The significance of preoperative radiological examinations in patients treated with Cloward's operation

Petersen, O. F.; Buhl, Mie; Eriksen, Erik Fink; Fode, Kirsten; Klaerke, A; Krøyer, L; Lindeberg, H; Madsen, Charlotte Bernhard; Miletić, Tomislav; Strange, P

doi:10.1007/bf01400513

Cited by 4 publications

(2 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other studies have highlighted the predominance of qualitative radicular symptoms in the context of superior outcomes. 4,[32][33][34] While these studies have shown that axial versus radicular pain symptoms may guide surgical treatment, none of these studies quantified region specific pain ratios as a prognostic value.…”

Section: Discussionmentioning

confidence: 99%

Arm Pain Versus Neck Pain: A Novel Ratio as a Predictor of Post-Operative Clinical Outcomes in Cervical Radiculopathy Patients

et al. 2018

View full text Add to dashboard Cite

Background: Informed patient selection and counseling is key in improving surgical outcomes. Understanding the impact that certain baseline variables can have on postoperative outcomes is essential in optimizing treatment for certain symptoms, such as radiculopathy from cervical spine pathologies. The aim was to identify baseline characteristics that were related to improved or worsened postoperative outcomes for patients undergoing surgery for cervical spine radiculopathic pain. Methods: Retrospective review of prospectively collected data. Patient Sample: Surgical cervical spine patients with a diagnosis classification of ''degenerative.'' Diagnoses included in the ''degenerative'' category were those that caused radiculopathy: cervical disc herniation, cervical stenosis, and cervical spondylosis without myelopathy. Baseline variables considered as predictors were: (1) age, (2) body mass index (BMI), (3) gender, (4) history of cervical spine surgery, (5) baseline Neck Disability Index (NDI) score, (6) baseline SF-36 Physical Component Summary (PCS) scores, (7) baseline SF-36 Mental Component Summary (MCS) scores, (8) Visual Analog Scale (VAS) Arm score, and (9) VAS Neck. Outcome Measures: Improvement in NDI (50%), VAS Arm/Neck (50%), SF-36 PCS/MCS (10%) scores at 2-years postoperative. An arm-to-neck ratio (ANR) was also generated from baseline VAS scores. Univariate and multivariate analyses evaluated predictors for 2-year postoperative outcome improvements, controlling for surgical complications and technique. Results: Three hundred ninety-eight patients were included. Patients with ANR 1 (n ¼ 214) were less likely to reach improvements in 2-year NDI (30.0% vs 39.2%, P ¼ .050) and SF-36 PCS (42.4% vs 53.5%, P ¼ .025). Multivariate analysis for neck disability revealed higher baseline SF-36 PCS (odds ratio [OR] 1.053) and MCS (OR 1.028) were associated with over 50% improvements. Higher baseline NDI were reduced odds of postoperative neck pain improvement (OR 0.958). Arm pain greater than neck pain at baseline was associated with both increased odds of postoperative arm pain improvement (OR 1.707) and SF36 PCS improvement (OR 1.495). Conclusions: This study identified specific symptom locations and health-related quality of life (HRQL) scores, which were associated with postoperative pain and disability improvement. In particular, baseline arm pain greater than neck pain was determined to have the greatest impact on whether patients met at least 50% improvement in their upper body pain score. These findings are important for clinicians to optimize patient outcomes through effective preoperative counseling.

show abstract

Section: Discussionmentioning

confidence: 99%

Arm Pain Versus Neck Pain: A Novel Ratio as a Predictor of Post-Operative Clinical Outcomes in Cervical Radiculopathy Patients

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Myelography and post-myelography CT scan are of great value in determing the right level for surgery [10,26,27]. …”

Section: Radiological Examinationmentioning

confidence: 99%

Surgical treatment of myeloradiculopathy in cervical spondylosis. A report on 438 operations

et al. 1989

View full text Add to dashboard Cite

In the past eleven years we have performed 438 microsurgical ventral discectomies with bilateral foraminotomy followed by fusion with palacos in the cervical spine in our clinic. An analysis of the preoperative symptoms shows a great variability and overlapping of the various segments. To determine the right level for the operation it is crucial that the results of the clinical and the radiological examinations be evaluated. The results of ascending myelography and CT scans are of great value. In cases of cervical myelopathy a multisegmental operation is often necessary to obtain good results. The complication rate was small in our patients and a second operation was only necessary in a few cases. We had very good postoperative results in radicular pain and muscle weakness. In patients with symptoms of cervical myelopathy we achieved considerable improvement.

show abstract

Treatment of cervical disc disease using Cloward's technique

Espersen

Klaerke²,

Buhl

et al. 1987

Acta neurochir

View full text Add to dashboard Cite

Among 1,106 patients with cervical disc disease in whom Cloward's operation had been performed over a fifteen-year period, 145 patients were reoperated upon with a new Cloward procedure. In the 1st year after the first operation 3/4 of the patients were operated upon on the previous level, whereas reoperations performed later mainly were done on new levels. The effect of the reoperation was poorer than the effect of the 1st operation. Early reoperations--which were due to: an initially unsatisfactory clinical course, postoperative complications or graft problems--had a poor result, but late reoperations--which were caused by relapses--showed a result corresponding to the first operation. The frequency of relapses leading to a 2nd Cloward operation was 8.8% in the first year falling to 0.2% in the following years of observation.

show abstract

The significance of preoperative radiological examinations in patients treated with Cloward's operation

Cited by 4 publications

References 19 publications

Arm Pain Versus Neck Pain: A Novel Ratio as a Predictor of Post-Operative Clinical Outcomes in Cervical Radiculopathy Patients

Arm Pain Versus Neck Pain: A Novel Ratio as a Predictor of Post-Operative Clinical Outcomes in Cervical Radiculopathy Patients

Surgical treatment of myeloradiculopathy in cervical spondylosis. A report on 438 operations

Treatment of cervical disc disease using Cloward's technique

Contact Info

Product

Resources

About