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Robert F. Heary, Paul A. Anderson and Paul M. Arnold

performed from anterior, posterior, and combined anterior-posterior approaches. Since the treatment of lumbar spinal stenosis has increasingly involved older patients, with their frequent medical comorbidities, strategies that limit approach-related morbidity, through the use of minimally invasive approaches, have enabled surgical treatment to include elderly individuals who might not have been considered candidates for surgical intervention in the past. Furthermore, some patients who have a combination of stenosis and spinal deformity or scoliosis are able to undergo

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Paul A. Anderson, Paul G. Matz, Michael W. Groff, Robert F. Heary, Langston T. Holly, Michael G. Kaiser, Praveen V. Mummaneni, Timothy C. Ryken, Tanvir F. Choudhri, Edward J. Vresilovic and Daniel K. Resnick

improved 1 grade, 5 two grades, & 8 ≥ three grades. 2 patients had plate failure. III Good neurological outcomes. No radio-graphic analysis. Miyazaki et al., 1989 46 patients w/ myelopathy from CSM & OPLL w/ instability or deformity. Outcome assessed w/ radiography & JOA scale. Mean FU 53 mos (range 12–118 mos). Used French door technique w/ onlay bone graft. JOA score improved 89%. >5 points in 46%, 3–4 points in 13%, & 1–2 points in 30%. Radiographic stability achieved in only 80% & 1 case worsening. Kyphosis increased 40%. Fusion occurred in 65%. No

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Timothy C. Ryken, Robert F. Heary, Paul G. Matz, Paul A. Anderson, Michael W. Groff, Langston T. Holly, Michael G. Kaiser, Praveen V. Mummaneni, Tanvir F. Choudhri, Edward J. Vresilovic and Daniel K. Resnick

radiographs. Hamanishi & Tanaka, 1996 69 patients, 34 judged unstable combined w/ fusion. JOA scale used, mean FU 3.5 yrs. III Results:  No fusion: 50.8% improvement.  Fusion: 51.2% improvement (p = NS). Authors concluded that wide laminectomy w/ or w/o posterolateral fusion is a simple operation that can be recommended. Ishida et al., 1989 Retrospective comparison: laminectomy (55); laminoplasty (55). Evaluation of postop radiographs JOA assessment. Mean FU 61 mos. III Laminectomy: 13 of 55 (24%) developed kyphotic deformity. Overall JOA

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Paul G. Matz, Paul A. Anderson, Michael W. Groff, Robert F. Heary, Langston T. Holly, Michael G. Kaiser, Praveen V. Mummaneni, Timothy C. Ryken, Tanvir F. Choudhri, Edward J. Vresilovic and Daniel K. Resnick

timing of surgery. Rationale The purpose of this review is to examine questions regarding the efficacy of laminoplasty using an evidence-based approach. Cervical laminoplasty was described in the 1970s as an alternative to laminectomy in patients with myelopathy. 10 The impetus for laminoplasty was the desire to decompress long segments while avoiding postlaminectomy membrane formation and/or kyphotic deformity. 10 The authors of multiple reports have demonstrated that laminoplasty increases canal diameter. 23 , 28 However, this increase in canal diameter

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Michael G. Kaiser, Praveen V. Mummaneni, Paul G. Matz, Paul A. Anderson, Michael W. Groff, Robert F. Heary, Langston T. Holly, Timothy C. Ryken, Tanvir F. Choudhri, Edward J. Vresilovic and Daniel K. Resnick

pseudarthrosis. 11 , 24 , 25 Complaints associated with a cervical nonunion include persistent or recurrent axial neck pain, radiculopathy, and myelopathy. Development of a pseudarthrosis has also been associated with kyphotic deformity, potentially leading to pain and neurological deficits. Search Criteria We completed a computerized search of the database of the National Library of Medicine and the Cochrane database between 1966 and 2007 using the MeSH search terms “cervical pseudo-arthrosis,” “cervical spine AND fusion failure,” and “cervical spine AND revision

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Praveen V. Mummaneni, Michael G. Kaiser, Paul G. Matz, Paul A. Anderson, Michael W. Groff, Robert F. Heary, Langston T. Holly, Timothy C. Ryken, Tanvir F. Choudhri, Edward J. Vresilovic and Daniel K. Resnick

association of laminectomy with late deformity, laminoplasty should be considered when stability is an issue over time (quality of evidence, Class III; strength of recommendation, D). Technique: Laminectomy Versus Laminectomy/Arthrodesis There is insufficient evidence to recommend laminectomy with arthrodesis over laminectomy because both approaches have produced comparable improvement in the surgical treatment of CSM in the near term; however, because of the association of laminectomy with late deformity, laminectomy with arthrodesis should be considered when

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Paul G. Matz, Timothy C. Ryken, Michael W. Groff, Edward J. Vresilovic, Paul A. Anderson, Robert F. Heary, Langston T. Holly, Michael G. Kaiser, Praveen V. Mummaneni, Tanvir F. Choudhri and Daniel K. Resnick

.03). Complication rates were higher after ACDF (6 vs 1.3%; p < 0.0001). 15 Several studies have examined the incidence of deformity and graft collapse after plating. Zoëga et al. 41 reported on 27 patients (ACDFI in 15 and ACDF in 12) randomized with sealed envelopes. The authors assessed outcome using RSA with tantalum markers and confirmed external reliability. The study used the VAS for clinical outcomes, and no clinical differences were detected. However, kyphosis developed in the ACDF group on RSA at 1 year postoperatively (p < 0.04). At 2 years, the difference in degree

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written permission from JNSPG. 2017 Introduction: Thoracolumbar burst fractures (TLBF) in neurologically intact patients can be treated non-operatively with an orthosis. This study aims to determine the radiological predictors of progressive kyphosis after TLBF in patients managed with a thoracolumbarsacral orthosis and to correlate clinical outcomes with severity and progression of kyphotic deformity. Methods: We retrospectively identified patients who during 2008–2012 sustained a thoracolumbar burst fractures and managed non-operatively using an