Spine
-
Case report of a 49-year-old woman with a lower thoracic disc herniation mimicking acute lumbosacral radiculopathy. ⋯ A case of thoracic disc herniation mimicking an acute lumbosacral radiculopathy is presented. Compression of the lumbosacral spinal nerve roots at the lower thoracic level after exit from the lumbar enlargement may be the mechanism for this unusual presentation.
-
The primary biomechanical stability of anterior internal fixation of the cervical spine obtained with a new monocortical expansion screw in vitro was evaluated. ⋯ In anterior instrumentation of the cervical spine using a H-plate, the new monocortical expansion screw provides the same biomechanical stability as the bicortical 3.5-mm AO screw and a significantly better biomechanical stability than the cervical spine locking plate. Therefore, the expansion screw may be an alternative to the bicortical fixation and does not involve the risk of penetration of the posterior vertebral body cortex.
-
Comparative Study
Hemodilution as a method to reduce transfusion requirements in adolescent spine fusion surgery.
A case-control study. ⋯ Hemodilution was safely used as a method to satisfy the perioperative transfusion requirements of adolescents undergoing extensive spinal surgery. By allowing patients to arrive at surgery with a higher preoperative hemoglobin and hematocrit, and by decreasing the quantity of predonated autologous blood-collected and therefore used, the hemodilution method may indirectly decrease the quantity of postoperative autologous transfusions in this population. Cell saver was not shown to be effective, and its selective use is recommended.
-
A lateral radiographic analysis of the cervical spine was performed on 20 asymptomatic volunteers. ⋯ A greater range of motion at Occ-C1 and C1-C2 was found for the protruded and retracted positions compared with the full-length flexion and full-length extension positions. Effects on cervical symptoms reported to occur in response to flexion, extension, protrusion, and retraction test movements may correspond with the position of lower cervical segments.
-
Multicenter Study Comparative Study Clinical Trial
Comparison of anterior and posterior instrumentation for correction of adolescent thoracic idiopathic scoliosis.
This was a prospective study of two cohort groups of patients (one group receiving anterior instrumentation and the other posterior instrumentation) receiving treatment for thoracic idiopathic scoliosis. ⋯ 1) Coronal correction and balance were equal in both the anterior and posterior groups, even though the anterior group had the majority of curves (97%) fused short or to L1, whereas only 18% were fused short or to L1 in the posterior group. 2) In the anterior group there was a better correction of sagittal profile in those with a preoperative hypokyphosis less than 20 degrees. However, hyperkyphosis (with a mean of 54 degrees) occurred in 40% of those in the anterior group with a preoperative kyphosis of more than 20 degrees. 3) An average of 2.5 lumbar levels can be saved with anterior fusion and instrumentation according to the criteria used for choosing posterior fusion levels in this study. 4) Using the 3.2-mm flexible rod in this study, loss of correction, pseudarthrosis, and rod breakage were unacceptably highe