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Harry T Mai, Robert J Burgmeier, Sean M Mitchell, Andrew C Hecht, Joseph C Maroon, Gordon W Nuber, Wellington K Hsu
STUDY DESIGN: Retrospective cohort study OBJECTIVE.: To determine if the level of a cervical disc herniation (CDH) procedure will uniquely impact performance-based outcomes in elite athletes of the National Football League (NFL). SUMMARY OF BACKGROUND DATA: Comparative assessments of post-surgical outcomes in NFL athletes with CDH at different levels are unknown. Further, the surgical decision making for these types of injuries in professional football athletes remains controversial...
September 30, 2016: Spine
Peter C Gerszten, Erin Paschel, Hazem Mashaly, Hatem Sabry, Hasan Jalalod'din, Khaled Saoud
BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is a well-accepted treatment option for patients with cervical spine disease. Three- and four-level discectomies are known to be associated with a higher complication rate and lower fusion rate than single-level surgery. This study was performed to evaluate and compare zero-profile fixation and stand-alone PEEK cages for three- and four-level ACDF. METHODS: Two cohorts of patients who underwent ACDF for the treatment of three- and four-level disease were compared...
September 10, 2016: Curēus
Shota Takenaka, Yukitaka Nagamoto, Hiroyuki Aono, Takashi Kaito, Noboru Hosono
BACKGROUND CONTEXT: The time of onset of postoperative upper limb palsy (ULP), also referred to as C5 palsy, varies among patients. Although some studies addressed the relationship between the time of onset of ULP and potential etiologies, no meta-analysis has been conducted regarding the association between the time of onset of ULP and other factors such as surgical procedure type and treated diseases. PURPOSE: To elucidate differences in the time of onset of ULP among spinal surgical procedures and treated diseases to understand its etiology...
October 7, 2016: Spine Journal: Official Journal of the North American Spine Society
Wei Lin, Yuan Xue, Ying Zhao, Yaqi Zong, Chao Sun, Bo Pei, Pei Wang
PURPOSE: The generation and tissue origination of disc-associated axial pain is still under exploration. This study was performed to evaluate disc-associated axial pain and to explore whether it originates in the disc or its surrounding components. METHODS: A 6-year series of 88 single-level Smith-Robinson disc and posterior longitudinal ligament (PLL) resections performed to treat single-level cervical spondylotic myelopathy was retrospectively examined. All single-level anterior disc decompressions were performed under local infiltration anesthesia; the PLL was not anesthetized to avoid cervical cord block...
October 6, 2016: European Spine Journal
Christopher S Graffeo, Ross C Puffer, Eelco F M Wijdicks, William E Krauss
BACKGROUND: Ischemic stroke following anterior cervical diskectomy and fusion (ACDF) is an exceedingly rare complication. There are only three previous cases focusing on this problem in the literature; here, we present the fourth case. CASE DESCRIPTION: A patient, cared for at an outside institution, developed a delayed ischemic stroke 3 days following an ACDF. This complication was attributed to carotid manipulation precipitating vascular injury in the setting of multiple comorbid vascular and coagulopathic risk factors, including previously undiagnosed carotid atherosclerosis, a prior history of pulmonary embolus requiring Warfarin anticoagulation (held perioperatively), acute dehydration, and atrial fibrillation...
2016: Surgical Neurology International
G B Mahadewa Tjokorda, Golden Nyoman, Maliawan Sri, Mizuno Junichi
This report presents two cases of cervicobrachialgia and radiculopathy due to multiple cervical herniated discs and spur formation that dealt with anterior cervical discectomy and fusion (ACDF) using different titanium interbody cages. The description of the clinical presentation, magnetic resonance imaging (MRI) appearances and management strategy are discussed. Both cases showed chronic neck pain and radiating pain from the shoulder to the arm. They had a history of blurry vision, cluster head ache, weakness, and numbness on the shoulder for 2 years...
October 2016: Asian Journal of Neurosurgery
Shun-Li Kan, Zhi-Fang Yuan, Guang-Zhi Ning, Fei-Fei Liu, Jing-Cheng Sun, Shi-Qing Feng
OBJECTIVE: Cervical disc arthroplasty (CDA) has been designed as a substitute for anterior cervical discectomy and fusion (ACDF) in the treatment of symptomatic cervical disc disease (CDD). Several researchers have compared CDA with ACDF for the treatment of symptomatic CDD; however, the findings of these studies are inconclusive. Using recently published evidence, this meta-analysis was conducted to further verify the benefits and harms of using CDA for treatment of symptomatic CDD. METHODS: Relevant trials were identified by searching the PubMed, EMBASE, and Cochrane Library databases...
October 2, 2016: International Journal of Surgery
Benjamin C Mayo, Dustin H Massel, Daniel D Bohl, Ankur S Narain, Fady Y Hijji, William W Long, Krishna D Modi, Bryce A Basques, Alem Yacob, Kern Singh
OBJECTIVE Prior studies have correlated preoperative depression and poor mental health status with inferior patient-reported outcomes following lumbar spinal procedures. However, literature regarding the effect of mental health on outcomes following cervical spinal surgery is limited. As such, the purpose of this study is to test for the association of preoperative SF-12 Mental Component Summary (MCS) scores with improvements in Neck Disability Index (NDI), SF-12 Physical Component Summary (PCS), and neck and arm pain following anterior cervical discectomy and fusion (ACDF)...
September 30, 2016: Journal of Neurosurgery. Spine
Monish M Maharaj, Kevin Phan, Ralph J Mobbs
BACKGROUND: Patient dissatisfaction with donor site morbidity has led to the search for alternative grafting options and techniques. This report compares patient satisfaction rates between autograft and graft substitutes for anterior cervical discectomy and fusion (ACDF). METHODS: This study was performed with the approval of the local area health network ethics committee. Over a 9-year period, the author performed 574 ACDF procedures (697 levels). Of these, 22 patients had previous surgery with autograft, with a subsequent ACDF procedure performed using a graft substitute...
June 2016: J Spine Surg
Owoicho Adogwa, Aladine Elsamadicy, Elizabeth Reiser, Cole Ziegler, Kyle Freischlag, Joseph Cheng, Carlos A Bagley
BACKGROUND: The primary aim of this study was to assess and compare the complications profile as well as long-term clinical outcomes between patients undergoing an Anterior Cervical Discectomy and Fusion (ACDF) procedure with and without the use of an intra-operative microscope. METHODS: One hundred and forty adult patients (non-microscope cohort: 81; microscope cohort: 59) undergoing ACDF at a major academic medical center were included in this study. Enrollment criteria included available demographic, surgical and clinical outcome data...
March 2016: J Spine Surg
Monish M Maharaj, Ralph J Mobbs, Jarred Hogan, Dong Fang Zhao, Prashanth J Rao, Kevin Phan
BACKGROUND: Surgical approaches are usually required in cases of severe cervical disc disease. The traditional method of anterior cervical disc fusion (ACDF) has been associated with reduced local mobility and increased occurrence of adjacent segment disease. The newer method of anterior cervical disc arthroplasty (ACDA) relies upon artificial discs of various products. Current literature is inconsistent in the comparative performance of these methods with regards to clinical, radiological and patient outcomes...
December 2015: J Spine Surg
Victor M Lu, Lucy Zhang, Daniel B Scherman, Prashanth J Rao, Ralph J Mobbs, Kevin Phan
PURPOSE: The traditional surgical approach to treat multi-level cervical disc disease (mCDD) has been anterior cervical discectomy and fusion (ACDF). There has been recent development of other surgical approaches to further improve clinical outcomes. Collectively, when elements of these different approaches are combined in surgery, it is known as hybrid surgery (HS) which remains a novel treatment option. A systematic review and meta-analysis was conducted to compare the outcomes of HS versus ACDF for the treatment of mCDD...
September 27, 2016: European Spine Journal
Dong-Ju Yun, Sang-Jin Lee, Sang-Joon Park, Hyeong Seok Oh, Young Jae Lee, Hyun Min Oh, Sang-Ho Lee
BACKGROUND: A new zero-profile, standalone device (Zero P) was recently developed and has shown a lower incidence rate of complications and competitive clinical outcomes compared to CP in single and multi-level ACDF. However, there is still concern whether Zero P is appropriate for multi-level ACDF. In addition, there have been few reports of contiguous two-level ACDF used in conjunction with Zero P. METHODS: We reviewed contiguous two-level ACDF performed from December 2006 to February 2015...
September 23, 2016: World Neurosurgery
Seokchun Lim, Louanne M Carabini, Robert D Kim, Ryan Khanna, Nader S Dahdaleh, Zachary A Smith
BACKGROUND CONTEXT: Higher ASA classification is a known predictor of postoperative complication in diverse surgical settings. However, its predictive value is not established in single-level elective anterior cervical discectomy and fusion (SLE-ACDF). PURPOSE: To evaluate the predictive value of American Society of Anesthesiology (ASA) classification system on 30-day morbidity following SLE-ACDF STUDY DESIGN/SETTING: Patients who underwent SLE-ACDF between 2011-2013 were selected from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database...
September 23, 2016: Spine Journal: Official Journal of the North American Spine Society
David N Bernstein, Amit Jain, David Brodell, Yue Li, Paul T Rubery, Addisu Mesfin
OBJECTIVE: To analyze overall trends of elective cervical spine surgery in the United States from 2003-13 with the goal of determining whether the economic downturn had an impact. METHODS: Codes from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) were used in order to identify elective cervical spine surgery procedures in the Nationwide Inpatient Sample (NIS) from 2003-13. National Health Expenditure, Gross Domestic Product (GDP) and Standard and Poor's (S&P) 500 Index were used as measures of economic performance...
September 22, 2016: World Neurosurgery
Sean C Martin, Bassam O Dabbous, Elliott E Ridgeon, Shailendra A Magdum, Thomas A D Cadoux-Hudson, Erlick A C Pereira
OBJECTIVES: Anterior cervical discectomy and fusion (ACDF) is a common operative treatment of compressive pathology of the cervical spinal cord, when caused by one or more degenerated intervertebral discs or related osteophytes. In addition to intra-operative radiographs to confirm spinal level before discectomy and implant position after insertion, traditional practice is to obtain post-operative antero-posterior and lateral plain radiographs (XR) before hospital discharge, despite a paucity of evidence supporting their benefit to patient care...
September 22, 2016: British Journal of Neurosurgery
Eric B Laxer, Craig D Brigham, Bruce V Darden, P Bradley Segebarth, R Alden Milam, Alfred L Rhyne, Susan M Odum, Leo R Spector
PURPOSE: Many investigators have reported the financial conflicts of interest (COI), which could result in potential bias in the reporting of outcomes for patients undergoing total disc replacement (TDR) rather than anterior cervical discectomy and fusion (ACDF). This bias may be subconsciously introduced by the investigator in a non-blinded radiographic review. The purpose of this study was to determine if bias was present when a group of spine specialists rated adjacent segment degeneration (ASD) following cervical TDR or ACDF...
September 20, 2016: European Spine Journal
Ali Haghnegahdar, Mahsa Sedighi
Background and Aim. First-line treatment strategy for managing cervical disc herniation is conservative measures. In some cases, surgery is indicated either due to signs/symptoms of severe/progressive neurological deficits, or because of persistence of radicular pain despite 12 weeks of conservative treatment. Success for treatment of cervical disc herniation using ACDF has been successfully reported in the literature. We aim to determine the outcome of ACDF in treatment of cervical disc herniation among Iranians...
2016: Neuroscience Journal
Sudhir Kumar Srivastava, Rishi Anil Aggarwal, Sunil Krishna Bhosale, Pradip Sharad Nemade
CONTEXT: Approaches suggested for treatment of neglected dislocations in the subaxial cervical spine (SACS) include only anterior approach (a), only posterior approach (b), posterior-anterior approach, posterior-anterior-posterior approach, and anterior-posterior-anterior-posterior approach. No protocol is suggested in literature to guide surgeons treating neglected dislocations. AIM: To describe a protocol for the treatment of neglected dislocation in the SACS...
July 2016: Journal of Craniovertebral Junction and Spine
Tarub Mabud, Justin Norden, Anand Veeravagu, Christian Swinney, Tyler Cole, Brandon A McCutcheon, John Ratliff
STUDY DESIGN: Retrospective database analysis. OBJECTIVE: To examine the impact of training pathway, either neurosurgical or orthopedic, on complications, readmissions, and revisions in spine surgery. SUMMARY OF BACKGROUND DATA: Training pathway has been shown to have an impact on outcomes in various surgical subspecialties. Although training pathway has not been shown to have a significant impact on spine surgery outcomes in the perioperative period, long-term results are unknown...
September 10, 2016: Clinical Spine Surgery
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