Journal of spinal disorders & techniques
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Severe refractory coccydynia occasionally requires coccygectomy. Methods involved a retrospective chart review plus telephone follow-up of 15 patients who had coccygectomy. Pain was assessed by the numerical rating scale and function by Oswestry Low Back Disability Score. ⋯ Twelve patients would have the same surgery for the same result. Coccygectomy provides statistically and clinically significant improvement in patients with severe refractory sacrococcygeal joint pain. Many patients have other lumbar spine pathology.
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A retrospective study was performed on the operative results following osteoporotic burst fractures with neurologic compromise. We sought to investigate the results of operative decompression and stabilization in patients with neurologic deficit as a result of an osteoporotic burst fractures. We examined the postoperative radiographic outcomes, level of disability, functional outcomes, and complications. ⋯ Osteoporotic fractures are not benign. Careful evaluation for neurologic deterioration is warranted. Neurologic recovery occurred in six of the 10 patients; however, significant disability secondary to pain was common.
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J Spinal Disord Tech · Feb 2003
The sacroiliac joint: a potential cause of pain after lumbar fusion to the sacrum.
The sacroiliac joint (SIJ) can cause pain after lumbosacral fusion. Diagnosis requires >75% relief after local anesthetic SIJ injection. This study is a retrospective review of patients with low back pain after lumbosacral fusion who had SIJ injections. ⋯ Eight had posterior iliac crest bone harvested, and there was no correlation between donor side and pain side. In 34 patients with low back pain after lumbosacral fusion, SIJ was the cause of pain in 32% and possibly the cause in 29%. This is the first detailed description of this problem.
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J Spinal Disord Tech · Dec 2002
Lumbar disc herniation regression after successful epidural steroid injection.
In some lumbar disc herniation patients, noninvasive measures fail, necessitating more aggressive treatment, such as epidural steroid injections or surgery. This study sought to determine whether improvement in patients who receive epidural steroid injections is related to regression of herniated nucleus pulposus or whether such patients' symptoms decrease because of the steroid effect in the presence of continued herniated nucleus pulposus. Two nonoperatively treated patient cohorts were followed who had follow-up MRI. ⋯ The epidural steroid injection group had fewer sequestered or extruded herniations that resorbed, and most were of lower hydration. In conclusion, epidural steroid injections do not alter ultimate herniated nucleus pulposus regression. Patients in whom the disc herniation has less hydration may have prolonged symptoms, but many improve with epidural steroid injections.
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J Spinal Disord Tech · Dec 2002
Review Case ReportsEsophageal perforation after fracture of the cervical spine: case report and review of the literature.
We present a posttraumatic esophageal tear that occurred in a 55-year old patient after a truck accident. He sustained a two-level injury with a type II odontoid fracture and a unilateral fracture of the left superior articular process of C6 with an incomplete quadriplegia at C5. Both lesions were treated nonoperatively. ⋯ The diagnosis of the esophageal perforation was delayed for 6 days. The treatment consisted of surgical debridement, volume expansion, antibiotic therapy, hyperbaric oxygenation, assisted ventilation, and esophageal exclusion. A complete review of the literature was performed.