Spine
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Comparative Study
The effectiveness of various cervical orthoses. An in vivo comparison of the mechanical stability provided by several widely used models.
The amount of motion allowed by various cervical orthoses was compared with the amount of unrestricted neck motion in vivo. ⋯ Although cervical orthoses can be helpful for other reasons, they do not provide a high level of mechanical restriction of motion. Additionally, the restriction they do provide can vary widely between people. Prescribing physicians should consider the relative merits of the various orthoses before deciding whether they will meet a patient's needs. The differences between the collars tested may not be enough to justify one of the more expensive or less comfortable collars.
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The authors analyzed motor-evoked potentials using transcranial electrical cortical stimulation during spinal surgery in 40 patients under conditions of partial neuromuscular blockade. ⋯ The authors support the utility of recording transcranial electrical motor-evoked potentials in spinal surgery under partial neuromuscular blockade. Recovery of lost motor-evoked potentials was not associated with postoperative motor deficits, whereas non-recovery of lost motor-evoked potentials was.
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The present study evaluated the cervical nerve groove and intervertebral foramen using dried vertebrae and cadaveric cervical spine. ⋯ These data may enhance understanding of the important bony elements associated with the cervical spinal nerves and roots as they pass through the cervical nerve groove and the intervertebral foramen.
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The cervical spine of an 86-year-old man known to have a fracture of the odontoid process was removed at autopsy and dissected. ⋯ Both the fatal outcome and the pathologic examination showed that established management concepts, particularly screw fixation of a fractured odontoid process, should be reconsidered in light of the potential occurrence of transdental posterior rotary subluxation. Because the incidence of capsular, ligamentous, and vascular injuries associated with fractures of the odontoid process is still poorly understood, more autopsies would be needed. The case also raises the question of whether, in an elderly patient like ours, a fracture of the odontoid process should prompt immediate surgical stabilization.
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Sixty radiographs were measured on two separate occasions by three physicians using four different techniques to evaluate the reliability and reproducibility of the measurement of lumbar lordosis. ⋯ The measurement of lumbar lordosis is reproducible and reliable if the technique is specified and one accepts 10 degrees as acceptable variation. Factors that affect the reproducibility of measurement include end vertebra selection (especially with transitional segments) and vertebral endplate architecture.