Calderonbuur4629
05), except for NT.
Cervical parameters and HRQOL values, which deteriorated in the early period, recovered in the late period in the long-term follow-up of patients undergoing laminoplasty. The important point is that preoperative cervical parameters suitable for laminoplasty should be present, and spinopelvic parameters should be normal.
Cervical parameters and HRQOL values, which deteriorated in the early period, recovered in the late period in the long-term follow-up of patients undergoing laminoplasty. The important point is that preoperative cervical parameters suitable for laminoplasty should be present, and spinopelvic parameters should be normal.
Posterior cranial fossa (PCF) is an important area in terms of anatomy and surgery. It is a common site of many neoplastic, vascular, and degenerative lesions. Craniovertebral surgeries require special attention regarding detailed information about the morphology and morphometry of this region. The aim of this study was to analyze the morphometric characteristics of PCF and distances between the inner base of the skull.
An observational, retrospective cross-sectional study was made. Fifty-five dry human skulls of unknown sex were measured ascertained using digital Vernier caliper with 0.01 mm precision.
The morphometric analysis of the mean length and width of the FM was 34.51 mm and 29.85 mm, respectively. We found a significant difference (
< 0.05) among the distance between the posterior tip of occipital condyle and basion of the right and left sides.
According to our observations, the present study yielded detailed morphometry of the PCF and neurovascular relationship. Bestatin It can facilitate successful instrumentation and minimize neurovascular injuries. Furthermore, it provides safe and suitable data for guiding neurosurgical procedures. The major limitation of this study was the lack of knowledge regarding the age and gender of the participants whose skull base was studied.
According to our observations, the present study yielded detailed morphometry of the PCF and neurovascular relationship. It can facilitate successful instrumentation and minimize neurovascular injuries. Furthermore, it provides safe and suitable data for guiding neurosurgical procedures. The major limitation of this study was the lack of knowledge regarding the age and gender of the participants whose skull base was studied.
Prospective case series, therapeutic Level IV.
Functional and radiographic outcome evaluation of patients with spondylolysis treated with pars interarticularis defect repair with iliac bone grafting and application of a construct consisting of a pair of polyaxial pedicle screws connected by a U-shaped rod passing beneath the spinous process.
Twenty-five patients (27 operated lumbar levels) with an average of 20 months of follow-up (range 12-24 m) with spondylolysis who met our inclusion criteria were treated with the above-mentioned technique. Functional assessment was by the Visual Analog Score (VAS) for low back pain (LBP) and Oswestry Disability Index (ODI). Fusion was confirmed with plain x-rays and when indicated with computed tomography scan. Return to activities of daily living (ADL) was also assessed.
There were 16 males (64%) and 9 females (36%), with a mean age of 18 ± 3 years at surgery, with a mean operating time of 79 ± 13 min and a mean blood loss of 186 ± 57 ml. ODI significantly improved from a mean of 63 ± 7 preoperatively to 10 ± 4 at 12 months postoperatively (
< 0.001). The mean preoperative LBP VAS score 8 ± 1 showed also a statistically significant decrease of values to 1 ± 1 at 12 months, (
< 0.001). At 12 m, all patients returned to unrestricted ADL. Pars healing was present in 19 patients (76%) at 6 months and in all patients at 12 months.
Polyaxial pedicular screws with a U-shaped rod offer an effective and reproducible treatment for spondylolysis with an appropriate fusion rate, predictable return to daily activities, and good pain relief in young adults.
Polyaxial pedicular screws with a U-shaped rod offer an effective and reproducible treatment for spondylolysis with an appropriate fusion rate, predictable return to daily activities, and good pain relief in young adults.
Lateral mass screw (LMS) and transpedicular screw (TPS) techniques are the two major options for performing posterior cervical fusion of the subaxial cervical spine. Although these two techniques can cover the vast majority of patients who require posterior fixation of the cervical spine, they are not without their limitations.
The objective of this study is to introduce a novel technique, lateral mass intrapedicular screw (LMIS) fixation, for posterior subaxial cervical spine (C3-C6) fixation.
The starting point of the screw is defined as the midpoint of the lateral mass. In the axial plane, the screw is angled at 20-25 with respect to the midline of the spinous process. In the sagittal plane, the screw is directed toward the rostral quarter (zone 1) of the vertebral body and placed within the pedicle. A preliminary, proof-of-concept experiment was performed using a bone model created with synthetic bone and computed tomography images before performing the operation on a patient.
During the preliminary experiment, insignificant breaching of the inner cortex of the pedicle was observed with one of the screws. However, no other screws breached the inner cortex in the same manner during the preliminary experiment or during the operation, and the intraoperative fixation was strong.
LMIS is a relatively simple and safe technique that can be performed for the fixation of subaxial cervical spines with screws that are longer than those used in LMS. We believe that this technique may join the two existing techniques to become a common alternative technique, particularly for patients with poor bone quality.
LMIS is a relatively simple and safe technique that can be performed for the fixation of subaxial cervical spines with screws that are longer than those used in LMS. We believe that this technique may join the two existing techniques to become a common alternative technique, particularly for patients with poor bone quality.
The aim is to investigate the relationship between cervical parameters and the modified Japanese Orthopedic Association scale (mJOA).
Surgical adult cervical deformity (CD) patients were included in this retrospective analysis. After determining data followed a parametric distribution through the Shapiro-Wilk Normality (
= 0.15,
> 0.05), Pearson correlations were run for radiographic parameters and mJOA. For significant correlations, logistic regressions were performed to determine a threshold of radiographic measures for which the correlation with mJOA scores was most significant. mJOA score of 14 and <12 reported cut-off values for moderate (M) and severe (S) disability. New modifiers were compared to an existing classification using Spearman's rho and logistic regression analyses to predict outcomes up to 2 years.
A total of 123 CD patients were included (60.5 years, 65%F, 29.1 kg/m
). For significant baseline factors from Pearson correlations, the following thresholds were predicted MGS for adult CD.
Roy-Camille reported only three patients in their Type 3 posttraumatic transverse sacral fracture (TSF) classification. A modified Roy-Camille classification has been already proposed by other authors suggesting further categorization of the TSFs as partially displaced or completely displaced to predict the rate of neurological recovery following lumbopelvic fixation.
We reported three adult cases of surgical fixation of fracture-dislocation (3A and 3B) of the sacrum due to traumatic injuries and submitted to lumbopelvic posterior reconstruction. A case of a 15-year-old male patient affected by Type 3C with vascular pelvic injury was also reported. A comprehensive literature search was performed on evaluation and management of Type 3 TSFs.
In Type 3A, there is a minimal anterior dislocation and the reduction is feasible with good chance of recovery. In Type 3B, the anterior dislocation is severe, neurological deficits are present, reduction is difficult, and there is a risk of vascular injury both at th the dislocation affects the surgical technique, the chance of neurological recovery, and the patient's life expectancy.
Although anterior cervical discectomy and fusion (ACDF) represents a standardized procedure for surgical treatment of a cervical herniated disc, several variables could affect patients' clinical and radiological outcome. We evaluated the impact of sex, age, body mass index (BMI), myelopathy, one- or two-level ACDF, and the use of postoperative collars on functional and radiological outcomes in a large series of patients operated for ACDF.
Databases of three institutions were searched, resulting in the enrollment of 234 patients submitted to one- or two-level ACDF from January 2013 to December 2017 and followed as outpatients at 6- and 12-month follow-up. The impact of variables on functional and radiological outcomes was evaluated using univariate and multivariate logistic regression analysis.
At univariate analysis, female sex, higher BMI, two-level ACDF, and postoperative collar correlated with a significantly worse early and late Neck Disability Index (NDI). Multivariate analysis showed that male patients had a lower risk of worse early (
= 0.01) and late NDIs (
= 0.009). Patients with myelopathy showed better early NDI (
= 0.004). Cervical collar negatively influenced both early and late NDIs (
< 0.0001), with a higher risk of early nonfusion (
= 0.001) but a lower risk of late nonfusion (
= 0.01). Patients operated for two-level ACDF have a worse early NDI (
= 0.005), a worse late NDI (
= 0.01), and a higher risk of early nonfusion (
= 0.048). BMI and age did not influence outcome.
Female sex, two-level surgery, and the use of postoperative collars significantly correlate with worse functional outcomes after one- or two-level ACDF.
Female sex, two-level surgery, and the use of postoperative collars significantly correlate with worse functional outcomes after one- or two-level ACDF.
This study investigated the segmentation metrics of different segmentation networks trained on 730 manually annotated lateral lumbar spine X-rays to test the generalization ability and robustness which are the basis of clinical decision support algorithms.
Instance segmentation networks were compared to semantic segmentation networks based on different metrics. The study cohort comprised diseased spines and postoperative images with metallic implants.
However, the pixel accuracies and intersection over union are similarly high for the best performing instance and semantic segmentation models; the observed vertebral recognition rates of the instance segmentation models statistically significantly outperform the semantic models' recognition rates.
The results of the instance segmentation models on lumbar spine X-ray perform superior to semantic segmentation models in the recognition rates even by images of severe diseased spines by allowing the segmentation of overlapping vertebrae, in contrary to the semantic models where such differentiation cannot be performed due to the fused binary mask of the overlapping instances.
