Neurosurgery

biomechanics of the cervical fixation device are somewhat limited; hence, fixation failure is more likely to occur in the presence of kyphosis.

In order to achieve reduction and attempt to re-establish cervical lordosis, the involved motion segments of the spine have to be mobile. The relative mobility of the deformity varies from patient to patient. Some are fixed deformities and others are mobile. Mobilization must be effected prior to correction of the deformity. Typically, the deformity occurs across the interspaces. Achieving mobility between adjacent vertebrae by diskectomies, facetectomies or osteotomies is carried out in order to effect mobilization. Application of axial force reestablishes a normal spinal alignment. The presence of osteophyte that is inaccessible to decompression along the lateral aspect of the vertebral bodies and the facet joints may sometimes limit reduction. The loss of anterior vertebral body height can also contribute to kyphosis. Resection of the trapezoidal-shaped vertebrae and reconstruction with a rectangular bone graft can treat this component of the deformity.

The need to perform a fusion in the setting of cervical spondylosis depends upon the nature of the spondylotic disease, patient factors and the extent and type of surgery required for decompression. The general indications for fusion surgery for spondylosis include deformity correction, treatment of instability or the presence of axial or mechanical neck pain. The presence of instability or neurological deficit caused by abnormal spinal movement is a clear indication to proceed with fusion surgery. Criteria to determine whether or not axial or mechanical pain should be treated by fusion surgery are much less clear and are controversial. The ability to localize the site of the pain generator and the severity of the pain and the associated disability are factors which determine the need and feasibility of segmental fusion for pain. Since the outcome of such surgery is somewhat unpredictable, this form of therapy should be considered only if the patient fails non-operative treatment and is quite limited by the pain. Also, segmental fusion likely predisposes to premature degeneration of the adjacent motion segments, which could result in a pain syndrome or neurological deficits in the future. Therefore, the decision to operate for axial pain must be made carefully.

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Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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