Journal of Craniovertebral Junction and Spine最新文献

{"title":"Atlantoaxial subluxation and Down syndrome: A cross-sectional analysis.","authors":"Matthew Merckling, Sima Vazquez, Bridget Nolan, Galadu Subah, Michael Fortunato, Alan Stein, Harsdadkumar Patel, David Asprinio, John Wainwright, Merritt Kinon, Chirag Gandhi, Fawaz Al-Mufti","doi":"10.4103/jcvjs.jcvjs_1_24","DOIUrl":"10.4103/jcvjs.jcvjs_1_24","url":null,"abstract":"<p><strong>Background: </strong>Atlantoaxial subluxation (AAS) is a diagnosis describing misalignment of the C1 vertebra relative to C2. Excessive translation of this joint, located adjacent to the medullary brain stem, can lead to devastating neurological consequences. A higher prevalence of AAS within the Down syndrome (DS) population has been well-established. This study aims to establish a prevalence rate of DS in patients hospitalized for AAS and compare outcomes between AAS patients with and without DS.</p><p><strong>Methods: </strong>This study utilized the National Inpatient Sample (NIS) provided by the Healthcare Cost and Utilization Project (HCUP). In accordance with HCUP 2023 Clinical Classifications Software Refined files, data were queried using the International Classification of Diseases 10^th Edition codes for DS and AAS. Demographics, comorbidities, hospital course, and outcomes were examined and compared using binary and linear multivariate regression. IBM SPSS software was used for data analysis.</p><p><strong>Results: </strong>Of the 213,095 patients in the NIS database admitted between 2016 and 2020 with AAS as their primary diagnosis, 7.2% were DS patients. DS patients were significantly younger (26.56 ± 20.81 vs. 49.39 ± 27.63, <i>P</i> < 0.01), less likely to be female (33.30% vs. 52.10%), and had fewer comorbidities (diabetes mellitus, hypertension, and hyperlipidemia) than non-DS patients. There was no significant difference in likelihood to undergo surgical fusion between DS patients and non-DS patients with AAS.</p><p><strong>Conclusion: </strong>This large-scale study using NIS data determined that 7.2% of all patients admitted to hospitals for AAS are DS patients. The analysis of demographics, hospital course, and outcomes can influence the development of treatment protocols for AAS in the DS population.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 2","pages":"173-177"},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative complications associated with fluoroscopy C1 lateral mass screw fixation (Goel technique) versus computed tomography-guided navigation technique: A review of 202 cases from the German Spine Registry (DWG-Register).","authors":"Juan Manuel Vinas-Rios, Vincent J Heck, Peer Eysel, Sebastian Gottfried Walter, Tamara Babasiz, Nikolaus Kernich","doi":"10.4103/jcvjs.jcvjs_36_24","DOIUrl":"10.4103/jcvjs.jcvjs_36_24","url":null,"abstract":"<p><strong>Background: </strong>Overview of the literature - Fractures of the C1 constitute 3%-13% of all cervical spine injuries in adults. Most isolated C1 fractures are stable and can be treated nonoperatively with external immobilization. Traditional surgical options for C1 fracture treatment are occiput-to-C2 fusion or C1 with lateral mass screws (LMSs). Purpose - The aim is to assess the management and perioperative complications of C1 fractures undergoing LMS fusion between fluoroscopy and computed tomography (CT)-guided navigation.</p><p><strong>Methods: </strong>This was a retrospective multicenter study of data from the DWG-Register of patients who underwent operative treatment for C1 traumatic fracture with LMSs from January 2017 to September 2022. Inclusion criteria - traumatic injury and age > 18 years old.</p><p><strong>Results: </strong>In total, 202 patients with traumatic C1 fracture requiring spinal surgery were identified in the registry; <i>n</i> = 175 (Group 1) were treated conventionally without CT-guided navigation and <i>n</i> = 27 were treated with CT-guided navigation (Group 2). C1-LMS was principally performed by spine surgeons <i>n</i> = 90 (53.4%) and <i>n</i> = 72 (18.5%) by neurosurgeons in both the groups. Intraoperative adverse events were as follows: dural tear in group 1 <i>n</i> = 0 and in group 2 <i>n</i> = 1, vascular injury, with one case in group 1 and no cases in group 2. General complications were: cardiovasculars in group 1 <i>n</i> = 6 (3.4%) and Group 2 <i>n</i> = 4 (14.8%) (<i>P</i> = 0.03), pulmonary complications in group1 <i>n</i> = 2 (1.1%) and <i>n</i> = 9 in group 2 (33.3%) (<i>P</i> < 0.001), stroke <i>n</i> = 1 (0.57%) in group1 and <i>n</i> = 4 in group 2 (14.8%) (<i>P</i> < 0.001), gastrointestinal bleeding <i>n</i> = 1 (0.57%) in group1 and no cases in group 2, renal insufficiency <i>n</i> = 2 (1.1%) in group 1 and <i>n</i> = 3 (11.1%) in group 2 (<i>P</i> = 0.01). One death was recorded in group 2 (3.7%).</p><p><strong>Conclusion: </strong>This series of 404 screws placed in 202 patients over 5 years who underwent two types of C1 fracture fixation had a considerably lower incidence of screw malposition and vertebral artery injury than has previously been reported in the literature. C1 screws can be safely placed with a low risk of vertebral artery and neurologic injury with and without CT-guided navigation support.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 2","pages":"241-246"},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive insights into lumbar epidural varicose veins: Three clinical cases and surgical strategies.","authors":"Kayode Agboola, Bipin Chaurasia, Gianluca Scalia, Giuseppe Emmanuele Umana, Nicola Montemurro, Eugene Slinko","doi":"10.4103/jcvjs.jcvjs_9_24","DOIUrl":"10.4103/jcvjs.jcvjs_9_24","url":null,"abstract":"<p><p>Lumbar epidural varicose veins (LEVs) present a challenging clinical scenario with limited literature. This series addresses the scarcity of comprehensive understanding, emphasizing the need for nuanced exploration. Varied prevalence estimates and clinical oversights underscore the urgency for a standardized approach to surgical interventions. We present three diverse clinical cases: (1) segmental varicose veins causing radicular pain, (2) local varicosities leading to lower paraparesis, and (3) widespread varicose veins with prolonged symptoms. Surgical tactics involved targeted coagulation, crossing of veins, and preservation of collateral blood flow. Advanced imaging techniques guided interventions. Tailoring interventions based on varicose vein subtype, preserving collateral flow, and adopting a staged postoperative approach contribute to successful outcomes. This series provides valuable insights into LEV management, emphasizing the significance of advanced imaging in diagnosis and surgical planning.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 2","pages":"205-209"},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consistent anatomical relationships of pedicle, lamina, and superior articulating process in severe idiopathic scoliosis allow for safe freehand pedicle screw placement: A proof-of-concept technical study.","authors":"Nicholas Dietz, Alexander Spiessberger","doi":"10.4103/jcvjs.jcvjs_16_24","DOIUrl":"10.4103/jcvjs.jcvjs_16_24","url":null,"abstract":"<p><strong>Introduction: </strong>Transpedicular screw placement has superior pullout strength compared to alternative forms of spinal fusion and is often performed in deformity correction surgery with navigation for optimal accuracy and reliability. Freehand technique for pedicle screws minimizes operation time and radiation exposure without fluoroscopy but is not widely adopted given the challenge of difficult anatomical corridors and accurate placement, especially in idiopathic scoliosis and advanced deformity. We used a computer-generated model to assess a proof-of-concept and anatomical feasibility of a freehand screw technique in severe scoliosis.</p><p><strong>Methods: </strong>Three-dimensional (3D) reconstructions of vertebra from a sample of two male patients with severe idiopathic scoliosis deformity (1 thoracic and 1 lumbar) with Cobb angles of 100° were used for planned placement of 17 levels of thoracolumbar (6.5 mm × 45 mm) pedicle screws. 3D reconstruction of each vertebra was created and measurements of screw entries and trajectories were reproduced with a 3D slicer software image computing platform.</p><p><strong>Results: </strong>Accurate transpedicular screw placement is possible with anatomical landmarks based on the 3D reconstructed vertebral levels. A series of 5 figures were assembled to demonstrate sagittal, coronal, and axial planes and key anatomical landmarks and trajectories of thoracic and lumbar freehand pedicle screws in severe idiopathic scoliosis.</p><p><strong>Conclusions: </strong>Anatomical landmarks for freehand transpedicular screw placement (between pedicle, lamina, and superior articulating process) are constant and reliable in severe idiopathic scoliosis as evidenced by 3D computer modeling. Preoperative computed tomography modeling may assist appropriate screw entry and trajectory based on anatomical landmarks for spine surgeons, and guide freehand technique for screw placement in adolescent idiopathic scoliosis.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 2","pages":"224-229"},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior vertebral column resection: Exploring practical uses in clinical settings.","authors":"Mehmet Akif Çaçan, Murat Birinci, Yilmaz Mertsoy, Kadir Uzel, Bilal Bostanci, Bekir Yavuz Uçar","doi":"10.4103/jcvjs.jcvjs_15_24","DOIUrl":"10.4103/jcvjs.jcvjs_15_24","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to present our experience in patients who had been treated with posterior vertebral column resection (PVCR) for various spinal deformities.</p><p><strong>Methods: </strong>Thirty-seven patients who performed PVCR between 2015 and 2018 were evaluated retrospectively. The mean follow-up period was 24 months (range: 12-50 months). The demographic data of the patients, mean blood loss, amount of blood replacement, duration of operation, intensive care and hospitalization period, PVCR level, instrumentation level, amount of preoperative curvature, amount of postoperative curvature improvement, preoperative and postoperative neurological status, and complications were examined. Angular measurements were performed on X-ray.</p><p><strong>Results: </strong>The mean age of the patients was 37.5 years (range: 3-80 years). PVCR was applied to patients due to different pathologies (congenital, tumor metastasis, posttraumatic kyphosis, revision scoliosis, and infection). The mean operation time was 445.5 min (260-720) with an average blood loss of 1903 ml (400-7000 ml). It was observed that the average local kyphosis angle decreased from 67.65° to 7.42° in 26 patients who were operated for advanced deformity (<i>P</i> < 0.001). When these values were compared in all 34 patients, the preoperative angle value decreased from 55.1° to 3.5° (<i>P</i> < 0.001) and decreased from 70° to 0° in 13 congenital kyphosis patients.</p><p><strong>Conclusion: </strong>PVCR is an effective method for correcting severe spinal deformities and can be used to correct curvature in different patient groups.</p><p><strong>Level of evidence: </strong>Level 3.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 2","pages":"190-195"},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding spinal gout: A comprehensive study of 88 cases and their clinical implications.","authors":"Tommy Alfandy Nazwar, Farhad Bal'afif, Donny Wisnu Wardhana, Christin Panjaitan","doi":"10.4103/jcvjs.jcvjs_166_23","DOIUrl":"10.4103/jcvjs.jcvjs_166_23","url":null,"abstract":"<p><strong>Background: </strong>Spinal gout, a rare and often underdiagnosed condition, significantly impacts patients' quality of life. Therefore, the aim of the research is to analyze cases of spinal gout, including clinical features, anatomical location of spinal gout, laboratory studies, imaging studies, treatment choices, and outcomes from various cases of spinal gout.</p><p><strong>Methods: </strong>The author conducted a systematic literature search in the PUBMED and Science Direct databases from 2013 to 2023. We included clinical case presentations of spinal cases in adults, published in English. The three researchers independently reviewed the title and abstract of each article, and any differences in opinions were resolved through consensus. The extracted data were subsequently analyzed descriptively.</p><p><strong>Results: </strong>A total of 88 cases of spinal gout were obtained and studied. Out of the total reviewed cases of spinal gout, 89.77% of the subjects were male, with an average age of 51.9 years (age range 16-87 years). Common symptoms include back/neck pain (78.41%) and lower extremity weakness (37.50%). The lumbar spine is the most frequently affected region (62.50%), diagnosed primarily through magnetic resonance imaging (MRI) scans. Surgery, performed in 61.36% of cases, commonly involves decompressive laminectomy. Posttreatment, symptoms resolve in 87.50% of cases.</p><p><strong>Conclusion: </strong>Cases of spinal gout present with a variety of symptoms, including back pain and weakness. Diagnosis typically involves an MRI examination and synovial fluid analysis for confirmation. Treatment varies and includes medication therapy and surgical interventions. A deeper understanding of these cases can assist healthcare practitioners in the management and diagnosis of spinal gout cases.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 2","pages":"133-140"},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construct length analysis of type B and C cervical and thoracolumbar fractures.","authors":"Jeremy C Heard, Mark J Lambrechts, Yunsoo Lee, Teeto Ezeonu, Delano R Trenchfield, Nicholas D D'Antonio, Azra N Dees, Bright M Wiafe, John J Mangan, Jose A Canseco, Barrett I Woods, Ian David Kaye, Alan S Hilibrand, Alexander R Vaccaro, Christopher K Kepler, Gregory D Schroeder","doi":"10.4103/jcvjs.jcvjs_17_24","DOIUrl":"10.4103/jcvjs.jcvjs_17_24","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study is to identify if construct length affects the rate of surgical complications and instrumentation revision following surgical fixation of subaxial and thoracolumbar Type B and C fractures. This study evaluates the effect of ankylosing spondylitis/diffuse idiopathic skeletal hyperostosis (AS/DISH) within this population on outcomes.</p><p><strong>Methods: </strong>Retrospective review of 91 cervical and 89 thoracolumbar Type B and C fractures. Groups were divided by construct length for analysis: short-segment (constructs spanning two or less segments adjacent to the fracture) and long-segment (constructs spanning more than two segments adjacent to the vertebral fracture).</p><p><strong>Results: </strong>For cervical fractures, construct length did not impact surgical complications (<i>P</i> = 0.641), surgical hardware revision (<i>P</i> = 0.167), or kyphotic change (<i>P</i> = 0.994). For thoracolumbar fractures, construct length did not impact surgical complications (<i>P</i> = 0.508), surgical hardware revision (<i>P</i> = 0.224), and kyphotic change (<i>P</i> = 0.278). Cervical Type B fractures were nonsignificantly more likely to have worsened kyphosis (<i>P</i> = 0.058) than Type C fractures. Assessing all regions of the spine, a diagnosis of AS/DISH was associated with an increase in kyphosis (<i>P</i> = 0.030) and a diagnosis of osteoporosis was associated with surgical hardware failure (<i>P</i> = 0.006).</p><p><strong>Conclusion: </strong>Patients with short-segment instrumentation have similar surgical outcomes and changes in kyphosis compared to those with long-segment instrumentation. A diagnosis of AS/DISH or osteoporosis was associated with worse surgical outcomes.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 2","pages":"196-204"},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spondylodiscitis: Understanding pathophysiology, surgical strategies, and postoperative management - A single-center study.","authors":"Daniel Encarnación-Santos, Kim-A Valerievich, Gianluca Scalia, Eugeny Shestov, Murat Pachev, Jack Wellington, Ismail Bozkurt, Dmitriy Rubenovich-Chikara, Igor Kirilin, Gennady Chmutin, Ariel Tapia, Naim Ekhsan, Bipin Chaurasia","doi":"10.4103/jcvjs.jcvjs_164_23","DOIUrl":"10.4103/jcvjs.jcvjs_164_23","url":null,"abstract":"<p><strong>Background: </strong>Spondylodiscitis (SD) is an inflammatory condition affecting the intervertebral discs and adjacent structures, often leading to serious complications, including epidural abscesses. This study aimed to differentiate postoperative SD from spontaneous cases caused by osteoporotic defects and associated pathologies, evaluating the frequency of SD in spinal diseases at a single center.</p><p><strong>Materials and methods: </strong>A retrospective observational study involving 25 patients was conducted, analyzing variations between postoperative revisions in SD patients and spontaneous SD due to concurrent pathology and osteoporotic defects. The effects of postoperative wound healing following transforaminal lumbar interbody fusion and decompressive hemilaminectomy with pedicle screws were also investigated. Ethical guidelines were strictly followed during the study, conducted from January 2023 to September 2023 at Moscow City Clinical Hospital No. 68, Demikhova V.P.</p><p><strong>Results: </strong>Among the 25 patients with spontaneous SD, 15 females and 10 males were included, with only two undergoing surgical revision. Predominant purulent inflammatory foci were observed at specific spinal levels, and demographics revealed prevalent comorbidities such as arterial hypertension (80%) and type 2 diabetes mellitus (60%). Postoperative complications included paravertebral abscesses and wound-related issues. Structural observations indicated vertebral destruction, joint gaps, and localized spinal canal narrowing, revealing complexities in SD cases.</p><p><strong>Conclusion: </strong>Surgical intervention remains crucial for addressing SD-related vertebral complications, while antimicrobial therapy tailored to specific pathogens is pivotal. Concurrent conditions necessitate comprehensive management, often involving cardiological interventions. Postoperatively, a combined approach of conservative therapy and calcium phosphate adjuncts is recommended, especially considering the observed low bone density, aiming to optimize patient recovery and spinal stability.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 2","pages":"185-189"},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone dust: A versatile material for hemostasis and reconstruction.","authors":"Atul Goel","doi":"10.4103/jcvjs.jcvjs_76_24","DOIUrl":"10.4103/jcvjs.jcvjs_76_24","url":null,"abstract":"","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 2","pages":"131-132"},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calcified Thoracic Disc - A descriptive classification with clinical and management implications.","authors":"Shahnawaz Haleem, Amirul Adlan, Christine Azzopardi, Rajesh Botchu","doi":"10.4103/jcvjs.jcvjs_167_23","DOIUrl":"10.4103/jcvjs.jcvjs_167_23","url":null,"abstract":"<p><strong>Introduction and objective: </strong>Thoracic disc calcification is a radiological finding which may be incidental or diagnosed in patients presenting with myelopathy due to spinal cord compression. We performed a study to analyze the imaging patterns of calcified thoracic discs (CTDs).</p><p><strong>Patients and methods: </strong>A retrospective review of the spinal and radiology database of a tertiary referral orthopedic hospital was conducted for the incidence of CTDs between 2007 and 2020. Patients' demographics and radiological findings were recorded. The relationship between disc size, morphology, spinal cord compression, and management was assessed.</p><p><strong>Results: </strong>Fifty-one cases of CTDs were identified. The mean size of CTD was 806.2 mm³ (range: 144-2340). The most common level of disc calcification was T9-T10 (24%) in 12 patients. Thoracic disc calcifications in our series commonly involved disc \"protrusion\" in 67% (34 patients), followed by \"mushroom\" type in 31% (16 patients) and \"extrusion\" in 2% (1 patient). 37% (19 patients) had spinal cord compression with 12% (6 patients) undergoing surgical interventions. There was no statistically significant difference in the mean sizes of CTD between the groups with and without spinal cord compression (<i>P</i> = 0.566, independent sample t-test). Patients with \"mushroom\" type calcification were more likely to have surgical intervention (<i>P</i> = 0.01, Fisher's exact test).</p><p><strong>Conclusion: </strong>Thoracic disc calcifications, while common, can still be underdiagnosed till late myelopathic deterioration. Care of the elderly physicians, spinal surgeons, and radiologists need to be aware of them to guide diagnosis and management. Our study demonstrates that disc morphology plays a vital role in myelopathic presentation and therefore determines the need for surgical intervention instead of the absolute size of disc calcification.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 2","pages":"236-240"},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}