Journal Article10.3171/2011.11.SPINE11102
Complications of cervical pedicle screw fixation for nontraumatic lesions: a multicenter study of 84 patients.
Hiroaki Nakashima,Yasutsugu Yukawa,Shiro Imagama,Tokumi Kanemura,Mitsuhiro Kamiya,Makoto Yanase,Keigo Ito,Masaaki Machino,Go Yoshida,Yoshimoto Ishikawa,Yukihiro Matsuyama,Naoki Ishiguro,Fumihiko Kato +12 more
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TL;DR: Surgeons should use PS fixation for nontraumatic cervical lesions only after thorough preoperative evaluation of each patient's cervical anatomy and after considering the risk factors specified in the present study, which occurred more often than in previous studies.
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Abstract: Object The cervical pedicle screw (PS) provides strong stabilization but poses a potential risk to the neurovascular system, which may be catastrophic. In particular, vertebrae with degenerative changes complicate the process of screw insertion, and PS misplacement and subsequent complications are more frequent. The purpose of this study was to evaluate the peri- and postoperative complications of PS fixation for nontraumatic lesions and to determine the risk factors of each complication. Methods Eighty-four patients who underwent cervical PS fixation for nontraumatic lesions were independently reviewed to identify associated complications. The mean age of the patients was 60.1 years, and the mean follow-up period was 4.1 years (range 6–168 months). Pedicle screw malpositioning was classified on postoperative CT scans as Grade I (< 50% of the screw outside the pedicle) or Grade II (≥ 50% of the screw outside the pedicle). Risk factors of each complication were evaluated using a multivariate analysis. Resu...
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Citations
Prevalence of Adjacent Segment Degeneration after Spine Surgery: A Systematic Review and Meta-analysis.
TL;DR: Spine surgery is associated with significant risk of ASD, and the prevalence rates determined by calculating proportions and 95% confidence interval (CI) for each study were useful in the estimation of the burden of the ASD after spine surgery.
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Screw-related complications in the subaxial cervical spine with the use of lateral mass versus cervical pedicle screws: a systematic review.
TL;DR: It appears that perioperative neurological and late biomechanical complication rates are similarly low for both LMS and CPS techniques, which may justify their nonroutine use in select cases.
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Prevalence of complications after surgery in treatment for cervical compressive myelopathy: A meta-analysis for last decade.
TL;DR: A meta-analysis on prevalence of all kinds of operation-related complications following surgery treating cervical compressive myelopathy and to provide reference for surgeons making surgical plan found patients with OPLL have a higher incidence of C5 palsy and CSF.
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Prevalence of adjacent segment disease following cervical spine surgery: A PRISMA-compliant systematic review and meta-analysis.
TL;DR: The results of this meta-analysis should be interpreted with caution because of the heterogeneity among the studies, but some details about the prevalence of radiographic ASD, symptomatic ASD, and reoperation ASD after cervical spine surgery are provided.
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Surgical safety of cervical pedicle screw placement with computer navigation system.
TL;DR: Evaluating the safety of CPS placement using computer navigation system for posterior cervical instrumented fixation and discussing its complication avoidance and management found that image-guided CPS placement has been an important advancement to secure the safe surgery.
References
Local kyphosis reduces surgical outcomes of expansive open-door laminoplasty for cervical spondylotic myelopathy
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C5 Palsy after Decompression Surgery for Cervical Myelopathy : Review of the Literature
TL;DR: Patients with C5 palsy generally have a good prognosis for functional recovery, but the severely paralyzed cases required significantly longer recovery times than the mild cases, and this value has not varied with different surgical procedures or disease etiologies.
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Biomechanical Analysis of Cervical Stabilization Systems: An Assessment of Transpedicular Screw Fixation in the Cervical Spine
TL;DR: Front and back approaches, employing the anterior plate and posterior triple-wiring, and transpedicular screw fixation demonstrated clear biomechanical advantages when the extent of instability increased to three-column or multilevel.
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The clinical risk of vertebral artery injury from cervical pedicle screws inserted in degenerative vertebrae
TL;DR: The deviation rate of CPS placement using anatomic landmarks was higher than anticipated, although no serious complications were encountered, although the risk of this procedure is still unclear.
315
C5 palsy after cervical laminoplasty: A MULTICENTRE STUDY
Shiro Imagama,Yukihiro Matsuyama,Y. Yukawa,N. Kawakami,Mitsuhiro Kamiya,T. Kanemura,Naoki Ishiguro +6 more
TL;DR: It may be that early foraminotomy in susceptible individuals and the avoidance of tethering of the cord by excessive laminoplasty may prevent a post-operative palsy of the C5 nerve root.
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