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European Spine Journal

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01-06-2018 | Original Article

A novel posterior approach preserving three muscles inserted at C2 in multilevel cervical posterior decompression and fusion using C2 pedicle screws

Authors: Kazunari Takeuchi, Toru Yokoyama, Takuya Numasawa, Taito Itabashi, Yoshihito Yamasaki, Hitoshi Kudo

Published in: European Spine Journal | Issue 6/2018

Abstract

Purpose

To present a novel posterior approach in multilevel cervical posterior decompression and fusion (PDF) using C2 pedicle screws that preserves the rectus capitis posterior major, oblique capitis inferior, and semispinalis cervicis.

Methods

We analyzed 30 consecutive patients who underwent C2–T1 PDF using an approach that preserved these three muscles without resecting. We assessed O-C2 range of motion (ROM), cross-sectional area of the cervical posterior muscles, rotational ROM, visual analog scale (VAS) for axial pain, neck disability index (NDI), and limitations of activities of daily living (ADL) involving neck movements.

Results

Mean preoperative O-C2 ROM (23.6°) was significantly increased postoperatively (33.0°). Mean atrophy rate of the cross-sectional area was 3.9%. Postoperatively, 69.8% of the preoperative rotational ROM (113.3°) was retained. The preoperative VAS for axial pain and the NDI did not increase postoperatively. The postoperative O-C2 ROM (33.9°) in 26 patients for whom extension ADL were possible was significantly larger than that in four patients for whom extension ADL were impossible (26.9°). The postoperative retained rate of rotational ROM (75.8%) in 18 patients for whom rotation ADL were possible was significantly larger than that in 12 patients for whom rotation ADL were impossible (62.3%).

Conclusions

This is potentially an effective approach for maintaining O-C2 ROM and rotational ROM, which enabled good levels of ADL after C2–T1 PDF. Axial pain and NDI were not worse after PDF.

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Title: A novel posterior approach preserving three muscles inserted at C2 in multilevel cervical posterior decompression and fusion using C2 pedicle screws
Authors: Kazunari Takeuchi
Toru Yokoyama
Takuya Numasawa
Taito Itabashi
Yoshihito Yamasaki
Hitoshi Kudo
Publication date: 01-06-2018
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 6/2018
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-017-5402-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A novel posterior approach preserving three muscles inserted at C2 in multilevel cervical posterior decompression and fusion using C2 pedicle screws

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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