• Reperfusion and Time-Dependent Recovery After Spinal Cord Injury

    INTRODUCTION: Residual spinal cord compression after impact occurs in the majority of patients with acute spinal cord injury. Our objectives were to determine the importance of early time-dependent spinal cord decompression on recovery of evoked potential and neurologic motor function and determine if regional blood flow changes are associated with neurologic recovery. Earlier decompression would prevent neural damage measured by histopathologic methods and MRI.
  • REDUCTION OF SAGITTAL ROTATION AFTER EN BLOC LAMINOPLASTY FOR CERVICAL SPONDYLOTIC MYELOPATHY

    INTRODUCTION: Laminopasty is one of the useful treatments for cervical myelopathy due to spondylosis and ossification of the posterior longitudinal ligament. However, several authors pointed out that motion of the cervical spine was reduced after laminoplasty. There have been a few detailed reports concerning the neck movement after laminoplasty. The purpose of this study was to demonstrate the longitudinal change of sagittal rotation of the cervical spine after en bloc laminoplasty. METHODS: Between 1986 and 1993, en bloc laminoplasty from C3 to C7 was performed on fifty-eight patients with cervical spondylotic myelopathy at our department. Of these, forty-four patients were included in this study.
  • Destructive Spondyloarthropathy of Cervical Spine in Hemodialyzed Patients Over Ten Years

    INTRODUCTION: Destructive spondyloarthropathy (DSA) in long-term hemodialysis patients was first described by Kuntz in 1984. Though DSA has recently been recognized in long-term hemodialysis patients, there is little knowledge of the epidemiology. This cross-sectional study was undertaken to provide some clarification of the prevalence of DSA. METHODS: Eighty-six patients who were undergoing maintenance hemodialysis over 10 years (an average of 17.2 years; range 10.8 - 26.3) entered into this study. They consisted of 41 males and 45 females, the mean age being 56.5 years (range 35-72). Lateral plain radiographs of the cervical spine was obtained in neutral position in all patients.
  • RETURN TO PLAY AFTER CERVICAL SPINE INJURY

    INTRODUCTION: The criteria to determine if and when an athlete can safely return to his or her sport after cervical spine injury are in the early stages of development. Published guidelines are admittedly based on anecdotal evidence and often the science behind the decision is nothing more than the good judgement and personal experiences of the treating physician. Because the consequences of cervical spine injury are potentially catastrophic, these decisions can be agonizing, especially if an athlete places high value on his or her sport and is reluctant to modify his or her activity. The present study attempted to elucidate the current thinking amongst orthopedists in making these decisions.
  • CERVICAL CORD NEURAPRAXIA IN PROFESSIONAL ATHLETES: A REVIEW OF TWENTY-SIX CASES

    INTRODUCTION: Recent accounts indicate that decisions to return the professional athlete to his activity following an episode of cervical cord neurapraxia has been based on fear of potential litigation rather than clinical science. This study reports on long-term follow of 26 professional athletes with documented CCN. METHODS: Study group consisted of 26 professional athletes that presented or were referred to the senior author. All participated in collision sports. There were 24 football players, 1 hockey player and 1 professional wrestler. Average age was 25.8 years, average follow-up is 32 months. The athletes were evaluated by history, physical examination, plane roentgenograms, and MRI of the cervical spine. Follow-up evaluation was by physical exam, questionnaire or telephone interview. Three case examples will be presented.
  • OCCIPITOCERVICAL FUSION BY COMBINATION OF CERVICAL PEDICLE SCREWS AND OCCIPITOCERVICAL ROD SYSTEMS

    INTRODUCTION AND PURPOSE: Many fixation procedures have been developed for stabilization of the occipitocervical junction. Although variable results of those procedures have been reported in the literature. Some techniques require long fusion and rigid postoperative external support due to mechanical weakness of the fixation systems. The purposes of this report were to show our surgical technique of occipitocervical fusion by combination of cervical pedicle screws and occipitocervical plate systems, and review the clinical outcome of our first 28 patients treated by this technique.
  • BIOMECHANICAL STABILITY OF A MOVABLE ARTIFICIAL CERVICAL JOINT

    INTRODUCTION: Anterior cervical discectomy with or without fusion is an acceptable surgical method for the treatment of cervical spondylosis or other spinal disc diseases. A spinal device may be used to immobilize the operated/injured region to promote bony fusion. Clinical studies have shown that motion at spinal segments adjacent to a fused region increases over time and may cause adjacent segment problems. An alternative approach to fusion surgery of the cervical spine is to restore the motion to the diseased joint using an implanted movable artificial joint. The biomechanical stability of the harvested and instrumented cervical spine was determined for physiologic flexion/extension and lateral bending loading mechanics. The instrumented spine consisted of a single level discectomy with subsequent disc replacement using a prototype movable intervertebral implant by Sofamor Danek Group, Memphis, TN.
  • A COMPARISON OF THE CLINICAL BEHAVIOR AND THE HISTOPATHOLOGY OF PLATE VERSUS CAGE-PLATE SYSTEMS FOR CERVICAL FUSION: AN IN VIVO STUDY

    INTRODUCTION: A recent advance in the technology for cervical fusions is the “The Telescopic Anterior Plate Spacer (TAPS)” (Interpore Cross, Inc.). This device is a combination of the anterior plate system and the fusion cage, and has several of the advantages of both. Further, failure modes such as piston effect and subsidence of the construct are believed to be minimized with the new device. The goal of this study was to compare the clinical performance of this device with a more commonly used and well-accepted device, “The CODMAN® Anterior Cervical Plate System” (Johnson and Johnson, Medical Inc.).