The Anatomy of the Distal Ulnar Tunnel

Gross, Michael S.; Gelberman, Richard H.

doi:10.1097/00003086-198506000-00032

Cited by 162 publications

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“…These findings showed that application of fusion after cervical discectomy helps improving preoperative alignment problems; however, ACD without fusion may cause new-onset alignment problems probably because of narrowing of the disc space. It was reported that abnormal movements due to these alignment issues may also cause adjacent segment problems (7,13,16,(18)(19)(20)(21)(22)(23) p<0.001). Those study results suggested that the primary cause of adjacent segment disease may be natural progression of cervical spondylosis (24).…”

Section: Discussionmentioning

confidence: 99%

Comparing the rate of radiological and clinical adjacent segment degeneration after simple anterior cervical discectomy versus discectomy plus fusion

Aktaş¹,

Abakay²,

Eren³

et al. 2016

Bagcilar Medical Bulletin

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Objective: To evaluate and compare the radiological changes on adjacent mobile segments and clinical findings in patients having undergone single-segment simple anterior cervical discectomy versus discectomy plus intervertebral fusion. Material and Methods: Twenty-five patients were treated with discectomy plus fusion and 20 patients with simple discectomy. Clinical pictures of the patients were evaluated with ODOM criteria before and 1 year after operation, and their improvement rates were calculated. The disc heights of superior and inferior adjacent segments, superior and inferior foramen heights, superior and inferior end plate heights of superior and inferior adjacent segments, new osteophyte development, segmental angulation and loss of cervical lordosis were evaluated on cervical radiographies before and 1 year after operation. Results: Although there were new degenerative findings in adjacent mobile segments in all patients when preoperative and postoperative measurements were compared, these radiological findings did not translate into clinical findings. In the fusion group, radiological degeneration findings were seen more frequently statistically; however, clinical results were not different between the two groups. On the other hand, loss of lordosis was significantly more frequent in the simple discectomy group. Conclusion: Although adding fusion to single-segment anterior cervical discectomy caused more frequent radiological degenerative changes in adjacent segments after 1 year compared to simple discectomy, clinical results were similar. It was thought that longer follow-up was necessary to observe clinical adjacent segment disease that was expected to become more frequent because of excessive mobility due to fusion. Keywords: Discectomy, intervertebral disc displacement, spinal fusions -adverse effects ÖZETTek seviye anterior servikal diskektomi ile diskektomi ve füzyon sonrası radyolojik ve klinik komşu seviye dejenerasyonu oranlarının karşılaştırılması Amaç: Tek seviye basit anterior servikal diskektomi uygulanan olgularda komşu seviyelerde gelişen radyolojik değişiklikleri ve klinik bulguları diskektomiyle birlikte füzyon uygulanan olgularda görülenlerle karşılaştırmak. Gereç ve Yöntemler: Diskektomiyle birlikte füzyon uygulanan 25, basit diskektomi uygulanan 20 olgu vardı. Olguların klinik tabloları girişim öncesinde ve girişimden 1 yıl sonra ODOM kriterlerine göre değerlen-dirildi ve iyileşme oranları hesaplandı. Üst ve alt komşu seviyelerdeki disk yükseklikleri, üst ve alt foramen yükseklikleri, üst ve alt komşu seviyelerin üst ve alt son plaklarının yükseklikleri, yeni osteofit gelişimi, segmenter açılanma ve servikal lordoz derecesi girişim öncesi ve girişimden 1 yıl sonraki grafilerde ölçüldü. Bulgular: Girişim öncesi ve 1 yıl sonraki ölçümler karşılaştırıldığında bütün olgularda bütün komşu seviyelerde yeni dejeneratif değişiklikler ortaya çıkmasına rağmen radyolojik bulgular klinik bulgulara yansıma-mıştı. Füzyon grubunda radyolojik dejenerasyon bulguları anlamlı olarak daha sı...

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Section: Discussionmentioning

confidence: 99%

Comparing the rate of radiological and clinical adjacent segment degeneration after simple anterior cervical discectomy versus discectomy plus fusion

Aktaş¹,

Abakay²,

Eren³

et al. 2016

Bagcilar Medical Bulletin

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“…Esophagus injury is a rare complication with anterior cervical surgery, the rate of which was 0-1.62% in large clinical reports [11][12][13][14][15][16]. From 2000 to 2010, we performed 1,045 cases of anterior cervical surgeries.…”

Section: Discussionmentioning

confidence: 99%

Esophagus perforation complicating anterior cervical spine surgery

Lü

Guo

2011

Eur Spine J

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Purpose To study the diagnosis and treatment strategy of esophagus perforation complicating anterior cervical spine surgery.Methods From 2000 to 2010, we performed 1,045 cases of anterior cervical surgeries. One developed esophagus perforation. The diagnosis and treatment strategy of this case and the other five patients with esophagus perforation from other hospitals were retrospectively reviewed. For an intraoperative perforation, primary double layer suture was performed. Postoperatively, the patient took nutrition by a nasogastric tube instead of oral intake for one week. For three cases of perforations early in the post-operative period, oral intake was forbidden and nasogastric tube was conducted for nutrition support. The wound was debrided and open drainage was conducted postoperatively. Intravenous broad-spectrum antibiotic therapy was utilized. For perforations at postoperative year 3 and 7, prohibition of oral intake, intravenous broad-spectrum antibiotics therapy, and nasogastric tube nutrition support were all conducted and surgical debridement was performed. In operation, fixation plates and screws were removed, and the edges of the perforation were loosely approximated by synthetic absorbable sutures. Postoperatively, skin wound was kept open for drainage.Results All the perforations healed evenly without secondary complications. Conclusions When a perforation is suspected, imaging techniques should be employed. Surgical treatment facilitates the healing of esophagus perforation. Supportive treatments including prohibition of oral intake, intravenous broad-spectrum antibiotic therapy, feeding with a nasogastric tube were mandatory parts of treatments.

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“…The results of this study show that the cervical CDI system can be safely used for stable cervical fixation without need for external support in severe pathologies of the cervical spine. spinous process with [36] and without [6] transverse K-wires are simple and safe, carrying no risk of neurovascular injury [4]. Plates and lateral mass screws can be used in multilevel cervical as well as occipitocervical instabilities [3,19].…”

Section: Introductionmentioning

confidence: 99%

Cotrel Dubousset instrumentation in occipito-cervico-thoracic fusion

Fagerström

Hedlund

2002

Eur Spine J

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IntroductionSince Hadra first described the time-honored technique of cervical wiring, several alternative fixation techniques have been developed, all with inherent limitations and risks.In atlanto-axial surgical stabilization, the Gallie wiring technique is still the gold standard, but it has several limitations [15,26]. Its mechanical stabilizing potential is limited, it does not result in rotational or translational sagittal stability and additional external fixation is needed, which is a great disadvantage, particularly in rheumatoid arthritis (RA) and metastatic disease. Transarticular C2-1 screws with additional Gallie type wire fixation is biomechanically attractive, offering rotational and translational stability, but is technically demanding, with a risk of vertebral artery injury [8,29,40].Wiring is also a traditional method of subaxial spine fixation [33]. Techniques based on wires through the Abstract There are today several techniques available for cervical fixation -all with inherent limitations and risks. In view of the drawbacks of wiring and screw fixation, which both presuppose good bone quality for stabilization, there is a need for a stable and safe fixation system that can also be used in osteoporotic bone. The objective of the present retrospective study was to assess the usefulness and safety of Cervical Cotrel Dubousset Instrumentation (CCDI), based on sublaminar hooks. The material comprises 60 consecutive patients, 28 men and 32 women, with a mean age of 57.3 years (range 17-84 years), operated on with CCDI. The diagnosis was trauma in 17 patients, rheumatoid arthritis in 16 patients, tumor in 20 patients and miscellaneous diagnoses in 7 patients. The material was dominated by severe pathologies, with neurological impairment in 17 patients (28%). Complications, subjective outcome and Frankel classification of neurological status pre-and postoperatively was documented. The patient outcome evaluation was excellent in 46%, good in 34%, fair in 10%, and poor in 10%. The physician's assessment was similar: 56% excellent, 27% good, 10% fair and 7% poor. Two patients improved by two Frankel grades, 7 by one and 47 patients had the same Frankel grade as preoperatively. Two patients deteriorated by one Frankel grade, one by three grades and one patient by four Frankel grades. Except for a 10% deep wound infection rate, there were few complications, with no evidence of neurological injury from the hooks in the spinal canal. The results of this study show that the cervical CDI system can be safely used for stable cervical fixation without need for external support in severe pathologies of the cervical spine.

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The Anatomy of the Distal Ulnar Tunnel

Cited by 162 publications

References 0 publications

Comparing the rate of radiological and clinical adjacent segment degeneration after simple anterior cervical discectomy versus discectomy plus fusion

Comparing the rate of radiological and clinical adjacent segment degeneration after simple anterior cervical discectomy versus discectomy plus fusion

Esophagus perforation complicating anterior cervical spine surgery

Cotrel Dubousset instrumentation in occipito-cervico-thoracic fusion

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