Journal of spinal disorders & techniques
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J Spinal Disord Tech · Feb 2005
Structures at risk following anterior instrumented spinal fusion for thoracic adolescent idiopathic scoliosis.
With the increasing popularity of anterior instrumented spinal fusion for adolescent idiopathic scoliosis, there has also been a rising concern over the proximity of the descending aorta to the screw tips and the possibility of vessel wall erosion over time. This computed tomography (CT) study attempts to define the relative position of the thoracic aorta and other vital structures to the spine (preoperatively) and to the projected instrumentation (postoperatively) by level and curve magnitude in deformity patients. ⋯ The course of the thoracic aorta may vary in individuals; however, in deformity patients, it generally moves from a relatively anterolateral position proximally to a posteromedial position at the apex. Distally, it moves more anteriorly. Consequently, the aorta moves closer to the screw tips both at the apex and distally, whereas the distal screws are more frequently juxtaposed to the descending aorta (P < 0.05).
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The sacral perineural cyst was first described by Tarlov in 1938 as an incidental finding at autopsy. There are very few data in the literature regarding the role of Tarlov cysts in causing symptoms, however. Most studies report low numbers, and consequently, the recommendations for treatment are vague. Our aim, therefore, is to present further detail regarding the clinical relevance of Tarlov cysts and to identify whether or not they are a cause of lumbosacral spinal canal stenosis symptoms. ⋯ The majority of Tarlov cysts are incidental findings on MRI. Where confusion exists as to the clinical relevance of a Tarlov cyst, treatment of the primary pathology (ie, non-Tarlov lesion) is usually sufficient. Tarlov cysts may, however, be responsible for a patient's symptoms; possible mechanisms by which this may occur and treatment strategies are discussed.
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J Spinal Disord Tech · Feb 2005
Comparative StudyA cross-cultural comparison between Canada and Germany of symptom expectation for whiplash injury.
Symptom expectation for whiplash injury has been shown to be low in countries with low rates of chronic whiplash when compared with countries like Canada, where chronic whiplash is common. The objective of the current study is to compare the frequency and nature of expected "whiplash" symptoms in Germany with that in Canada. ⋯ In Germany, despite the documented occurrence of neck sprain symptoms in individuals following motor vehicle collisions, there is a very low rate of expectation of any sequelae from this injury. The current or previous aspects of society that underlie this remain uncertain. This lack of expectation of chronicity in Germany may, in part, determine the low prevalence of the chronic whiplash syndrome there. Further studies of symptom expectation as an etiologic factor in the chronic whiplash syndrome are needed.