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  • Anderson, Paul A.  (16)
  • Resnick, Daniel K.  (16)
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  • 1
    Online Resource
    Online Resource
    Cervical laminoplasty for the treatment of cervical degenerative myelopathy
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2009
    In:  Journal of Neurosurgery: Spine Vol. 11, No. 2 ( 2009-08), p. 157-169
    Details
    In: Journal of Neurosurgery: Spine, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 11, No. 2 ( 2009-08), p. 157-169
    Abstract: The objective of this systematic review was to use evidence-based medicine to examine the efficacy of cervical laminoplasty in the treatment of cervical spondylotic myelopathy (CSM). Methods The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to cervical laminoplasty and CSM. Abstracts were reviewed and studies meeting the inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I–III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons and Congress of Neurological Surgeons. Results Cervical laminoplasty has improved functional outcome in the setting of CSM or ossification of the posterior longitudinal ligament. Using the Japanese Orthopaedic Association scale score, ~ 55–60% average recovery rate has been observed (Class III). The functional improvement observed after laminoplasty may be limited by duration of symptoms, severity of stenosis, severity of myelopathy, and poorly controlled diabetes as negative risk factors (Class II). There is conflicting evidence regarding age, with 1 study citing it as a negative risk factor, and another not demonstrating this result. Conclusions Cervical laminoplasty is recommended for the treatment of CSM or ossification of the posterior longitudinal ligament (Class III).
    Type of Medium: Online Resource
    ISSN: 1547-5654
    URL: Article
    DOI: 10.3171/2009.1.SPINE08726
    RVK:
    XA 55270.1
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2009
    Location Call Number Limitation Availability
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Indications for anterior cervical decompression for the treatment of cervical degenerative radiculopathy
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2009
    In:  Journal of Neurosurgery: Spine Vol. 11, No. 2 ( 2009-08), p. 174-182
    Details
    In: Journal of Neurosurgery: Spine, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 11, No. 2 ( 2009-08), p. 174-182
    Abstract: The objective of this systematic review was to use evidence-based medicine to identify the indications and utility of anterior cervical nerve root decompression. Methods The National Library of Medicine and Cochrane Database were queried using MeSH headings and key words relevant to surgical management of cervical radiculopathy. Abstracts were reviewed after which studies meeting inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I–III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results Anterior nerve root decompression via anterior cervical discectomy (ACD) with or without fusion for radiculopathy is associated with rapid relief (3–4 months) of arm/neck pain, weakness, and/or sensory loss compared with physical therapy (PT) or cervical collar immobilization. Anterior cervical discectomy and ACD with fusion (ACDF) are associated with longer term (12 months) improvement in certain motor functions compared to PT. Other rapid gains observed after anterior decompression (diminished pain, improved sensation, and improved strength in certain muscle groups) are also maintained over the course of 12 months. However, comparable clinical improvements with PT or cervical immobilization therapy are also present in these clinical modalities (Class I). Conflicting evidence exists as to the efficacy of anterior cervical foraminotomy with reported success rates of 52–99% but recurrent symptoms as high as 30% (Class III). Conclusions Anterior cervical discectomy, ACDF, and anterior cervical foraminotomy may improve cervical radicular symptoms. With regard to ACD and ACDF compared to PT or cervical immobilization, more rapid relief (within 3–4 months) may be seen with ACD or ACDF with maintenance of gains over the course of 12 months (Class I). Anterior cervical foraminotomy is associated with improvement in clinical function but the quality of data are weaker (Class III), and there is a wide range of efficacy (52–99%).
    Type of Medium: Online Resource
    ISSN: 1547-5654
    URL: Article
    DOI: 10.3171/2009.3.SPINE08720
    RVK:
    XA 55270.1
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2009
    Location Call Number Limitation Availability
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    Online Resource
  • 3
    Online Resource
    Online Resource
    Management of anterior cervical pseudarthrosis
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2009
    In:  Journal of Neurosurgery: Spine Vol. 11, No. 2 ( 2009-08), p. 228-237
    Details
    In: Journal of Neurosurgery: Spine, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 11, No. 2 ( 2009-08), p. 228-237
    Abstract: The objective of this systematic review was to use evidence-based medicine to identify the best methodology for diagnosis and treatment of anterior pseudarthrosis. Methods The National Library of Medicine and Cochrane Database were queried using MeSH headings and key words relevant to pseudarthrosis and cervical spine surgery. Abstracts were reviewed, after which studies meeting inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I–III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results Evaluation for pseudarthrosis is warranted, as there may be an association between clinical outcome and pseudarthrosis. The strength of this association cannot be accurately determined because of the variable incidence of symptomatic and asymptomatic pseudarthroses (Class III). Revision of a symptomatic pseudarthrosis may be considered because arthrodesis is associated with improved clinical outcome (Class III). Both posterior and anterior approaches have proven successful for surgical correction of an anterior pseudarthrosis. Posterior approaches may be associated with higher fusion rates following repair of an anterior pseudarthrosis (Class III). Conclusions If suspected, pseudarthrosis should be investigated because there may be an association between arthrodesis and outcome. However, the strength of this association cannot be accurately determined. Anterior and posterior approaches have been successful.
    Type of Medium: Online Resource
    ISSN: 1547-5654
    URL: Article
    DOI: 10.3171/2009.2.SPINE08729
    RVK:
    XA 55270.1
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2009
    Location Call Number Limitation Availability
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    Online Resource
  • 4
    Online Resource
    Online Resource
    Cervical surgical techniques for the treatment of cervical spondylotic myelopathy
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2009
    In:  Journal of Neurosurgery: Spine Vol. 11, No. 2 ( 2009-08), p. 130-141
    Details
    In: Journal of Neurosurgery: Spine, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 11, No. 2 ( 2009-08), p. 130-141
    Abstract: The objective of this systematic review was to use evidence-based medicine to compare the efficacy of different surgical techniques for the treatment of cervical spondylotic myelopathy (CSM). Methods The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to anterior and posterior cervical spine surgery and CSM. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I–III). The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results A variety of techniques have improved functional outcome after surgical treatment for CSM, including anterior cervical discectomy with fusion (ACDF), anterior cervical corpectomy with fusion (ACCF), laminoplasty, laminectomy, and laminectomy with fusion (Class III). Anterior cervical discectomy with fusion and ACCF appear to yield similar results in multilevel spine decompression for lesions at the disc level. The use of anterior plating allows for equivalent fusion rates between these techniques (Class III). If anterior fixation is not used, ACCF may provide a higher fusion rate than multilevel ACDF but also a higher graft failure rate than multilevel ACDF (Class III). Anterior cervical discectomy with fusion, ACCF, laminectomy, laminoplasty, and laminectomy with arthrodesis all provide near-term functional improvement for CSM. However, laminectomy is associated with late deterioration compared with the other types of anterior and posterior surgeries (Class III). Conclusions Multiple approaches exist with similar near-term improvements; however, laminectomy appears to have a late deterioration rate that may need to be considered when appropriate.
    Type of Medium: Online Resource
    ISSN: 1547-5654
    URL: Article
    DOI: 10.3171/2009.3.SPINE08728
    RVK:
    XA 55270.1
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2009
    Location Call Number Limitation Availability
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    Online Resource
  • 5
    Online Resource
    Online Resource
    Laminectomy and fusion for the treatment of cervical degenerative myelopathy
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2009
    In:  Journal of Neurosurgery: Spine Vol. 11, No. 2 ( 2009-08), p. 150-156
    Details
    In: Journal of Neurosurgery: Spine, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 11, No. 2 ( 2009-08), p. 150-156
    Abstract: The objective of this systematic review was to use evidence-based medicine to examine the efficacy of cervical laminectomy and fusion for the treatment of cervical spondylotic myelopathy (CSM). Methods The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to cervical laminectomy, fusion, and CSM. Abstracts were reviewed, after which studies that met the inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Class I–III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations which contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer-review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results Cervical laminectomy with fusion (arthrodesis) improves functional outcome in patients with CSM and ossification of the posterior longitudinal ligament (OPLL). Functional improvement is similar to laminectomy or laminoplasty for patients with CSM and OPLL. In contrast to laminectomy, cervical laminectomy with fusion it is not associated with late deformity (Class III). Conclusions Laminectomy with fusion (arthrodesis) is an effective strategy to improve functional outcome in CSM and OPLL.
    Type of Medium: Online Resource
    ISSN: 1547-5654
    URL: Article
    DOI: 10.3171/2009.2.SPINE08727
    RVK:
    XA 55270.1
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2009
    Location Call Number Limitation Availability
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    Online Resource
  • 6
    Online Resource
    Online Resource
    Clinical prognostic indicators of surgical outcome in cervical spondylotic myelopathy
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2009
    In:  Journal of Neurosurgery: Spine Vol. 11, No. 2 ( 2009-08), p. 112-118
    Details
    In: Journal of Neurosurgery: Spine, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 11, No. 2 ( 2009-08), p. 112-118
    Abstract: The objective of this systematic review was to use evidence-based medicine to assess whether clinical factors predict surgical outcomes in patients undergoing cervical surgery. Methods The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to clinical preoperative factors. Abstracts were reviewed, and studies that met the inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I–III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results Preoperative sensory-evoked potentials may aid in providing prognostic information in selected patients in whom clinical factors do not provide clear guidance (Class II). Age, duration of symptoms, and preoperative neurological function may commonly affect outcome (Class III). Conclusions Age, duration of symptoms, and preoperative neurological function should be discussed with patients when surgical intervention for cervical spondylotic myelopathy is considered. Preoperative sensory-evoked potentials may be considered for patients in whom clinical factors do not provide clear guidance if such information would potentially change therapeutic decisions.
    Type of Medium: Online Resource
    ISSN: 1547-5654
    URL: Article
    DOI: 10.3171/2009.1.SPINE08718
    RVK:
    XA 55270.1
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2009
    Location Call Number Limitation Availability
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    Online Resource
  • 7
    Online Resource
    Online Resource
    Introduction and methodology: guidelines for the surgical management of cervical degenerative disease
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2009
    In:  Journal of Neurosurgery: Spine Vol. 11, No. 2 ( 2009-08), p. 101-103
    Details
    In: Journal of Neurosurgery: Spine, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 11, No. 2 ( 2009-08), p. 101-103
    Abstract: In March 2006, the Joint Section on Disorders of the Spine and Peripheral Nerves of the American Association of Neurological Surgeons and Congress of Neurological Surgeons compiled an expert group to perform an evidence-based review of the clinical literature on management of cervical degenerative spine disease. This process culminated in the formation of the Guidelines for the Surgical Management of Cervical Degenerative Disease . The purpose of the Guidelines was to address questions regarding the therapy, diagnosis, and prognosis of cervical degenerative disease using an evidence-based approach. Development of an evidence-based review and recommendations is a multitiered process. Typical guideline development consists of 5 processes: 1) collection and selection of the evidence; 2) assessment of the quality and strength of the evidence; 3) analysis of the evidentiary data; 4) formulation of recommendations; and 5) guideline validation. This manuscript details the methodology in compiling the Guidelines for the Surgical Management of Cervical Degenerative Disease .
    Type of Medium: Online Resource
    ISSN: 1547-5654
    URL: Article
    DOI: 10.3171/2009.1.SPINE08712
    RVK:
    XA 55270.1
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2009
    Location Call Number Limitation Availability
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    Online Resource
  • 8
    Online Resource
    Online Resource
    Radiographic assessment of cervical subaxial fusion
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2009
    In:  Journal of Neurosurgery: Spine Vol. 11, No. 2 ( 2009-08), p. 221-227
    Details
    In: Journal of Neurosurgery: Spine, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 11, No. 2 ( 2009-08), p. 221-227
    Abstract: The objective of this systematic review was to use evidence-based medicine to identify the best methodology for radiographic assessment of cervical subaxial fusion. Methods The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to cervical fusion. Abstracts were reviewed and studies meeting inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I–III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results Pseudarthrosis is best assessed through the absence of motion detected between the spinous processes on dynamic radiographs (Class II). The measurement of interspinous distance on dynamic radiographs of ≥ 2 mm is a more reliable indicator for pseudarthrosis than angular motion of 2° based on Cobb angle measurements (Class II). Similarly, it is also understood that the pseudarthrosis rate will increase as the threshold for allowable motion on dynamic radiographs decreases. The combination of interspinous distance measurements and identification of bone trabeculation is unreliable when performed by the treating surgeon (Class II). Identification of bone trabeculation on static radiographs should be considered a less reliable indicator of cervical arthrodesis than dynamic films (Class III). Conclusions Consideration should be given to dynamic radiographs and interspinous distance when assessing for pseudarthrosis.
    Type of Medium: Online Resource
    ISSN: 1547-5654
    URL: Article
    DOI: 10.3171/2009.3.SPINE08719
    RVK:
    XA 55270.1
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2009
    Location Call Number Limitation Availability
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    Online Resource
  • 9
    Online Resource
    Online Resource
    Electrophysiological monitoring during surgery for cervical degenerative myelopathy and radiculopathy
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2009
    In:  Journal of Neurosurgery: Spine Vol. 11, No. 2 ( 2009-08), p. 245-252
    Details
    In: Journal of Neurosurgery: Spine, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 11, No. 2 ( 2009-08), p. 245-252
    Abstract: The objective of this systematic review was to use evidence-based medicine to examine the diagnostic and therapeutic utility of intraoperative electrophysiological (EP) monitoring in the surgical treatment of cervical degenerative disease. Methods The National Library of Medicine and Cochrane Database were queried using MeSH headings and key words relevant to cervical spine surgery and EP monitoring. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I–III). The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results The reliance on changes in EP monitoring as an indication to alter a surgical plan or administer steroids has not been observed to reduce the incidence of neurological injury during routine surgery for cervical spondylotic myelopathy or cervical radiculopathy (Class III). However, there is an absence of study data examining the benefit of altering a surgical plan due to EP changes. Conclusions Although the use of EP monitoring may serve as a sensitive means to diagnose potential neurological injury during anterior spinal surgery for cervical spondylotic myelopathy, the practitioner must understand that intraoperative EP worsening is not specific—it may not represent clinical worsening and its recognition does not necessarily prevent neurological injury, nor does it result in improved outcome (Class II). Intraoperative improvement in EP parameters/indices does not appear to forecast outcome with reliability (conflicting Class I data).
    Type of Medium: Online Resource
    ISSN: 1547-5654
    URL: Article
    DOI: 10.3171/2009.2.SPINE08730
    RVK:
    XA 55270.1
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2009
    Location Call Number Limitation Availability
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    Online Resource
  • 10
    Online Resource
    Online Resource
    Functional outcomes assessment for cervical degenerative disease
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2009
    In:  Journal of Neurosurgery: Spine Vol. 11, No. 2 ( 2009-08), p. 238-244
    Details
    In: Journal of Neurosurgery: Spine, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 11, No. 2 ( 2009-08), p. 238-244
    Abstract: The objective of this systematic review was to use evidence-based medicine to identify valid, reliable, and responsive measures of functional outcome after treatment for cervical degenerative disease. Methods The National Library of Medicine and Cochrane Database were queried using MeSH headings and key words relevant to functional outcomes. Abstracts were reviewed after which studies meeting inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I–III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results Myelopathy Disability Index, Japanese Orthopaedic Association scale, 36-Item Short Form Health Survey, and gait analysis were found to be valid and reliable measures (Class II) for assessing cervical spondylotic myelopathy. The Patient-Specific Functional Scale, the North American Spine Society scale, and the Neck Disability Index were found to be reliable, valid, and responsive (Class II) for assessing radiculopathy for nonoperative therapy. The Cervical Spine Outcomes Questionnaire was a reliable and valid method (Class II) to assess operative therapy for cervical radiculopathy. Conclusions Several functional outcome measures are available to assess cervical spondylotic myelopathy and cervical radiculopathy.
    Type of Medium: Online Resource
    ISSN: 1547-5654
    URL: Article
    DOI: 10.3171/2009.2.SPINE08715
    RVK:
    XA 55270.1
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2009
    Location Call Number Limitation Availability
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    Online Resource
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