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1.
Neurol India ; 2005 Sep; 53(3): 283-5; discussion 286
Article de Anglais | IMSEAR | ID: sea-121520

RÉSUMÉ

AIMS: To determine the surgical approach in patients with multisegmental (four or more segments) OPLL of the cervical spine. METHODS AND MATERIALS: Data of 27 patients who had undergone either an anterior (corpectomy with excision of OPLL and interbody fusion = 14 patients) or posterior approach (laminectomy = 12, laminoplasty = 1 patient) for the multisegmental cervical OPLL was analyzed retrospectively. The patients in each group were statistically similar in respect to preoperative factors such as age, duration of symptoms, preoperative modified Japanese orthopedic association score, OPLL thickness, effective canal diameter, and antero-posterior cord compression ratio. The clinical outcome was assessed by the Harsh grading system and recovery rate was assessed by Hirabayashi method. RESULTS: There was no statistical difference in the outcome, and recovery rate. Nine patients developed complications after anterior approach in contrast to one after posterior approach. CONCLUSIONS: In patients with multisegmental cervical OPLL, there was no significant difference in the short-term recovery rate and outcome between two groups. The immediate postoperative complications were less in patients who had undergone posterior approach. From our analysis, it appears that the posterior approach is probably the preferred method of treatment in a multisegmental OPLL in absence of preoperative kyphosis.


Sujet(s)
Adulte , Sujet âgé , Femelle , Humains , Ligaments longitudinaux/anatomopathologie , Mâle , Adulte d'âge moyen , Ossification hétérotopique/chirurgie , Complications postopératoires , Études rétrospectives , Résultat thérapeutique
2.
Neurol India ; 2004 Jun; 52(2): 215-9
Article de Anglais | IMSEAR | ID: sea-121288

RÉSUMÉ

Cervical spondylotic myelopathy (CSM) is uncommon at the C3-4 level. Fourteen patients with C3-4 CSM were treated over a period of 3 years. The radiological factors contributing to CSM at the C3-4 level were studied. These factors included the assessment of static and dynamic canal diameters, retrolisthesis, posterior osteophytes and degenerative spinal segmental fusion on plain X-rays; and, the antero-posterior cord compression ratio (APCR) on magnetic resonance imaging (MRI). The clinical status of the patients was assessed by the modified Japanese orthopedic association scale (mJOAS). The mean difference between the static and dynamic canal diameters was statistically significant at C3-4 (p < 0.01). The APCR obtained at different levels showed a significant compression at the C3-4 level in comparison to the lower level. There was a correlation between the APCR and the preop mJOAS, r=0.6 (p< 0.05). The mean mJOAS improved from 9.35 to 14.35 at follo-up. The recovery rate calculated using the modified Hirabayashi rate was 66.9%. Degenerative changes at lower cervical segments predispose to increased mobility and spondylotic changes at the C3-4 level. The patients in this study were young as compared to those reported in the international literature.


Sujet(s)
Vertèbres cervicales/anatomopathologie , Humains , Imagerie par résonance magnétique , Études prospectives , Indice de gravité de la maladie , Canal vertébral/imagerie diagnostique , Syndrome de compression médullaire/diagnostic , Ostéophytose vertébrale/complications
3.
Neurol India ; 2003 Jun; 51(2): 250-1
Article de Anglais | IMSEAR | ID: sea-120547

RÉSUMÉ

A rare case of the complete absence of the posterior elements of C2 is reported. The patient presented with neck pain without any neurological deficits and radiology revealed a mobile, partially reducible dislocation of the C2 over C3 vertebra. A posterior fusion utilizing a contour rod, sublaminar wire fixation, and onlay bone grafts between the occiput and the C3 vertebra was performed for spinal stability.


Sujet(s)
Adulte , Axis/malformations , Vertèbres cervicales/malformations , Femelle , Humains , Arthrodèse vertébrale , Rachis/chirurgie
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