Journal of Craniovertebral Junction and Spine最新文献

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Transdural retrieval of retropulsed transforaminal lumbar interbody fusion cages. 经硬膜外取回后枕经椎间孔腰椎椎体融合套管。
IF 1.4
Journal of Craniovertebral Junction and Spine Pub Date : 2024-04-01 Epub Date: 2024-05-24 DOI: 10.4103/jcvjs.jcvjs_29_24
Devon Lefever, Jean-Christophe Leveque, Thomas Allen Hanks, Rajiv K Sethi, Nicholas C Eley
{"title":"Transdural retrieval of retropulsed transforaminal lumbar interbody fusion cages.","authors":"Devon Lefever, Jean-Christophe Leveque, Thomas Allen Hanks, Rajiv K Sethi, Nicholas C Eley","doi":"10.4103/jcvjs.jcvjs_29_24","DOIUrl":"10.4103/jcvjs.jcvjs_29_24","url":null,"abstract":"<p><p>Transforaminal lumbar interbody fusions (TLIFs) are performed for various lumbar spine pathologies. Posterior migration of an interbody cage is a complication that may result in neurologic injury and require reoperation. Sparse information exists regarding the safety and efficacy of a transdural approach for cage retrieval. We describe a surgical technique, in which centrally retropulsed cages were safely retrieved transdurally. A patient with prior L3-S1 posterior lumbar fusion and L4-S1 TLIFs presented with radiculopathy and weakness in dorsiflexion. Imaging revealed posterior central migration of TLIF cages causing compression of the traversing L5 nerve root. Cages were removed transdurally; the correction was performed with an all-posterior T10-pelvis fusion. Aside from temporary weakness in right-sided dorsiflexion, the patient experienced complete resolution in their radiculopathy and strength returned to its presurgical state by 3 months. The transdural approach for interbody removal can be safely performed and should be a tool in the spine surgeon's armamentarium.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 2","pages":"258-261"},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494174","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}
引用次数: 0
Lumbar parafacetal cyst-spinal segmental instability is the cause and stabilization is the treatment: A clinical report of eight surgically-treated patients. 腰椎副椎体囊肿--脊柱节段不稳定是病因,稳定是治疗方法:八例手术治疗患者的临床报告。
IF 1.4
Journal of Craniovertebral Junction and Spine Pub Date : 2024-04-01 Epub Date: 2024-05-24 DOI: 10.4103/jcvjs.jcvjs_19_24
Atul Goel, Ravikiran Vutha, Abhidha Shah, Apurva Prasad, Kumar Abhinav, Ashutosh Kumar Shukla
{"title":"Lumbar parafacetal cyst-spinal segmental instability is the cause and stabilization is the treatment: A clinical report of eight surgically-treated patients.","authors":"Atul Goel, Ravikiran Vutha, Abhidha Shah, Apurva Prasad, Kumar Abhinav, Ashutosh Kumar Shukla","doi":"10.4103/jcvjs.jcvjs_19_24","DOIUrl":"10.4103/jcvjs.jcvjs_19_24","url":null,"abstract":"<p><strong>Objective: </strong>The authors report the results of \"only-fixation\" of the affected spinal segment without any decompression of the bones or soft tissue or manipulation of the cyst wall or contents in eight cases having lumbar parafacetal cyst (LPFC). This surgical strategy was based on the concept that LPFCs are secondary to spinal instability, has a protective or adaptive role, and is reversible following stabilization.</p><p><strong>Materials and methods: </strong>During the period from January 2018 to January 2023, eight consecutive patients having LPFC were surgically treated. There were 5 males and 3 females, and their ages ranged from 48 to 72 years (average 63 years). Seven patients had a single cyst and one patient had multiple cysts. The patients presented with symptoms classically attributed to lumbar canal stenosis. Apart from the cyst-affected spinal segment, degenerative alterations were observed in adjoining spinal segments in six out of seven patients having a single cyst. All patients underwent \"only fixation\" of the unstable spinal segments without any kind of bone or soft-tissue resection and without any manipulation or handling of the cyst wall or contents.</p><p><strong>Results: </strong>During the follow-up period that ranged from 12 to 57 months (average 29 months), all patients improved from their symptoms. The recovery was observed in the immediate postoperative period and was lasting.</p><p><strong>Conclusions: </strong>LPFCs are one of the several secondary alterations observed in spinal degeneration. Identification of unstable spinal segments and their fixation constitutes rational treatment of lumbar parafacetal cysts. Direct handling and resection of cysts are unnecessary.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 2","pages":"178-184"},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494148","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}
引用次数: 0
A systematic review of risk factors and adverse outcomes associated with anterior cervical discectomy and fusion surgery over the past decade. 对过去十年中与颈椎椎间盘前路切除术和融合术相关的风险因素和不良后果的系统性回顾。
IF 1.4
Journal of Craniovertebral Junction and Spine Pub Date : 2024-04-01 Epub Date: 2024-05-24 DOI: 10.4103/jcvjs.jcvjs_168_23
Vikramaditya Rai, Vipin Sharma, Mukesh Kumar, Lokesh Thakur
{"title":"A systematic review of risk factors and adverse outcomes associated with anterior cervical discectomy and fusion surgery over the past decade.","authors":"Vikramaditya Rai, Vipin Sharma, Mukesh Kumar, Lokesh Thakur","doi":"10.4103/jcvjs.jcvjs_168_23","DOIUrl":"10.4103/jcvjs.jcvjs_168_23","url":null,"abstract":"<p><strong>Background: </strong>Anterior cervical discectomy and fusion (ACDF) is one of the most frequently performed cervical surgeries in the world, yet there have been several reported complications.</p><p><strong>Objective: </strong>To determine the actual incidence of complications related to ACDF as well as any risk variables that may have been identified in earlier research.</p><p><strong>Methods: </strong>To evaluate the origin, presentation, natural history, and management of the risks and the complications, we conducted a thorough assessment of the pertinent literature. An evaluation of clinical trials and case studies of patients who experienced one or more complications following ACDF surgery was done using a PubMed, Cochrane Library, and Google Scholar search. Studies involving adult human subjects that were written in the English language and published between 2012 and 2022 were included in the search. The search yielded 79 studies meeting our criteria.</p><p><strong>Results: </strong>The overall rates of complications were as follows: Dysphagia 7.9%, psudarthrosis 5.8%, adjacent segment disease (ASD) 8.8%, esophageal perforations (EPs) 0.5%, graft or hardware failure 2.2%, infection 0.3%, recurrent laryngeal nerve palsy 1.7%, cerebrospinal fluid leak 0.8%, Horner syndrome 0.5%, hematoma 0.8%, and C5 palsy 1.9%.</p><p><strong>Conclusion: </strong>Results showed that dysphagia was a common postoperative sequelae with bone morphogenetic protein use and a higher number of surgical levels being the major risk factors. Pseudarthrosis rates varied depending on the factors such as asymptomatic radiographic graft sinking, neck pain, or radiculopathy necessitating revision surgery. The incidence of ASD indicated no data to support anterior cervical plating as more effective than standalone ACDF. EP was rare but frequently fatal, with no correlation found between patient age, sex, body mass index, operation time, or number of levels.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 2","pages":"141-152"},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494211","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}
引用次数: 0
Advancing insights into recurrent lumbar disc herniation: A comparative analysis of surgical approaches and a new classification. 对复发性腰椎间盘突出症的深入了解:手术方法的比较分析和新的分类。
IF 1.1
Journal of Craniovertebral Junction and Spine Pub Date : 2024-01-01 Epub Date: 2024-03-13 DOI: 10.4103/jcvjs.jcvjs_177_23
Gerald Musa, Medetbek Dzhumabekovich Abakirov, Gennady E Chmutin, Samat Temirbekovich Mamyrbaev, Manuel De Jesus Encarnacion Ramirez, Kachinga Sichizya, Alexander V Kim, Gennady I Antonov, Egor G Chmutin, Dmitri V Hovrin, Mihail V Slabov, Bipin Chaurasia
{"title":"Advancing insights into recurrent lumbar disc herniation: A comparative analysis of surgical approaches and a new classification.","authors":"Gerald Musa, Medetbek Dzhumabekovich Abakirov, Gennady E Chmutin, Samat Temirbekovich Mamyrbaev, Manuel De Jesus Encarnacion Ramirez, Kachinga Sichizya, Alexander V Kim, Gennady I Antonov, Egor G Chmutin, Dmitri V Hovrin, Mihail V Slabov, Bipin Chaurasia","doi":"10.4103/jcvjs.jcvjs_177_23","DOIUrl":"https://doi.org/10.4103/jcvjs.jcvjs_177_23","url":null,"abstract":"<p><strong>Background: </strong>The management of recurrent lumbar disc herniation (rLDH) lacks a consensus. Consequently, the choice between repeat microdiscectomy (MD) without fusion, discectomy with fusion, or endoscopic discectomy without fusion typically hinges on the surgeon's expertise. This study conducts a comparative analysis of postoperative outcomes among these three techniques and proposes a straightforward classification system for rLDH aimed at optimizing management.</p><p><strong>Patients and methods: </strong>We examined the patients treated for rLDH at our institution. Based on the presence of facet resection, Modic-2 changes, and segmental instability, they patients were categorized into three groups: Types I, II, and III rLDH managed by repeat MD without fusion, MD with transforaminal lumbar interbody fusion (TLIF) (MD + TLIF), and transforaminal endoscopic discectomy (TFED), respectively.</p><p><strong>Results: </strong>A total of 127 patients were included: 52 underwent MD + TLIF, 50 underwent MD alone, and 25 underwent TFED. Recurrence rates were 20%, 12%, and 0% for MD alone, TFED, and MD + TLIF, respectively. A facetectomy exceeding 75% correlated with an 84.6% recurrence risk, while segmental instability correlated with a 100% recurrence rate. Modic-2 changes were identified in 86.7% and 100% of patients experiencing recurrence following MD and TFED, respectively. TFED exhibited the lowest risk of durotomy (4%), the shortest operative time (70.80 ± 16.5), the least blood loss (33.60 ± 8.1), and the most favorable Visual Analog Scale score, and Oswestry Disability Index quality of life assessment at 2 years. No statistically significant differences were observed in these parameters between MD alone and MD + TLIF. Based on this analysis, a novel classification system for recurrent disc herniation was proposed.</p><p><strong>Conclusion: </strong>In young patients without segmental instability, prior facetectomy, and Modic-2 changes, TFED was available should take precedence over repeat MD alone. However, for patients with segmental instability, MD + TLIF is recommended. The suggested classification system has the potential to enhance patient selection and overall outcomes.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 1","pages":"66-73"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11029108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856941","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}
引用次数: 0
The impact of robotic assistance for lumbar fusion surgery on 90-day surgical outcomes and 1-year revisions. 腰椎融合手术机器人辅助对 90 天手术效果和 1 年翻修的影响。
IF 1.1
Journal of Craniovertebral Junction and Spine Pub Date : 2024-01-01 Epub Date: 2024-03-13 DOI: 10.4103/jcvjs.jcvjs_145_23
Jeremy C Heard, Yunsoo A Lee, Nicholas D D'Antonio, Rajkishen Narayanan, Mark J Lambrechts, John Bodnar, Caroline Purtill, Joshua D Pezzulo, Dominic Farronato, Pat Fitzgerald, Jose A Canseco, Ian David Kaye, Alan S Hilibrand, Alexander R Vaccaro, Christopher K Kepler, Gregory D Schroeder
{"title":"The impact of robotic assistance for lumbar fusion surgery on 90-day surgical outcomes and 1-year revisions.","authors":"Jeremy C Heard, Yunsoo A Lee, Nicholas D D'Antonio, Rajkishen Narayanan, Mark J Lambrechts, John Bodnar, Caroline Purtill, Joshua D Pezzulo, Dominic Farronato, Pat Fitzgerald, Jose A Canseco, Ian David Kaye, Alan S Hilibrand, Alexander R Vaccaro, Christopher K Kepler, Gregory D Schroeder","doi":"10.4103/jcvjs.jcvjs_145_23","DOIUrl":"https://doi.org/10.4103/jcvjs.jcvjs_145_23","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the (1) 90-day surgical outcomes and (2) 1-year revision rate of robotic versus nonrobotic lumbar fusion surgery.</p><p><strong>Methods: </strong>Patients >18 years of age who underwent primary lumbar fusion surgery at our institution were identified and propensity-matched in a 1:1 fashion based on robotic assistance during surgery. Patient demographics, surgical characteristics, and surgical outcomes, including 90-day surgical complications and 1-year revisions, were collected. Multivariable regression analysis was performed. Significance was set to <i>P</i> < 0.05.</p><p><strong>Results: </strong>Four hundred and fifteen patients were identified as having robotic lumbar fusion and were matched to a control group. Bivariant analysis revealed no significant difference in total 90-day surgical complications (<i>P</i> = 0.193) or 1-year revisions (<i>P</i> = 0.178). The operative duration was longer in robotic surgery (287 + 123 vs. 205 + 88.3, <i>P</i> ≤ 0.001). Multivariable analysis revealed that robotic fusion was not a significant predictor of 90-day surgical complications (odds ratio [OR] = 0.76 [0.32-1.67], <i>P</i> = 0.499) or 1-year revisions (OR = 0.58 [0.28-1.18], <i>P</i> = 0.142). Other variables identified as the positive predictors of 1-year revisions included levels fused (OR = 1.26 [1.08-1.48], <i>P</i> = 0.004) and current smokers (OR = 3.51 [1.46-8.15], <i>P</i> = 0.004).</p><p><strong>Conclusion: </strong>Our study suggests that robotic-assisted and nonrobotic-assisted lumbar fusions are associated with a similar risk of 90-day surgical complications and 1-year revision rates; however, robotic surgery does increase time under anesthesia.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 1","pages":"15-20"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11029112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858926","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}
引用次数: 0
An institutional study on accuracy of freehand cervical C1 C2 screws placement by knock and drill technique in craniovertebral anomalous bony anatomy: An evaluation of more than 600 screws based on SGPGI screw accuracy criteria. 一项关于在颅椎骨解剖异常的情况下采用敲击和钻孔技术徒手放置颈椎 C1 C2 螺钉的准确性的机构研究:根据 SGPGI 螺钉准确性标准对 600 多枚螺钉进行评估。
IF 1.1
Journal of Craniovertebral Junction and Spine Pub Date : 2024-01-01 Epub Date: 2024-03-13 DOI: 10.4103/jcvjs.jcvjs_116_23
Sudhir Bisan Sasapardhi, Pawan Kumar Verma, Arun Kumar Srivastava, Kuntal Kanti Das, Ashutosh Kumar, Priyadarshi Dikshit, Ved Prakash Maurya, Kamlesh Singh Bhaisora, Anant Mehrotra, Awadhesh Kumar Jaiswal, Prabhaker Mishra, Sanjay Behari, Raj Kumar, Harshit Mishra, Kalyani Shahare
{"title":"An institutional study on accuracy of freehand cervical C1 C2 screws placement by knock and drill technique in craniovertebral anomalous bony anatomy: An evaluation of more than 600 screws based on SGPGI screw accuracy criteria.","authors":"Sudhir Bisan Sasapardhi, Pawan Kumar Verma, Arun Kumar Srivastava, Kuntal Kanti Das, Ashutosh Kumar, Priyadarshi Dikshit, Ved Prakash Maurya, Kamlesh Singh Bhaisora, Anant Mehrotra, Awadhesh Kumar Jaiswal, Prabhaker Mishra, Sanjay Behari, Raj Kumar, Harshit Mishra, Kalyani Shahare","doi":"10.4103/jcvjs.jcvjs_116_23","DOIUrl":"https://doi.org/10.4103/jcvjs.jcvjs_116_23","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the accuracy of freehand cervical C1 C2 screws placement by knock and drill (K and D) technique in craniovertebral anomalous bony anatomy.</p><p><strong>Materials and methods: </strong>From January 2017 to December 2022, 682 consecutive C1 C2 screws in 215 patients with craniovertebral junction (CVJ) anomalies were enrolled. All patients underwent posterior fixation with K and D technique without any fluoroscopic guidance. The patient's demographic details, clinical details, radiological details, major intraoperative events, and postoperative complications were noted. The screws malposition grades and direction on CT images in the axial and sagittal plane were defined as new per proposed \"SGPGI accuracy criteria.\" All patients had a clinical evaluation at 3-month follow-up.</p><p><strong>Results: </strong>Total 682 C1, C2 screws were placed in 215 patients for CVJ anomalies using K and D technique. The accuracy of screws placement by freehand technique was 84.46% (576/682). So with technique explained the rate of malplacement in simple (16.35%) and complex (15.19%) groups were almost comparable and comparison difference was not significant (<i>P</i> = 0.7005).</p><p><strong>Conclusion: </strong>The freehand technique, as described, is effective in cases of anomalous bony anatomy, and it is mandatory in complex CVJ anomalies. The accuracy of screw placement and VA injury is comparable with major studies. This technique is supposedly cost-effective and less hazardous to both health-care workers and patients.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 1","pages":"83-91"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11029100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868224","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}
引用次数: 0
En bloc resection followed by gluteal advancement flap for sacral Ewing's sarcoma: A novel technique. 骶骨尤文氏肉瘤的整体切除术和臀部推进皮瓣术:一项新技术。
IF 1.1
Journal of Craniovertebral Junction and Spine Pub Date : 2024-01-01 Epub Date: 2024-03-13 DOI: 10.4103/jcvjs.jcvjs_162_23
Jeena Joseph, Krishna Prabhu, Edmond Jonathan, Mark Ranjan Jesudason, Ashish Kumar Gupta
{"title":"<i>En bloc</i> resection followed by gluteal advancement flap for sacral Ewing's sarcoma: A novel technique.","authors":"Jeena Joseph, Krishna Prabhu, Edmond Jonathan, Mark Ranjan Jesudason, Ashish Kumar Gupta","doi":"10.4103/jcvjs.jcvjs_162_23","DOIUrl":"https://doi.org/10.4103/jcvjs.jcvjs_162_23","url":null,"abstract":"<p><p>Ewing's sarcoma is a rare and highly aggressive bone tumor primarily affecting children and adolescents. It commonly presents in the pelvic and axial skeleton, with sacral involvement posing unique challenges due to its intricate anatomical location. This report details the case of an 18-year-old male with sacral Ewing's sarcoma, emphasizing the diagnostic, surgical, and reconstructive aspects of management. The patient presented with lower back pain, lower limb weakness, and urinary incontinence, which prompted an extensive diagnostic evaluation. Magnetic resonance imaging and computed tomography scans revealed a large lytic mass extending from the S2 vertebra to the coccyx invading the presacral space. Biopsy confirmed the diagnosis of Ewing's sarcoma, characterized by the EWS-FLI1 type 1 translocation. A multidisciplinary team comprising neurosurgeons, colorectal surgeons, and plastic surgeons was formulated. En bloc resection of the tumor, lumbopelvic fixation, and soft-tissue reconstruction using bilateral gluteus maximus advancement flaps were successfully performed. The procedure aimed to address both the oncological and functional aspects of the patient's condition. Chemotherapy and radiotherapy were administered as adjuvant therapies. At 2-year follow-up, the patient was ambulating independently with no residual tumor on imaging. This case highlights the complex nature of sacral Ewing's sarcoma and underscores the importance of a multidisciplinary approach. The described surgical technique, including the innovative use of gluteus maximus advancement flaps for soft-tissue reconstruction, contributes to reducing wound complications and promoting successful patient outcomes. The presented approach serves as a valuable addition to the armamentarium of treatment options for this challenging malignancy.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 1","pages":"110-113"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11029106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872837","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}
引用次数: 0
A radiological parametric comparison of low-grade lytic spondylolisthesis to degenerative spondylolisthesis - A retrospective approach to establish its dysplastic origin. 低度溶解性脊柱滑脱与退行性脊柱滑脱的放射学参数比较--确定其发育不良起源的回顾性方法。
IF 1.1
Journal of Craniovertebral Junction and Spine Pub Date : 2024-01-01 Epub Date: 2024-03-13 DOI: 10.4103/jcvjs.jcvjs_136_23
K R Pratap, Vikas Tandon, Aditya Sunder Goparaju, Aayush Aryal
{"title":"A radiological parametric comparison of low-grade lytic spondylolisthesis to degenerative spondylolisthesis - A retrospective approach to establish its dysplastic origin.","authors":"K R Pratap, Vikas Tandon, Aditya Sunder Goparaju, Aayush Aryal","doi":"10.4103/jcvjs.jcvjs_136_23","DOIUrl":"https://doi.org/10.4103/jcvjs.jcvjs_136_23","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to compare low-grade lytic spondylolisthesis (LS) and degenerative spondylolisthesis (DS) radiologically. In addition, it seeks to identify underlying similarities between LS and DS.</p><p><strong>Methods: </strong>This study included patients with low-grade single-level spondylolisthesis at L4-L5 or L5-S1. They were categorized into LS and DS. Radiological features, including pedicle height, width, transverse, and sagittal angle, as well as anterior vertebral heights (AVH) and posterior vertebral heights (PVH), were measured using T1-weighted magnetic resonance imaging.</p><p><strong>Results: </strong>The study involved 88 patients: 46 in the DS group and 42 in the LS group. In the LS group, the AVH was significantly higher than the posterior height at L4 and L5 (L4 PVH/AVH ratio 0.93 in LS vs. 0.96 in DS; L5 PVH/AVH ratio 0.84 in LS vs. 0.92 in DS), and pedicles were more medially oriented (L4: 19.62° in LS vs. 17.7° in DS; L5: 28.92° in LS vs. 26.47° in DS). In addition, at L5, the pedicle height (10.67 mm in LS vs. 11.48 mm in DS) and width (13.56 mm in LS vs. 14.37 mm in DS) were smaller compared to the DS group.</p><p><strong>Conclusions: </strong>Low-grade LS shows distinct radiological vertebral and pedicle anatomy compared to DS. Short and thin pedicles and wedge-shaped vertebrae in LS resemble DS, indicating its dysplastic origin.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 1","pages":"30-36"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11029101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856940","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}
引用次数: 0
The demographic, clinical, and management differences between traumatic dens fracture patients with and without simultaneous atlas fractures. 有寰椎骨折和无寰椎骨折的外伤性颅骨骨折患者在人口统计学、临床和管理方面的差异。
IF 1.1
Journal of Craniovertebral Junction and Spine Pub Date : 2024-01-01 Epub Date: 2024-03-13 DOI: 10.4103/jcvjs.jcvjs_147_23
Michael Brendan Cloney, Pavlos Texakalidis, Anastasios G Roumeliotis, Vineeth Thirunavu, Nathan A Shlobin, Kevin Swong, Najib El Tecle, Nader S Dahdaleh
{"title":"The demographic, clinical, and management differences between traumatic dens fracture patients with and without simultaneous atlas fractures.","authors":"Michael Brendan Cloney, Pavlos Texakalidis, Anastasios G Roumeliotis, Vineeth Thirunavu, Nathan A Shlobin, Kevin Swong, Najib El Tecle, Nader S Dahdaleh","doi":"10.4103/jcvjs.jcvjs_147_23","DOIUrl":"https://doi.org/10.4103/jcvjs.jcvjs_147_23","url":null,"abstract":"<p><strong>Introduction: </strong>Atlas fractures often accompany traumatic dens fractures, but existing literature on the management of simultaneous atlantoaxial fractures is limited.</p><p><strong>Methods: </strong>We examined all patients with traumatic dens fractures at our institution between 2008 and 2018. We used multivariable logistic regression and ordinal logistic regression to identify factors independently associated with presentation with a simultaneous atlas fracture, as well myelopathy severity, fracture nonunion, and selection for surgery.</p><p><strong>Results: </strong>Two hundred and eighty-two patients with traumatic dens fractures without subaxial fractures were identified, including 65 (22.8%) with simultaneous atlas fractures. The distribution of injury mechanisms differed between groups (χ<sup>2</sup> <i>P</i> = 0.0360). On multivariable logistic regression, dens nonunion was positively associated with type II fractures (odds ratio [OR] = 2.00, <i>P</i> = 0.038) and negatively associated with having surgery (OR = 0.52, <i>P</i> = 0.049), but not with having a C1 fracture (<i>P</i> = 0.3673). Worse myelopathy severity on presentation was associated with having a severe injury severity score (OR = 102.3, <i>P</i> < 0.001) and older age (OR = 1.28, <i>P</i> = 0.002), but not with having an atlas fracture (<i>P</i> = 0.2446). Having a simultaneous atlas fracture was associated with older age (OR = 1.29, <i>P</i> = 0.024) and dens fracture angulation (OR = 2.62, <i>P</i> = 0.004). Among patients who underwent surgery, C1/C2 posterior fusion was the most common procedure, and having a simultaneous atlas fracture was associated with selection for occipitocervical fusion (OCF) (OR = 14.35, <i>P</i> = 0.010).</p><p><strong>Conclusions: </strong>Among patients with traumatic dens, patients who have simultaneous atlas fractures are a distinct subpopulation with respect to age, mechanism of injury, fracture morphology, and management. Traumatic dens fractures with simultaneous atlas fractures are independently associated with selection for OCF rather than posterior cervical fusion alone.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 1","pages":"21-29"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11029115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868872","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}
引用次数: 0
Surgical management of spinal metastases from primary thyroid carcinoma: Demographics, clinical characteristics, and treatment outcomes - A retrospective analysis. 原发性甲状腺癌脊柱转移的手术治疗:人口统计学、临床特征和治疗效果 - 一项回顾性分析。
IF 1.1
Journal of Craniovertebral Junction and Spine Pub Date : 2024-01-01 Epub Date: 2024-03-13 DOI: 10.4103/jcvjs.jcvjs_7_24
Rahul Kishore Chaliparambil, Mykhaylo Krushelnytskyy, Nathan A Shlobin, Vineeth Thirunavu, Anastasios G Roumeliotis, Collin Larkin, Hanna Kemeny, Najib El Tecle, Tyler Koski, Nader S Dahdaleh
{"title":"Surgical management of spinal metastases from primary thyroid carcinoma: Demographics, clinical characteristics, and treatment outcomes - A retrospective analysis.","authors":"Rahul Kishore Chaliparambil, Mykhaylo Krushelnytskyy, Nathan A Shlobin, Vineeth Thirunavu, Anastasios G Roumeliotis, Collin Larkin, Hanna Kemeny, Najib El Tecle, Tyler Koski, Nader S Dahdaleh","doi":"10.4103/jcvjs.jcvjs_7_24","DOIUrl":"https://doi.org/10.4103/jcvjs.jcvjs_7_24","url":null,"abstract":"<p><strong>Objective: </strong>Metastatic spinal tumors represent a rare but concerning complication of primary thyroid carcinoma. We identified demographics, metastatic features, outcomes, and treatment strategies for these tumors in our institutional cohort.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed patients surgically treated for spinal metastases of primary thyroid carcinoma. Demographics, tumor characteristics, and treatment modalities were collected. The functional outcomes were quantified using Nurik, Modified Rankin, and Karnofsky Scores.</p><p><strong>Results: </strong>Twelve patients were identified who underwent 17 surgeries for resection of spinal metastases. The primary thyroid tumor pathologies included papillary (4/12), follicular (6/12), and Hurthle cell (2/12) subtypes. The average number of spinal metastases was 2.5. Of the primary tumor subtypes, follicular tumors averaged 2.8 metastases at the highest and Hurthle cell tumors averaged 2.0 spinal metastases at the lowest. Five patients (41.7%) underwent preoperative embolization for their spinal metastases. Seven patients (58.3%) received postoperative radiation. There was no significant difference in progression-free survival between patients receiving surgery with adjuvant radiation and surgery alone (<i>P</i> = 0.0773). Five patients (41.7%) experienced postoperative complications. Two patients (16.7%) succumbed to disease progression and two patients (16.7%) experienced tumor recurrence following resection. Postsurgical mean Nurik scores decreased 0.54 points, mean Modified Rankin scores decreased 0.48 points, and mean Karnofsky scores increased 4.8 points.</p><p><strong>Conclusion: </strong>Surgery presents as an important treatment modality in the management of spinal metastases from thyroid cancer. Further work is needed to understand the predictive factors for survival and outcomes following treatment.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 1","pages":"92-98"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11029107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853519","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}
引用次数: 0
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