Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Symposium: Current Concepts in Cervical Spine Surgery 17 articles


Cervical Spine Surgery: An Historical Perspective

Vincenzo Denaro MD, Alberto Di Martino MD, PhD

Continued innovation in surgery requires a knowledge and understanding of historical advances with a recognition of successes and failures.

What Is the Incidence and Severity of Dysphagia After Anterior Cervical Surgery?

Jeffrey A. Rihn MD, Justin Kane MD, Todd J. Albert MD, Alexander R. Vaccaro MD, PhD, Alan S. Hilibrand MD

Existing studies suggest a relatively high incidence of dysphagia after anterior cervical decompression and fusion (ACDF). The majority of these studies, however, are retrospective in nature and lack a control group.

The Best Surgical Treatment for Type II Fractures of the Dens Is Still Controversial

Vincenzo Denaro MD, Rocco Papalia MD, PhD, Alberto Di Martino MD, PhD, Luca Denaro MD, PhD, Nicola Maffulli MD, MS, PhD, FRCS(Orth)

Odontoid fractures are the most common odontoid injury and often cause atlantoaxial instability. Reports on postoperative status of patients who underwent surgery for such injuries are limited to small case series, and it is unclear whether any one technique produces better outcomes than another.

Spinal Cord Injury: A Systematic Review of Current Treatment Options

David W. Cadotte MSc, MD, Michael G. Fehlings MD, PhD, FRCSC, FACS

Spinal cord injury (SCI) is a devastating event often resulting in permanent neurologic deficit. Research has revealed an understanding of mechanisms that occur after the primary injury and contribute to functional loss. By targeting these secondary mechanisms of injury, clinicians may be able to offer improved recovery after SCI.

Laminoplasty versus Laminectomy and Fusion for Multilevel Cervical Spondylotic Myelopathy

Barrett I. Woods MD, Justin Hohl MD, Joon Lee MD, William Donaldson MD, James Kang MD

Cervical spondylotic myelopathy is increasingly prevalent in the elderly and is the leading cause of spinal cord dysfunction in this population. Laminectomy with fusion and laminoplasty halt progression of myelopathy in these patients; however, both procedures have well-documented complications and associated morbidity and it is unclear which might be most advantageous.

Operated and Adjacent Segment Motions for Fusion versus Cervical Arthroplasty: A Pilot Study

Tomoya Terai MD, PhD, Ahmad Faizan PhD, Koichi Sairyo MD, PhD, Vijay K. Goel PhD

Anterior cervical discectomy and fusion (ACDF) represent the standard treatment for cervical spondylolytic radiculopathy and myelopathy. To achieve solid fusion, appropriate compressive loading of the graft and stability are essential. Fusion may lead to adjacent segment degeneration. Artificial discs have been introduced as motion-preserving devices to reduce the risk of fusion-related complications.

Patients With Cervical Metastasis and Neoplastic Pachymeningitis are Less Likely to Improve Neurologically After Surgery

Vincenzo Denaro MD, Alberto Di Martino MD, PhD, Rocco Papalia MD, PhD, Luca Denaro MD, PhD

Although many patients with cervical spine metastases are treated surgically, it is unknown whether certain subsets achieve better pain relief and improvement of neurologic function.

Sagittal Segmental Alignment as Predictor of Adjacent-Level Degeneration After a Cloward Procedure

Cesare Faldini MD, Stavroula Pagkrati MD, Danilo Leonetti MD, Maria Teresa Miscione MD, Sandro Giannini MD

The Cloward anterior interbody fusion is commonly performed for cervical disc herniation or spondylosis. In followup studies, various authors have noted clinically relevant adjacent-level degeneration. However, factors associated with adjacent-level degeneration are not well known.

A New Zero-profile Implant for Stand-alone Anterior Cervical Interbody Fusion

M. Scholz MD, K. J. Schnake MD, A. Pingel MD, R. Hoffmann MD, F. Kandziora MD

Several studies suggest fusion rates are higher with anterior cervical discectomy and fusion procedures if supplemented with a plate. However, plates may be associated with higher postoperative morbidity and higher rates of dysphagia. This led to the development of a cervical stand-alone cage with integrated fixation for zero-profile segmental stabilization.

The Development and Evaluation of the Subaxial Injury Classification Scoring System for Cervical Spine Trauma

Peter G. Whang MD, Alpesh A. Patel MD, Alexander R. Vaccaro MD, PhD

Fractures and dislocations of the subaxial cervical spine may give rise to devastating consequences. Previous algorithms for describing cervical trauma largely depend on retrospective reconstructions of injury mechanism and utilize nonspecific terminology which thus diminish their clinical relevance add to the difficulty of educating doctors and performing prospective research.

Does Smoking Influence Fusion Rates in Posterior Cervical Arthrodesis With Lateral Mass Instrumentation?

Jason David Eubanks MD, Steven W. Thorpe MD, Vinay K. Cheruvu MSc, MS, Brett A. Braly MD, James D. Kang MD

Smoking is associated with reduced fusion rates after anterior cervical decompression and arthrodesis procedures. Posterior cervical arthrodesis procedures are believed to have a higher fusion rate than anterior procedures.

Percutaneous Vertebroplasty Relieves Pain in Metastatic Cervical Fractures

S. Masala MD, G. C. Anselmetti MD, M. Muto MD, M. Mammucari MD, T. Volpi MD, G. Simonetti MD

Percutaneous vertebroplasty is currently an alternative for treating vertebral fractures of the thoracic and lumbar spine, providing both pain control and vertebral stabilization. In the cervical spine, however, percutaneous vertebroplasty is technically challenging because of the complex anatomy of this region.

Increased In-hospital Complications After Primary Posterior versus Primary Anterior Cervical Fusion

Stavros G. Memtsoudis MD, PhD, Alexander Hughes MD, Yan Ma PhD, Ya Lin Chiu MS, Andrew A. Sama MD, Federico P. Girardi MD

Although anterior (ACDF) and posterior cervical fusion (PCDF) are relatively common procedures and both are associated with certain complications, the relative frequency and severity of these complications is unclear. Since for some patients either approach might be reasonable it is important to know the relative perioperative risks for decision-making.

An Observational Study of Patient-rated Outcome After Atlantoaxial Fusion in Patients With Rheumatoid Arthritis and Osteoarthritis

Dieter Grob MD, Andrea Luca MD, Anne F. Mannion BSc, PhD

Fusion is used to address several types of abnormality of the atlantoaxial segment. Traditionally, outcome has been assessed by achieving solid bony union. Recently, however, patient-rated outcome instruments have been increasingly used, although these may be influenced by concomitant comorbidity.