Medicine and Health Sciences Commons^™

Decompressive Cervical Laminectomy And Lateral Mass Screw-Rod Fusion For Multisegmental Cervical Spondylotic Myelopathy With Flexible Sagittal Cervical Alignment, Mohamed Hussein, Mohamed A Abdelrazek, Amr Eladawy

Advanced Spine Journal

Background data: Posterior cervical laminectomy and lateral mass screw-rod fusion techniques were classically recommended in flexible sagittal cervical alignment relying on indirect decompression via posterior cord shift. Purpose: This study aims to investigate the efficacy of posterior cervical laminectomy with lateral mass screw-rod fixation for treating multisegmental cervical spondylotic myelopathy with flexible sagittal cervical alignment. Study Design: Prospective clinical cohort study. Patients and Methods: In total, 38 patients with clinically symptomatic M-CSM with instability and/or flexible kyphosis were admitted to our Zagazig university hospitals for posterior cervical laminectomy and lateral mass screw-rod fusion (long-segment instrumented fusion ≥3 segments) and completed …

Transforaminal Percutaneous Endoscopic Lumbar Discectomy (Tpeld) In Caudal Migrated Lumbar Disc Herniations: A Case Series And Literature Review, Maha Abdelfattah, Mohamed Elkazaz, Ali Salah Khedr

Advanced Spine Journal

Background Data: Since the initial idea by Kambin and Gellman in 1973 of percutaneous posterolateral lumbar disc decompression, the evolution of minimally invasive interventions in disc herniation has been widely growing. The advancements in optics and surgical instruments allowed surgeons to perform true minimally invasive procedures in a wide range of spine pathologies. In addition, transforaminal percutaneous endoscopic lumbar discectomy (TPELD) has been widely utilized in various degenerative spine pathologies, due to the presence of high-speed drills, flexible forceps, scissors, curettes, and probes to manage pathologies such as disc herniation or canal stenosis.

Study Design: Prospective clinical case study.

Purpose: …

A Comparison Between Standalone Cage And Conventional Cage And Plate In Anterior Cervical Discectomy And Fusion For The Treatment Of Cervical Spondylotic Myelopathy: An Ambispective Study, Abhishek Vijayan, Prakash Goswami, Sanu Vijayan, Arun Sathyababu, Anil Peethambaran, Jyothish Laila Sivananda Panicker, Sunil Kumar Balakrishnan Sreemathy Amma

Advanced Spine Journal

Background Data: Anterior cervical discectomy and fusion (ACDF) is accepted as a standard surgical treatment for cervical spondylotic myelopathy (CSM). The options for instrumentation in fusion include standalone cage (SC) and conventional cage and plate (CCP). However, there is no clear consensus regarding the superiority of the technique.Purpose: To compare the radiologic and clinical outcomes between SC and CCP in ACDF for the treatment of CSM.Study Design: Ambispective clinical case study.Patients and Methods: The patients who underwent ACDF for CSM using SC or CCP between January 2014 and December 2018 were included in the study. Forty-six patients out of 230 …

Long-Term Outcomes After Four-Level Cervical Arthrodesis With Stand-Alone Peek Cage Versus Peek Cage With Anterior Plating: A Retrospective Multicenter Comparative Study, Walid Abouzeid, Momen Almamoun, Tamer Niazy, Mohamed Abdel Tawab

Advanced Spine Journal

Abstract Background Data: Anterior cervical discectomy and fusion (ACDF) is a gold-standard option for treating cervical degenerative disc diseases (DDD). Anterior plating enhances stabilization with improved outcomes and reduced risk of pseudarthrosis yet with annoying morbidities. Fusion with stand-alone cages avoids such complications, although its use in multilevel disc arthrodesis is still controversial. Study Design: Retrospective multicenter comparative cohort study. Purpose: To evaluate clinical and radiological long-term outcomes after ACDF with stand-alone polyetheretherketone (PEEK) cages versus ACDF with cages and plating. Patients and Methods: Patients who underwent four-level stand-alone ACDF (Group 1) or ACDF with plating (Group 2) between July …

Clinical Outcome Assessment Following Open Reduction And Instrumented Posterior Interbody Fusion Of Adult Single-Level Lumbar Spondylolisthesis, Essam Youssef, Ahmed Rizk, Mohamed Yahia

Advanced Spine Journal

Background Data: Posterior lumbar decompression combined with instrumented posterior lumbar interbody fusion (PLIF) is the gold standard management of adult spondylolisthesis. Complete anatomic surgical reduction of slippage, although controversial, is associated with encouraging results. Purpose: This study aims to assess the clinical outcome of complete open surgical reduction and instrumented PLIF in adult single-level lumbar spondylolisthesis. Study design: Retrospective clinical case study. Patients and Methods: Retrospective review of standing data and radiographs of adult patients with single-level lumbar spondylolisthesis (regardless of the aetiology) from January 2018 to January 2020. All patients have undergone posterior lumbar decompression, pedicle screw instrumentation, complete …

Lumbar Facet Joint Cyst Caused By Calcium Pyrophosphate Arthropathy Of The Spine: Case_Report And Review Of Literature, Mahmoud Alkharsawi, Heinrich Boehm, Mootaz Shousha, Mohamed Alhashash

Advanced Spine Journal

Background Data: Calcium pyrophosphate dihydrate (CPPD) deposition disease is a metabolic disorder caused by the deposition of CPPD crystals in the articular or periarticular structures that leads to inflammation of the joints. Spine affection is rare. Purpose: To present a rare case of lumbar facet joint cyst caused by calcium pyrophosphate arthropathy. Study Design: A case_report with a brief review of the literature. Patient and Methods: Seventy-three-year-old man, who underwent PLIF L5/S1 ten years ago, presented with right L4 nerve root compression symptoms that have started two months ago. Clinical examination revealed no motor function disturbance but hypoesthesia in the …

Multiple-Level Low-Grade Lumbar Spondylolisthesis: Instrumented Posterolateral Fusion Using A Local Bone Graft, Elsayed Said, Mohamed Abdel-Wanis, Mohamed Ameen, Hamdy Tammam

Advanced Spine Journal

Background Data: Lumbar spondylolisthesis is a major cause of back pain. It occurs most commonly at only one spinal level. Multiple-level lumbar spondylolisthesis is uncommon, with few reports available in the literature. It can be treated by instrumented posterolateral fusion (PLF) using iliac crest bone graft (ICBG) with possible reported donor site complications. A reasonable alternative is local bone graft obtained from the laminae and spinous processes harvested during neural decompression. Purpose: To evaluate the outcome of multiple-level spondylolisthesis treated by PLF using a local bone graft. Study Design: Prospective clinical case series. Patients and Methods: Eleven patients (6 males …

Transforaminal Endoscopic Discectomy Versus Microdiscectomy For Treatment Of Lumbar Disc Herniation And Associated Unilateral Sciatica: A Comparative Study, Ayman Ismail, Ihab Mohamed Hosny, Esam Daoud

Advanced Spine Journal

Abstract Background Data: Recently, transforaminal endoscopic discectomy (TED) has become accepted as a safe alternative procedure for microdiscectomy (MID) in lumbar disc surgery. Numerous studies compared microdiscectomy with interlaminar endoscopic discectomy; however, the number of studies comparing MID with TED is relatively limited. Purpose: To compare TED and MID in treating lower lumbar disc prolapse (LDP) and associated unilateral sciatica in terms of overall outcome, complications, and rate of recurrence. Study Design: Retrospective clinical case series. Patients and Methods: This retrospective study included one hundred patients with low back pain and unilateral sciatica due to lower lumbar herniated discs. They …

Recurrence Of Backache Following Discectomy: An Analysis Of Management., Shyamasunder Bhat, Sourab Shetty, Nishanth Ampar

Advanced Spine Journal

Abstract Background Data: Intervertebral disc prolapse, being one of the most common spine problems in the industrialized world, has a lot of medical, social, legal, and economic implications following the recurrence of pain following surgery. Due to variability in the causes of the pain generators, it is hard to devise a definitive treatment plan. However, the threshold for conservative and surgical management needs to be understood. Purpose: The study was conducted to find out the causes for recurrence of backache following lumbar discectomy and to evaluate the effect of conservative management. The number of patients requiring a second surgery, the …

Spinal Involvement In Adult Patients With Sickle Cell Disease, Mohamed Nagy, Doaa Nabil

Advanced Spine Journal

Background Data: Sickle cell disease (SCD) is the most common inherited blood disease that has obvious effects on the osteoarticular system and the spine. Despite Although vaso-occlusive crises and osteomyelitis are the most frequent complications requiring hospitalization for patients with SCD, the spinal involvement in adult patients with SCD has not been fully explored. Study Design: Retrospective clinical case series. Purpose: To elaborate on various types of spinal affection in adults with SCD and to discuss the effectiveness of conservative management in these patients. Patients and Methods: Between January 2018 and December 2019, a retrospective study was conducted on 21 …

Dynamic Cervical Implants (Dci) Versus Anterior Cervical Discectomy And Fusion (Acdf) In Single-Level Cervical Disc Disease (Cdd): Clinical And Radiographic Outcome, Mahmoud Wahdan, Ramy Taema, Moataz Elawady,

Advanced Spine Journal

Background Data: In spite of being successful, anterior cervical discectomy and fusion ACDF has some complications, among them, pseudoarthrosis, implant failure, and adjacent level disease. Dynamic Cervical Implants (DCI) are motion-preserving implants started to take part in treating cervical spondylotic disease with promising results. Purpose: To compare the clinical and radiographic outcomes of ACDF versus DCI in patients with degenerativecervical radiculo- and/or myelopathy. Study Design: A prospective randomized controlled study. Patients and Methods: Forty patients with cervical spondylotic radiculo- and/or myelopathy were recruited for this study. They were 21 males and 19 females with mean age of 45±8.9 years. They …

Endoscopic Fenestration In Management Of Monosegmental Degenerative Lumbar Spinal Canal Stenosis: A Clinical Cohort Study, Mohamed Hussein, Amr Eladawy, Tarek El-Hewala

Advanced Spine Journal

Background Data: Minimally invasive fenestration has evolved recently to become the modern standard surgical solution for degenerative lumbar spinal canal stenosis (DLCS).Purpose: To investigate the safety and the efficacy of the endoscopic fenestration for patients with monosegmental degenerative lumbar spinal canal stenosis.Study Design: Prospective clinical cohort study.Patients and Methods: Thirty-five consecutive patients with DLCS were treated with endoscopic fenestration. Patients were treated with METRx system (Medtronic Sofamor Danek, Inc., Memphis, TN, USA), at Orthopedic Department, Zagazig University, between May 2012 and June 2015. Primary outcomes parameters included Numerical Rating Scale (NRS) for back and leg symptoms and Oswestry Disability Index …

The Effect Of Fusion Added To Lumbar Discectomy In Patients With Modic Changes: A Retrospective Comparative Outcome Analysis Regarding Back Pain Control, Ahmad Elayouty, Walid Abdel Ghany

Advanced Spine Journal

Background Data: In 1988, Modic et al first described magnetic resonance (MR) degenerative changes in the lumbar vertebral bodies. changes in the intervertebral endplates, Modic Changes (MC) can also be incriminated in the production of such pain due to the mechanical failure and structural changes that can be detected the most in the region of the highly pain sensitive intervertebral endplates. There is still a controversy regarding the surgical treatment of the predominantly axial pain secondary to degenerative lumbar disc disease.Study Design: This is a retrospective cohort study.Purpose: To evaluate the effect of adding fusion to simple discectomy in treatment …

Posterolateral Fusion Versus Transforaminal Lumbar Interbody Fusion In The Surgical Treatment Of Low-Grade Isthmic Spondylolisthesis, Ashraf Farid, Ahmed Elkholy

Advanced Spine Journal

Background Data: Surgical treatment of isthmic spondylolisthesis includes decompression, fixation and bone fusion. There are different suitable techniques for fusion as (PLF) posterolateral fusion (TLIF) transforaminal lumbar interbody fusion, (PLIF) posterior lumbar interbody fusion, (ALIF) anterior lumbar interbody fusion but still controversy remains about the best technique.Purpose: To evaluate and compare the surgical results of PLF versus TLIF with pedicle screw fixation in treatment of low-grade isthmic spondylolisthesis.Study design: A prospective randomized clinical case series.Patients and methods: This study included 40 patients with low grade isthmic spondylolisthesis. All patients were surgically treated by posterior decompression, transpedicular screw fixation and bone …

Does Cervical Plate Add Value In Single Or Double Level Anterior Cervical Discectomy And Fusion?, Tariq Elemam, Salem Faisel, Moawad El-Adawy

Advanced Spine Journal

Background Data: Optimal surgical approach for anterior cervical discectomy and fusion (ACDF) is still controversial. Some authors believe that addition of locking plate (ACDFP) has higher costs and longer operative time. Other surgeons believe that ACDFP have better clinical outcomes and more sound fusion. The debate is higher in single and doublelevel ACDF.Purpose: To compare the clinical and radiological outcomes in patients with single or double level cervical disc herniation operated by ACDF versus those operated by ACDFP. Study Design: A retrospective, descriptive controlled, non-randomized, clinical case study. Patients and Methods: Forty patients underwent ACDF. They were divided into twogroups; …

Reperforming Minimally Invasive Microdiscectomy Approaches For Recurrent Lumbar Intervertebral Disc Prolapse, Waeel Hamouda

Advanced Spine Journal

Background Data: Reperforming minimally invasive discectomy (MID) approaches are typically challenging and demanding for patients with recurrent lumbar disc herniation (rLDH).Purpose: The aim of this study to assess the safety and efficacy of reperforming Minimally invasive discectomy in recurrent lumbar disc herniation surgery.Study Design: Retrospective clinical case study.Patients and Methods: The author reviewed the medical records all patients re-operated after MID during the period from June 2010 to April 2016 via minimally invasive approaches for recurrent lumbar disc herniation. Age, gender, presenting symptoms, disc herniation level and side, type of MID approach used in first surgery, period between 1st and …

Instrumented Posterolateral Spinal Arthrodesis As An Effective Treatment For Single Level Symptomatic Vacuum Lumbar Disc Degeneration In Elderly Patients, Waeel Hamouda

Advanced Spine Journal

Background Data: Lumbar intervertebral disc vacuum phenomenon is an advanced form of spinal destabilizing degenerative changes. It is common in the elderly population and can cause refractory low back pain.Purpose: To evaluate the efficacy and safety of instrumented posterolateral fusion in treating symptomatic lumbar single level vacuum phenomenon in elderly population.Study Design: Retrospective descriptive clinical case series.Patients and Methods: Twenty-one patients (16 males & 5 females), aging more than 65 years, had all their files reviewed. They were operated by instrumented posterolateral fusion to treat chronic refractory low back pain due to single level intervertebral lumbar disc vacuum phenomenon. They …

Posterior Cervical Keyhole Foraminotomy In Treatment Of Cervical Radiculopathy Following Anterior Cervical Discectomy And Fusion, Hazem Negm, Mohammad Shadad

Advanced Spine Journal

Background Data: Cervical radiculopathy after prior anterior cervical discectomy may result from residual compression after the first surgery or development of new compression at the same level or an adjacent level. Treatment for recurrent or residual symptoms can involve conservative measures or surgery. The anterior approach may be used with ease for the treatment of fresh level disc disease although it may be difficult in recurrent or residual situations.Purpose: To describe the surgical outcome of posterior keyhole foraminotomy with or without discectomy for treatment of cervical radiculopathy following anterior cervical discectomy and fusion (ACDF).Study Design: Retrospectively analysis of a prospectively …

Oblique Cervical Corpectomy In The Management Of Unilateral Multilevel Spondylotic Radiculopathy Associated With Myelopathy, Omar Ragab, Hamdy Nabawi, Osama Elfahl, Mohamed Elmaghraby

Advanced Spine Journal

Background Data: Oblique cervical corpectomy involves direct decompression of the spinal cord as well as the ipsilateral nerve root but does not require bone fusion or postoperative immobilization. This approach preserves the motion unit anatomically and decreases the risk of adjacent segment disease.Purpose: is to assess the indications, safety, efficacy and complications of oblique cervical corpectomy in the management of unilateral cervical spondylotic radiculopathy associated with myelopathy.Study Design: A prospective clinical case study.Patients and Methods: This study conducted on twelve patients with unilateral cervical spondylotic radiculopathy associated with myelopathy refractory to non-surgical measures for at least 6 months in the …

Therapeutic Interventional Procedures Following Failed Back Surgery; Is It Worth It?, Ayman Galhom, Mohammad Al-Shatouri

Advanced Spine Journal

Background Data: Treatment of failed back surgery syndrome (FBSS) is challenging to any spine surgeon or pain specialist. Purpose: The study aims to evaluate pain and functional outcome in response to lumbar spine interventional procedures in failed back. Study Design: Prospective non-randomized clinical case study. Patients and methods: Between Jan 2013 to Jan 2016, 35 patients with FBSS were included. Every patient was subjected to history taking, physicalexamination, and diagnostic imaging. Patients received a fluoroscopy guided lumbar spine procedures according to the failed back cause. A visual analog scale (VAS) for pain intensity, and Oswestry Disability index (ODI) were completed …

Ligamentum Flavum Cyst In The Lumbar Spine: A Case_Report, Tarek Abotakia, Ahmad Allam, Wae Koptan

Advanced Spine Journal

Background Data: Ligamentum flavum cysts have rarely been reported, it is believed to be a result of degenerative process. Complete excision of the cyst leads to excellent results. Ligamentum flavum cysts have rarely been reported worldwide and never published as an Egyptian case. Purpose: To report a case of ligamentum flavum cysts in the lumbar spine. Study Design: case_report. Patients and Methods: We reported a case of ligamentum flavum cyst atthe level of L4-5 in a 45 year old Egyptian woman, meticulous complete excision of the cyst without any durotomy or CSF leakage. Histopathological examination reported myxoid degeneration of the …

Bilateral Lumbar Facet Screw Fixation And Posterior Lumbar Interbody Fusion In Lumbar Disc Prolapse, Wael Moussa, Wael Khedr

Advanced Spine Journal

Background Data: Lumbar disc prolapse is a common neurosurgical diagnosis. A trial of medical treatment, bed rest and physiotherapy is tried at first. Surgical treatment is resorted to if conservative treatment fails. However, postoperative complications including recurrent lumbar disc prolapse, postlaminectomy spondylolisthesis and failed back syndromecan occur. This is usually caused by instability at the discectomy level. In a trial to reduce these complications, we will use posterior lumbar interbody fusion together with bilateral facet screw fixation implanted during discectomy to reduce postoperative instability. Purpose: To study the effect of posterior lumbar interbody fusion with bilateral facet screw fixation to …

Spontaneous Resorption Of Intervertebral Disc Herniation: A Series Of 7 Patients, Abdel Aal Abdel Baky, Mohamed Emara

Advanced Spine Journal

Background Data: With advancement of MRI technology, numerous studies have showed probability of spontaneous regression of the herniated disc. This is usually associated with recovery of neurological symptoms. Purpose: The purpose of this study is to highlight the potential for spontaneous resorption of intervertebral disc herniation, review the literature and discuss the duration of conservative treatment. Study Design: Retrospective clinical case study. Patients and Methods: In this study patients with spontaneous regression of intervertebral disc herniation were reviewed. All patients were presented with a single level intervertebral disc herniation and radiculopathy. Six patients had lumber disc herniation and one patient …

Motion Characteristics Of The Vertebral Segments With Lumber Degenerative Spondylolisthesis In Elderly Patients, Hany El-Nemr, Hossam Ibrahim

Advanced Spine Journal

Background Data: Spondylolisthesis refers to the forward displacement of one vertebra relative to another. Whether degenerative spondylolisthesis (DS) leads to instability was controversial in the literature. DS was conventionally considered to be instable but some papers have reported that there was no evidence that the range of motions (ROMs) of the vertebrae with DS were increased compared with normal vertebrae. Purpose: The aim of the work was to study motor characteristics of the vertebral segments with lumber degenerative spondylolisthesis in elderly patients aftersurgical management. Study Design: This is a prospective study. Patients and Methods: Thirty patients (age more than 55 …

Multi-Level Acdf Using Standalone Peek Cages For The Treatment Of Degenerative Cervical Myelopathy: Clinical And Radiological Assessment., Yasser Allam, Tarek Al-Feki

Advanced Spine Journal

Background Data: Degenerative cervical myelopathy is a complex neurologic disorder that usually develops insidiously, although abrupt deterioration in function can occur. The natural history of cervical myelopathy is highly variable,with some patients having progressive disability, whereas others have a mild course. The treatment of cervical myelopathy may be conservative or surgical, depending on the severity of symptoms at initial examination.Purpose: The aim of this work is to assess the clinical improvement as well as the bony fusion in patients with cervical myelopathy treated by multi-level ACDF using stand-alone PEEK cages.Study design: clinical_studyPatients and Methods: The material of this study consisted …

Early Outcome Of Sciatica After Redo Surgeries For Recurrent Lumbar Disc Herniation, Hazem Alkosha, Ashraf Zidan

Advanced Spine Journal

Background Data: Result of redo discectomies varies widely in the literature. This may be due to variability in inclusion criteria and associated pathologies which may alter results. We tried to evaluate the early outcome of recurrent sciatica after redo discectomies in highly selected cases and risk factors for poor outcome. Purpose: to assess the rate of success of redo lumbar discectomy in patients with recurrent sciatica. Study Design: A retrospective clinical case studyPatients and Methods: A retrospective study including 30 cases with recurrent sciatica caused by true recurrent disc herniation over a period of 8 years. Clinical and radiological data …

Reduction Of Lumbar Spondylolisthesis, Surgical Technique And Clinical Outcome., Mohamed Eshra

Advanced Spine Journal

Background Data: Reduction of the slipped vertebrae as a part of surgical approach is now attempted. In the current literature, the studies have paid attention to the surgical reduction of the slippage or in situ spinal fixationtechnique. These studies have a lack of comparison between these variable techniques. Purpose: To define the role and benefits of reduction and stabilization of lumbar spondylolisthesis. Study Design: A retrospective clinical case study.Patients and Methods: 24 patients with low grade isthmic lumbar spondylolisthesis between January 2008 and June 2010 were enrolled for this study. Patients were treated by slip reduction, interbody fusion with or …

Posterior Lumbar Interbody Fusion (Plif) Augmented With Pedicle Screw Fixation Versus Plif Augmented With Percutaneous Pedicle Screw Fixation In Low Grade Lumbar Spondylolisthesis, Esam Elkhatib,

Advanced Spine Journal

Background Data: The optimal treatment for patients with Spondylolisthesis has been the subject of many recent studies which provide some of the best evidence for lumbar spinal fusion. Purpose: Compare the clinical and radiological outcome of treating low grade lumbar spondylolisthesis patients with PLIF augmented with PSF versus those treated with PLIF augmented with Percutaneous PSF. Study Design: This is a prospective comparative clinical case study.Patients and Methods: Seventeen patients with low grade spondylolisthesis who underwent instrumented fixation were retrospectively analyzed from the period of 2011 to 2012. A PLIF and PSF (Group A) was performed in 9 patients, andPLIF …

Adjacent Segment Degeneration (Asd) Following Lumber Arthrodesis; Risk Factors And Management., Mohammed Eshra

Advanced Spine Journal

Background Data: Spinal bony fusion is considered to be a good method for treating deformity, trauma, and degenerative lesions. Fusion rates have a good outcome due to improvements in instrumented fixation and bone graft sources. In contrast, numerous complications of fusion surgery may occur and are considered as the predisposing factors for clinical failure after instrumented lumbar fusion. Adjacent segment disease after lumbar spine fusion has been found to occur nowadays with a variable incidence. The risk factors for ASD have not been precisely documented.Purpose: To identify the possible risk factors responsible for adjacent segment affection following lumbosacral fixation and …

Clinical Improvement After Spontaneous Partial Or Complete Absorption 0f Herniated Lumbar Disc., Alaa Abdelraouf, Ahmed Yehya, Mohamed Eshra

Advanced Spine Journal

Background Data: Intervertebral disc herniation is a common disease that usually occurs in middle aged active persons. It presents by back pain and involved nerve root radiculopathy. Some neurologic symptoms in the majority of patients improve after a period of conservative therapy due to regression in the size of the herniated disc. The exact mechanism of disc regression is not yet clear, however clinical improvement and MRI follow up can document this condition.Study Design: Retrospective clinical case review. Purpose: To assess the clinical improvement of patients with herniated lumbar disc if it occurred by the conservative treatment due to partial …