Journal of spinal disorders & techniques
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J Spinal Disord Tech · Apr 2004
Long-term clinical manifestations of retained bullet fragments within the intervertebral disk space.
A retrospective review of 12 patients who were victims of penetrating trauma with a bullet or bullet fragments lodged within the intervertebral disk space was conducted. The objective of the review was to evaluate the potential systemic effects of lead resorption at long-term follow-up. Literature regarding the potential for lead toxicity due to retained bullet fragments within the intervertebral disk space is lacking. ⋯ The patient subsequently underwent a partial laminectomy and diskectomy with excision of the bullet fragments. The patient's complaints, specific for plumbism, resolved 2 months postoperatively. We conclude that patients with retained lead-based bullet fragments in the intervertebral disk should be educated about the rare potential for plumbism due to partial bullet fragment resorption and that long-term observation for this disorder is recommended.
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J Spinal Disord Tech · Apr 2004
Case ReportsPosterior C2 fixation using bilateral, crossing C2 laminar screws: case series and technical note.
Rigid screw fixation of the axis, for either atlantoaxial fixation or for incorporation of C2 into subaxial cervical constructs, provides significant stability and excellent long-term fusion results but remains technically demanding due to the danger of injury to the vertebral artery. Anatomic variability of the foramen transversarium in the body of the axis can preclude safe transarticular C1-C2 screw placement in up to 20% of patients. Although more recent methods of C2 screw fixation with pedicle screws allow safer fixation in a higher number of patients, there remains a significant risk to the vertebral artery with C2 pedicle screw placement. ⋯ This technique has been successfully used by the author in cases of craniocervical and atlantoaxial fixation as well as for incorporation of C2 into subaxial fixations. The technique is illustrated, and the author's initial experience in treating 10 patients with crossing, bilateral C2 aminar screws for indications of trauma, neoplasm, pseudarthrosis, and degenerative disease is reviewed. The possible advantages of C2 fixation with C2 laminar screws are discussed.
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J Spinal Disord Tech · Feb 2004
Clinical TrialAn interspinous process distractor (X STOP) for lumbar spinal stenosis in elderly patients: preliminary experiences in 10 consecutive cases.
Lumbar spinal stenosis (LSS) is often a position-dependent condition that is aggravated in extension and relieved in flexion. ⋯ This new surgical method is effective in elderly LSS patients.
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J Spinal Disord Tech · Feb 2004
Radiologic stability of titanium mesh cages for anterior spinal reconstruction following thoracolumbar corpectomy.
This work evaluated the radiologic stability of titanium mesh cages (TMCs) when used for single-level corpectomy reconstruction of thoracic and thoracolumbar spine. ⋯ This report suggests that TMCs are a sound reconstruction alternative after thoracic and thoracolumbar corpectomy at a single level and may prevent complications associated with the harvest and use of large structural autografts for these reconstructions. Failure to correctly align the spine so the cage can be vertically placed is a contraindication to the use of TMCs.
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J Spinal Disord Tech · Feb 2004
Correlation between backpack weight and way of carrying, sagittal and frontal spinal curvatures, athletic activity, and dorsal and low back pain in schoolchildren and adolescents.
This cross-sectional study was carried out to investigate any correlation between backpack carrying, spinal curvatures, and athletic activities on schoolchildren's dorsal (DP) and low back pain (LBP). Three thousand four hundred forty-one students aged from 9 to 15 years who carried backpacks to school were included in this study and asked for DP and LBP experiences in the school period while carrying the backpack. Nonradiating methods (surface back contour analysis) were used to indirectly measure frontal spinal curve (scoliosis) with the scoliometer and lateral curves (thoracic kyphosis and lumbar lordosis) with the kyphometer. ⋯ The peak in pain prevalence was immediately before puberty as well as immediately after its onset. Girls who participated in sports activities seem to experience more often DP and LBP than boys. Short children who carry backpacks as heavy as do tall children at the same age are more prone to LBP.