Objective: The clinical outcome following multilevel stabilization in patients who suffered cervical spinal injury and developed severe neurological deficits and then gradually partially recovered is evaluated. The basis of the surgical concept was that cervical spinal degeneration is a result of single or multilevel spinal instability and that spinal trauma exaggerates the instability.
Materials And Methods: During the period 2015-2020, 14 patients who suffered severe cervical spinal injury and could be included in the classification of spinal cord injury without computed tomography evidence of trauma were surgically treated. There were 11 males and 3 females. The ages ranged from 45 to 67 years, average being 53 years. Cervical canal stenoses related to degenerative spinal changes were observed in all patients. All patients suffered severe neurological deficits and within few days or weeks had shown significant but incomplete neurological recovery. The identification of the levels of unstable spinal segments was done on the basis of radiological and clinical parameters and direct observation of spinal instability in adjoining spinal segments. Transarticular fixation was done by Camille's transarticular fixation technique. Using ASIA score, modified JOA score, and Goel Clinical Grading Scale, the clinical course of the patients was monitored.
Results: All patients showed recovery in the neurological status. Recovery started in the immediate postoperative period and the improvement progressed during the period of follow-up.
Conclusions: Surgery for spinal stabilization can be indicated even in cases that improve in the neurological function.
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http://dx.doi.org/10.4103/jcvjs.jcvjs_110_21 | DOI Listing |
Front Neurol
January 2025
Oregon Hearing Research Center, Oregon Health & Science University, Portland, OR, United States.
Introduction: The brainstem vestibular nuclei neurons receive synaptic inputs from inner ear acceleration-sensing hair cells, cerebellar output neurons, and ascending signals from spinal proprioceptive-related neurons. The lateral (LVST) and medial (MVST) vestibulospinal (VS) tracts convey their coded signals to the spinal circuits to rapidly counter externally imposed perturbations to facilitate stability and provide a framework for self-generated head movements.
Methods: The present study describes the morphological characteristics of intraaxonally recorded and labeled VS neurons monosynaptically connected to the 8th nerve.
Asian Spine J
January 2025
Department of Neurosurgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
Ossification of the posterior longitudinal ligament (OPLL) is a significant spinal condition that can lead to severe neurological deficits. Recent advancements in machine learning (ML) and deep learning (DL) have led to the development of promising tools for the early detection and diagnosis of OPLL. This systematic review evaluated the diagnostic performance of ML and DL models and clinical implications in OPLL detection.
View Article and Find Full Text PDFAsian Spine J
January 2025
Department of Orthopaedic Surgery, Hanyang University College of Medicine, Seoul, Korea.
Selecting the optimal surgical treatment for multilevel cervical spondylotic myelopathy and radiculopathy significantly affects symptom improvement, postoperative prognosis, and quality of life. Proper patient selection and precise surgical execution are crucial for achieving successful outcomes, considering the favorable natural course of cervical radiculopathy. Several factors must be considered, including the number of affected segments, spinal alignment, kyphosis degree, stiffness, and surgeon expertise, when determining the surgical approach for cervical spondylotic myelopathy.
View Article and Find Full Text PDFAsian Spine J
January 2025
Department of Spinal Surgery, Henan Provincial People's Hospital, Zhengzhou, China.
Study Design: This was a retrospective study.
Purpose: The current study aimed to investigate the clinical efficacy of atlantodentoplasty using the anterior retropharyngeal approach against irreducible atlantoaxial dislocation with atlantodental bony obstruction.
Overview Of Literature: In cases of atlantoaxial dislocation with atlantodental bony obstruction, owing to the presence of an osteogenic mass between the atlas and odontoid process, reduction is challenging to complete using the posterior approach.
Adv Healthc Mater
January 2025
Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, 30332-0363, USA.
Anterior cervical spine surgeries are often complicated by difficulty swallowing due to local postoperative swelling, pain, scarring, and tissue dysfunction. These postoperative events lead to systemic steroid and narcotic use. Local, sustained drug delivery may address these problems, but current materials are unsafe for tight surgical spaces due to high biomaterial swelling, especially upon degradation.
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