Morphology of the triangular fibrocartilage complex of the Vietnamese adult: a cadaveric study.

Objective: This descriptive study aims to describe various anatomical morphological indicators of the triangular fibrocartilage complex (TFCC) in Vietnamese adults. Materials and methods: We analyzed 30 wrist joints from 15 fresh cadavers. To access the components of the TFCC, the wrist joints were dissected and measured, and anatomical morphological indices, inclu-ding length, width, thickness, origin, and insertion, were recorded. Results: Nine of 30 articular discs had central tears. The average length of the articular disc was 10.05±2.26 mm, while the average width was 12.10±1.39 mm. The average thickness of the articular disk on the ulnar side was 1.56±0.42 mm, while the average thickness of the articular disk on the radial side was 2.63±1.04 mm. Most meniscus homologues (86.6%) were of the narrow opening type according to the Ishii classification, with a horizontal dimension of 6.98±2.05 mm, anteroposterior diameter of 8.94±2.46 mm, and thickness of 1.27±0.41 mm. The volar radioulnar ligament averaged 12.75±2.17 mm in length and 2.54±0.77 mm in width, while the dorsal radioulnar ligament ave-raged 12.82±2.63 mm in length and 2.37±0.65 mm in width. The ulnar collateral ligament averaged 13.59±2.79 mm in length, 3.75±0.80 mm in width, and 0.95±0.46 mm in thickness. The ulnolunate and ulnotriquetral ligaments had average lengths of 7.34±2.87 mm and 5.70±2.98 mm, widths of 3.93±1.55 mm and 4.87±1.06 mm, and thicknesses of 0.96±0.61 mm and 1.43±0.98 mm, respectively. Conclusions: There are no differences in the shape or structure of the adult Vietnamese TFCC. No significant differences were noted in any TFCC component according to wrist side or gender.

Prognostic factors for surgical outcomes among patients with multilevel cervical spondylotic myelopathy.

OBJECTIVE: Many clinical and imaging characteristics can influence the prognosis of multilevel cervical spondylotic myelopathy (M-CSM). This study investigated the factors that influence surgical outcomes among patients with M-CSM. PATIENTS AND METHODS: This prospective study included 30 patients who underwent surgical treatment for M-CSM from June 2019 to June 2021. RESULTS: The average age was 62.29 years, and the average follow-up time was 13.13 months. Preoperative, postoperative, and follow-up Modified Japanese Orthopaedic Association (mJOA) scores were 10.17, 13.53, and 16.17, respectively. The average postoperative and follow-up recovery rates were 45.46% and 76.69%, respectively. Patients older than 60 years (p = 0.04), male patients (p = 0.023), and smokers (p = 0.027) had lower preoperative mJOA scores than other groups. Patients with symptoms duration longer than 6 months had lower recovery rates (p = 0.021) than those with shorter symptom duration. Patients with intramedullary hyperintensity in ≤ 2 vertebra (p = 0.041) or anterior surgery (p = 0.022) had better postoperative recovery rates than their counterparts. A shorter period of hyperintensity in the intramedullary region on sagittal T2-weighted magnetic resonance imaging (T2W MRI) was significantly associated with faster discharge (p = 0.044). Patients with type 3 (discrete focal) hyperintensity in the intramedullary region on axial T2W MRI had a 6.75-fold increase in experiencing less than 50% postoperative recovery compared with other groups (odds ratio: 6.75, 95% confidence interval: 2.73-16.67). CONCLUSIONS: Good prognostic factors for a shorter recovery included hyperintensity in the intramedullary region for ≤ 2 levels, shorter period of hyperintensity in the intramedullary region on sagittal T2W MRI, and an anterior surgical approach. A duration of symptoms longer than 6 months and discrete hyperintensity in the intramedullary region on axial T2W MRI were poor prognostic indicators associated with a longer recovery period.