What is the Real Rate of Radial Nerve Injury After Humeral Nonunion Surgery?
Location
LSUHSC-NO Lion's Building
Document Type
Presentation
Start Date
16-6-2018 9:20 AM
End Date
16-6-2018 9:30 AM
Publication Date
June 2018
Description
Introduction: The use of anterior plates has become standard in anterior cervical discectomy and fusion (ACDF) procedures. Previous biomechanical research has demonstrated no effect of plate positioning in the coronal plane on structural integrity. The aim of this study was to evaluate radiographic positioning of the anterior plate in the coronal plans and follow the clinical results utilizing a variety of parameters in a group of patients after ACDF.
Methods: 71 consecutive ACDF patients operated on by a single surgeon, for various pathologies consistent with accepted indications, were followed clinically utilizing a variety of outcome measures as well as via initial postoperative AP radiograph of the cervical spine. The post-operative angulation in the coronal plane was measured. Preoperative and postoperative outcomes data included: nerve distribution of radicular pain, Nu rick score, pain scale score, usage of narcotic pain medicine, and location/severity of any motor deficits. Follow up visits occurred at the 2, 6, and 12, and 52 week mark.
Results: Mean angulation of anterior plate on the AP radiograph was 2.657° (Range 0-9°). No significant relationship between plate angle and postoperative Nurick score when controlling for BMI, gender, and age (p=0.822). Also, there was no significant relationship to plate angle and the change in Nurick scores when the above controls were applied (p=0.238). No significant relationship between plate angle and pain scale, pain distribution, and motor deficit when the above control were applied (p values of 0.6734, 0.347, 0.0967). Utilizing odds ratios, the odds of using narcotics postoperatively as plate angle increased did not significantly differ from 1.
Conclusion: There seemingly is no demonstrable clinical effect of off-axis anterior cervical plates. This could cut down on surgical time spent on obtaining numerous xrays for plate alignment or intraoperative hardware removal due to mispositioning. Additionally immediate postoperative radiography man not be necessary.
Recommended Citation
Delarosa, Matthew MD, "What is the Real Rate of Radial Nerve Injury After Humeral Nonunion Surgery?" (2018). Dept. of Orthopaedics: Robert D. D’Ambrosia Lectureship & Research Day. 3.
https://digitalscholar.lsuhsc.edu/ortho_rd/2018/presentations/3
What is the Real Rate of Radial Nerve Injury After Humeral Nonunion Surgery?
LSUHSC-NO Lion's Building
Introduction: The use of anterior plates has become standard in anterior cervical discectomy and fusion (ACDF) procedures. Previous biomechanical research has demonstrated no effect of plate positioning in the coronal plane on structural integrity. The aim of this study was to evaluate radiographic positioning of the anterior plate in the coronal plans and follow the clinical results utilizing a variety of parameters in a group of patients after ACDF.
Methods: 71 consecutive ACDF patients operated on by a single surgeon, for various pathologies consistent with accepted indications, were followed clinically utilizing a variety of outcome measures as well as via initial postoperative AP radiograph of the cervical spine. The post-operative angulation in the coronal plane was measured. Preoperative and postoperative outcomes data included: nerve distribution of radicular pain, Nu rick score, pain scale score, usage of narcotic pain medicine, and location/severity of any motor deficits. Follow up visits occurred at the 2, 6, and 12, and 52 week mark.
Results: Mean angulation of anterior plate on the AP radiograph was 2.657° (Range 0-9°). No significant relationship between plate angle and postoperative Nurick score when controlling for BMI, gender, and age (p=0.822). Also, there was no significant relationship to plate angle and the change in Nurick scores when the above controls were applied (p=0.238). No significant relationship between plate angle and pain scale, pain distribution, and motor deficit when the above control were applied (p values of 0.6734, 0.347, 0.0967). Utilizing odds ratios, the odds of using narcotics postoperatively as plate angle increased did not significantly differ from 1.
Conclusion: There seemingly is no demonstrable clinical effect of off-axis anterior cervical plates. This could cut down on surgical time spent on obtaining numerous xrays for plate alignment or intraoperative hardware removal due to mispositioning. Additionally immediate postoperative radiography man not be necessary.