Journal of spinal disorders & techniques
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Acute traumatic L5-S1 spondylolisthesis is a rare condition, almost exclusively the result of major trauma, frequently associated with L5 transverse process fracture and neurologic deficit. In recent years, open reduction and internal fixation with posterior stabilization has been the method of treatment most frequently reported. In the current case, the lesion was found in a victim of an automobile accident. ⋯ A computed tomography scan revealed several fractures in the posterior parts of L5 and anterior displacement of L5 on S1. A magnetic resonance imaging (MRI) scan verified that the lesion was indeed acute by showing the ruptured L5 disc and posterior ligaments, thereby demonstrating the importance of MRI in the planning of the treatment of these lesions. This case was successfully treated with an acute circumferential instrumented L4-S1 spondylodesis.
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J Spinal Disord Tech · Oct 2003
Comparative StudyComparison of motion restriction and trunk stiffness provided by three thoracolumbosacral orthoses (TLSOs).
The amounts of thoracic and lumbar spine motion restriction and passive trunk stiffness provided by three thoracolumbosacral orthoses (TLSOs) (Aspen TLSO, Boston Body Jacket, and CAMP TLSO) were compared. Ten subjects executed maximum trunk flexion, extension, and lateral bending motions. ⋯ The subjects also did not perceive any difference in the restriction of motion but rated the Aspen TLSO significantly more comfortable than the other two orthoses. The rigid custom orthosis design may not be important for restricting the spine motion and providing passive trunk stiffness, or there may be other measures that reflect better the function of orthoses.
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J Spinal Disord Tech · Oct 2003
Radiographic analysis of transforaminal lumbar interbody fusion for the treatment of adult isthmic spondylolisthesis.
The radiographs of 35 consecutive adult patients with isthmic spondylolisthesis who underwent a transforaminal lumbar interbody fusion (TLIF) with one or two Brantigan carbon fiber cages and pedicle screw instrumentation were evaluated. Anterolisthesis, disk space height, and slip angle were measured in preoperative and postoperative standing neutral radiographs. ⋯ The restoration of lordosis across the listhetic disk space correlated with a more anterior placement of the interbody cage within the disk space. The TLIF technique, performed with the Brantigan cage and pedicle screw instrumentation, appears to be able to restore disk height and reduce forward translation in patients with isthmic spondylolisthesis, but improvement in sagittal alignment is dependent upon anterior placement of the interbody device.
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J Spinal Disord Tech · Oct 2003
Multicenter Study Clinical TrialPosterior lumbar interbody fusion for degenerative disc disease using a minimally invasive B-twin expandable spinal spacer: a multicenter study.
Acquired degenerative disc disease causes gradual disc space collapse, concurrent discogenic or facet-induced pain, and possible compression radiculopathy. Surgical treatment aims to re-expand the intervertebral space and stabilize the involved segment in balanced alignment until fusion is complete. The prevailing methods make use of a twin cage device of predetermined size. ⋯ Disc space height that averaged 7.53 +/- 2.42 mm before surgery increased to 10.03 +/- 2.00 mm at the time of surgery and stabilized at 9.47 +/- 2.10 mm upon final follow-up. Visual Analog Scale and Oswestry Index decreased by 60% and 58%, respectively. PLIF using the ESS achieves the same ultimate outcome as do other methods currently in use but does not share the handicaps and hazards and is more user-friendly to the surgeon.
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J Spinal Disord Tech · Oct 2003
Clinical TrialProspective study evaluating total disc replacement: preliminary results.
For many years, there has been an interest in disc replacements. There are a few retrospective studies from Europe reporting promising results for these devices. The purpose of this study is to review the preliminary results of the SB Charité disc replacement device in a prospective study. ⋯ This study found that significant improvements were achieved by the 6-week postoperative visit in the pain and disability scores following disc replacement surgery. Significant improvement was maintained through the 12-month follow-up visit. Although these preliminary results are encouraging, long-term follow-up and a greater number of patients are needed to further evaluate the outcome of these devices.