with the head frame reduction and atlantoaxial arthrodesis technique from June 2015 to December 2018 were retrospectively analyzed.
Objective: To investigate the biomechanical effect of C1 lateral mass-C2 pedicle screw-rod (C1LM-C2PS) fixation with and without transverse connectors (TC) in an atlantoaxial instability (AAI) model.
Methods: Ten freshly frozen cadaveric specimens were tested using an industrial robot under the following conditions: intact model, AAI model, C1-C2 model, C1-C2 with one TC model, and C1-C2 with two TCs model. Three types of motion, flexion-extension (FE), lateral bending (LB), and axial rotation (AR), were applied (1.
Objective: The authors describe a novel "in-out-in" technique as an alternative option for posterior C2 screw fixation in cases that involve narrow C2 isthmus. Here, they report the preliminary radiological and clinical outcomes in 12 patients who had a minimum 12-month follow-up period.
Methods: Twelve patients with basilar invagination and atlantoaxial dislocation underwent atlantoaxial reduction and fixation.
Objective: To report the technical nuances and clinical outcomes of posterior atlantoaxial facet joint reduction, fixation and fusion (AFRF) technique as a revision procedure for BI and AAD patients with failed suboccipital decompression and large occipital bone defect.
Patients And Methods: We reviewed 32 patients with BI and AAD who were misdiagnosed as a simple Chiari malformation and received a suboccipital decompression surgery before admission. All patients underwent AFRF as a revision surgery.
Objective: The authors conducted a study to investigate the biomechanical feasibility and stability of C1 lateral mass-C2 bicortical translaminar screw (C1LM-C2TL) fixation, C1 lateral mass-C2/3 transarticular screw (C1LM-C2/3TA) fixation, and C1LM-C2/3TA fixation with transverse cross-links (C1LM-C2/3TACL) as alternative techniques to the Goel-Harms technique (C1 lateral mass-C2 pedicle screw [C1LM-C2PS] fixation) for atlantoaxial fixation.
Methods: Eight human cadaveric cervical spines (occiput-C7) were tested using an industrial robot. Pure moments that were a maximum of 1.
Objective: To evaluate the usefulness of 3-dimensional (3D) printed models as an aid for the treatment of complex CVJ anomalies.
Methods: 3D printed models were fabricated for 21 patients with complex CVJ anomalies, including vertebral artery anomaly, thin C2 pedicle, vertical atlantoaxial facet joint, or rotational dislocation combined with atlantoaxial dislocation and basilar invagination. Preoperative planning, surgical simulation, and intraoperative reference were achieved using the 3D model during the surgical treatment.
Objective: To identify clinical factors predicting the development of myelopathy in cervical ossification of the posterior longitudinal ligament (OPLL) patients with radiculopathy.
Methods: We retrospectively reviewed 83 cervical OPLL patients who presented with radiculopathy. On the basis of the symptoms and physical findings, we divided patients into 2 groups: myelopathy group and nonmyelopathy group.
Background: Vascular complications following anterior cervical spine surgery are rare but potentially devastating. Complications associated with the carotid artery are even more disastrous but largely anecdotal, with no more than 4 reported cases.
Materials And Methods: We report 3 new cases of carotid artery-related perioperative stroke following anterior cervical spine surgery.
Objective: To investigate risk factors and outcomes and to develop a cogent perioperative management algorithm for dural defects (DDs) in anterior surgery for cervical ossification of the posterior longitudinal ligament (OPLL).
Methods: Ninety OPLL patients who had undergone anterior cervical decompression between January 2014 and December 2016 were reviewed. DDs occurred in 12 patients.