• SURGICAL PLANNING FOR CERVICAL SPONDYLOTIC DISEASE: ARE MR AND MYELO-CT BOTH NECESSARY?

    INTRODUCTION: A previous presentation at CSRS concluded that when radiologists independently examined MR and Myelogram-CTs (M-CT) of patients with cervical spondylosis, there was poor concordance between the two studies. The present study examines, from the surgeons’ perspective, the utility of obtaining both radiological modalities in the pre-operative work-up for cervical stenosis surgery. METHODS: The MRI and/or M-CT (myelography and CT), clinical information and plain radiographs of 18 patients (average age 56, 9 female, 9 male) with cervical spondylosis requiring surgical decompression, were independently presented to five spine surgeons (four orthopaedic surgeons and one neurosurgeon) on three separate occasions, separated by at least one week.
  • INCREASED SIGNAL INTENSITY OF THE SPINAL CORD ON MR IMAGES DOES NOT PREDICT POOR OUTCOME OF CONSERVATIVE TREATMENT FOR CERVICAL MYELOPATHY

    INTRODUCTION: Increased signal intensity of the spinal cord on MR images (ISI) is considered to reflect various intramedullary lesions including edema, gliosis, and cavity formation. Some authors reported that ISI might reflect irreversible changes of the spinal cord and predict poor prognosis of compressive cervical myelopathy, although this is still controversial. So far, ISI has been studied mainly in relation with surgical outcome. The purpose of this study is to investigate relationships between ISI and the outcome of conservative treatment for cervical myelopathy. MATERIALS AND METHODS: Fifty-two patients with compressive cervical myelopathy were treated conservatively for more than 6 months between 1991 and 1997.
  • DIAGNOSTIC, TEMPORARY EXTERNAL FIXATION OF THE CERVICAL SPINE A five year follow-up

    INTRODUCTION: In the lumbar spine, temporary external fixation has been used to overcome diagnostic problems for identification of painful segments. We adopted this method to the cervical spine to enlarge the diagnostic armamentarium in difficult diagnostic problems with soft tissue injury of the cervical spine in which clinical symptoms differ significantly from objective findings. METHODS: Twenty-six patients with suspected mono-or bisegmental posttraumatic instability of the cervical spine underwent temporary external fixation for diagnostic reasons between 1989 and 1993. Ten females and 10 males were examined. The average age of the patients was 31.6 (19-52) years and the duration of symptoms (accident) was average 3.4 (1 - 10) years.
  • POSTERIOR CERVICAL LATERAL MASS FIXATION WITH A RIGID LOCKING IMPLANT

    OBJECTIVE: To compare the biomechanical stiffness of a standard posterior cervical lateral mass plate (P) to an adjustable posterior cervical lateral mass rod with standard screws (RS) and an adjustable posterior cervical lateral mass rod with rigid locking screws (RL). SUMMARY OF BACKGROUND DATA: Previous studies have demonstrated increased stiffness of posterior cervical mass plate and screw devices (P) in comparison to different posterior wiring constructs and anterior fixation devices. A limitation of posterior cervical plate devices is potential difficulty in aligning screw holes in the plate with the lateral masses. A posterior cervical rod device has been developed to allow flexibility in the positioning of the screws (Synthes, Paoli, PA).
  • COMPARING OUTCOMES OF ANTERIOR CERVICAL DISCECTOMY AND FUSION IN WORKMAN’S COMPENSATION VERSUS NON-WORKMAN’S COMPENSATION POPULATIONS

    INTRODUCTION: The purpose of this study is to analyze the functional outcome of anterior cervical discectomy and fusion (ACDF) between patients who had a work related injury versus patients who did not have a work related injury. METHODS: Eighty consecutive patients undergoing ACDF were analyzed. The same surgeon performed all the surgeries using the Smith-Robinson technique. The indications ACDF were cervical myelopathy or radiculopathy due to herniated nucleus pulposus and /or cervical spondylosis that did not respond to conservative treatments. There were 30 work related injury patients (Group I), and 50 non-work related injury patients (Group II).