No abstract available.
Prolapse ; Tropism ; Zygapophyseal Joint

No abstract available.
Kyphosis* ; Laminectomy* ; Spinal Cord Diseases*

STUDY DESIGN: Retrospective analysis. PURPOSE: To compare results of laminectomy in multisegmental compressive cervical myelopathy (CSM) with lordosis versus segmental kyphosis. OVERVIEW OF LITERATURE: Laminectomy is an established procedure for decompression in CSM with cervical lordosis. However in patients with segmental kyphosis, it is associated with risk of progression of kyphosis and poor outcome. Whether this loss of sagittal alignment affects functional outcome is not clear. METHODS: We retrospectively reviewed 68 patients who underwent laminectomy for CSM from 1998 to 2009. As per preoperative magnetic resonance images, 36 patients had preoperative lordosis (Group 1) and 32 had segmental kyphosis (Group 2). We studied age at the time of surgery, duration of preoperative symptoms, recovery rate, magnitude of postoperative backward shifting of spinal cord and loss of sagittal alignment. RESULTS: Mean follow up was 5.05 years (range, 2–13 years) and mean age at the time of surgery 61.88 years. Group 1 had 20 men and 16 women and Group 2 had 19 men and 13 women. Mean recovery rate in Group 1 was 60.32%, in Group 2 was 63.7% without any statistical difference (p-value 0.21, one tailed analysis of variance). Two patients of Group 1 had loss of cervical lordosis by five degrees. In Group 2 seven patients had progression of segmental kyphosis by 5–10 degrees and two patients by more than 10 degrees. Mean cord shift was more in Group 1 (mean, 2.41 mm) as compared to Group 2 (mean, –1.97 mm) but it had no correlation to recovery rate. Patients with younger age (mean, 57 years) and less duration of preoperative symptoms (mean, 4.86 years) had better recovery rate (75%). CONCLUSIONS: Clinical outcome in CSM is not related to preoperative cervical spine alignment. Thus, lordosis is not mandatory for planning laminectomy in CSM. Good outcome is expected in younger patients operated earliest after onset of symptoms.
Animals ; Decompression ; Female ; Follow-Up Studies ; Humans ; Kyphosis* ; Laminectomy* ; Lordosis ; Male ; Retrospective Studies ; Spinal Cord ; Spinal Cord Diseases* ; Spine ; Tail

No abstract available.
Osteoporotic Fractures ; Retrospective Studies ; Risk Factors ; Vertebroplasty

Methods: An analysis of 49 consecutive patients who underwent 2L-ACDF (n=22) and H-TDR (n=27) from January 1, 2014 to December 31, 2017 was performed. Data were studied as retrieved from InstaPACS ver. 4.0 (Mediff Technologies Pvt. Ltd., Bengaluru, India) and medical records. Results: Twenty-two patients with 2L-ACDF and 27 patients with H-TDR were included. The mean±standard deviation (SD) follow-up duration was 4.0±1.5 years in H-TDR and 3.1±1.1 years in 2L-ACDF. The mean±SD Neck Disability Index (NDI) decreased from 26.1±7.6 to 6.5±3.9 in the H-TDR group and from 27.6±7.2 to 6.4±4.8 in the 2L-ACDF group at final follow-up. Disc height at suprajacent level in the 2L-ACDF group was 4.12±0.48 mm, 4.10±0.45 mm, and 4.05±0.48 mm preoperatively, at 1-year, and final follow-up, respectively. Disc height at supradjacent level in the H-TDR group was 4.28±0.36 mm, 4.20±0.32 mm, and 4.19±0.34 mm preoperatively, at 1-year, and final follow-up, respectively. Conclusions There was significantly improved NDI in both groups. Adjacent segment disc height loss was greater in the 2L-ACDF group than in H-TDR but not statistically significant (p =0.304). Supradjacent segment range of motion was greater in the 2L-ACDF group than in the H-TDR group (p =0.003). Both findings supported radiographic adjacent segment degeneration (ASD), but symptomatic ASD was absent in both groups.

Methods: Patients requiring a single-level TLIF were divided into two groups. In the TXA group (n=75), the wound surface was soaked with TXA (1 g in 100 mL saline solution) for 3 minutes after exposure, after decompression, and before wound closure, and in the control group (n=175) using only saline. Intraoperative blood loss drain volume was recorded on each of the first 2 days immediately after surgery. An estimated cost analysis was made on the basis of the length of hospital stay and the blood transfusion. Results: IBL for the control group was 783.33±332.71 mL and for intervention group 410.57±189.72 mL (p <0.001). The operative time for control group was 3.24±0.38 hours and for intervention group 2.99±0.79 hours (p <0.695). Hemovac drainage on days 1 and 2 for control group was 167.10±53.83 mL and 99.33±37.5 mL, respectively, and for intervention group 107.03±44.37 mL and 53.38±21.99 mL, respectively (p <0.001). The length of stay was significantly shorter in the intervention group (4.8±1.1 days) compared to control group (7.0±2.3 days). The cost of treatment in the intervention group was US dollar (USD) 4,552.57±1,222.6 compared with that in the control group USD 6,529.9±1,505.04. Conclusions Topical TXA is a viable, cost-effective method of decreasing perioperative blood loss in major spine surgery with fewer overall complications than other methods. Further studies are required to find the ideal dosage and timing.