Study Design: Retrospective multicenter study with propensity score matching.
Objective: To compare the clinical outcomes of single-level and multilevel intervertebral decompression for cervical degenerative radiculopathy.
Summary Of Background Data: In patients with cervical radiculopathy, physical examination findings are sometimes inconsistent with imaging data. Multilevel decompression may be necessary for multiple foraminal stenosis. Additional decompression is more invasive yet expected to comprehensively decompress all suspected nerve root compression areas. However, the surgical outcomes of this approach compared with that of single-level decompression remain unknown.
Materials And Methods: The data of patients with spinal surgery for pure cervical radiculopathy were collected. Patients were categorized into the single-level (SLDG) or multilevel (MLDG) intervertebral decompression group at C3/C4/C5/C6/C7/T1. Demographic data and patient-reported outcome scores, including the Neck Disability Index (NDI) and Numerical Rating Scale (NRS) scores for pain and numbness in the neck, upper back, and arms, were collected. The NDI improvement rates and changes in NRS scores were analyzed one year postoperatively at patient-reported outcome evaluation. Propensity score matching was performed to compare both groups after adjusting for baseline characteristics, including the preoperative NDI and NRS scores.
Results: Among the 357 patients in this study, SLDG and MLDG comprised 231 and 126 patients, respectively. Two groups (n=112, each) were created by propensity score matching. Compared with the MLDG, the SLDG had a higher postoperative NDI improvement rate ( P =0.029) and lower postoperative arm numbness NRS score ( P =0.037). Other outcomes tended to be more favorable in the SLDG than in the MLDG, yet no statistical significance was detected.
Conclusions: In patients with cervical radiculopathy, the surgical outcomes of the SLDG showed better improvement in clinical outcomes than those of the MLDG. Numbness remained on the distal (arms) rather than the central (neck and upper back) areas in patients receiving multilevel decompression.
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http://dx.doi.org/10.1097/BRS.0000000000004508 | DOI Listing |
Anesth Pain Med (Seoul)
January 2025
Department of Anesthesia, Intensive Care and Pain Medicine, Faculty of Medicine, Alfayoum University, Alfayoum, Egypt.
Background: Epidural steroid injections are frequently used to treat chronic radicular pain of a discogenic origin; however, their efficacy remains limited. Magnesium sulfate and dexmedetomidine are emerging adjuvants with the potential to enhance the effectiveness and prolong the therapeutic duration of steroid injections.
Methods: In this randomized, double-blind study, 90 patients with unilateral lower limb radiculopathy due to lumbar disc prolapse who did not respond to conservative treatment for 12 weeks were assigned to three groups.
BMJ Case Rep
January 2025
Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
Slimmer's paralysis is a peripheral mononeuropathy of the common peroneal (fibular) nerve (CPN/CFN), typically associated with rapid weight loss resulting in loss of subcutaneous fat pad and subsequent neural compression at the fibular head. Here, we describe a young man with a 1-year history of right-sided foot drop, which developed following a rapid intentional weight loss of 11 kg over a period of 15 days. This weight loss was preceded by rapid weight gain over 2 days owing to binge eating.
View Article and Find Full Text PDFSAGE Open Med Case Rep
January 2025
Department of Orthopaedic Surgery, UPMC Central PA, Harrisburg, PA, USA.
Paraspinal hematomas are common complications following spine surgery. In general, these hematomas are asymptomatic and resolve without issue. Unfortunately, there is a paucity of literature that describes the recurrence of these hematomas in a chronic setting.
View Article and Find Full Text PDFJ Orthop
July 2025
Orthopedic Spine Surgeon, USA.
Background: High-grade Isthmic Spondylolisthesis often requires surgical intervention for spinal realignment and decompression. This study describes a modified Bohlman procedure utilizing robotic-assisted navigation and a Globus SI-LOK interbody device.
Methods: A retrospective review was conducted on three patients who underwent the modified Bohlman procedure for high-grade spondylolisthesis at a single hospital between 2022 and 2023.
J Orthop Case Rep
January 2025
Department of Orthopaedics, Malabar Medical College Kozhikode, Kerala, India.
Introduction: Endoscopic spine surgery (ESS) is a minimally invasive technique that allows for direct visualization of spinal pathologies and has become a safe and effective alternative to traditional open spine surgery. Conventionally performed in the prone position, biportal endoscopy can also be done in the lateral position to avoid prone-associated complications. To our knowledge, the use of unilateral biportal endoscopy (UBE) in the lateral position has not been previously reported.
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