Spine
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Retrospective patient identification and prospective data collection were performed. ⋯ Anterior cervical diskectomy and fusion appears to be quite effective for discogenic cervical headache, but should be reserved for patients who are extremely impaired and refractory to all other treatments.
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A case of a perirectal urinoma from a ureteral injury incurred during spinal surgery is reported. ⋯ Although ureteral injury after abdominal surgery is not so uncommon, it is very rarely incurred during spinal surgery. Because symptoms are usually nonspecific, the radiologist should be aware of this possible complication, and should perform CT with intravenous contrast material and with delayed scans because a rapid-sequence helical CT may not yet show opacification of the fluid present in the abdomen. This is the hallmark of the diagnosis.
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The case of a 14-year-old boy who sustained simultaneous fractures of every cervical vertebra in a high-energy snowmobile accident is reported. ⋯ This case report is the first to describe a patient of any age who sustained simultaneous fractures of every cervical vertebra. Treatment with a halo vest was successful in protecting the cervical spine until healing was complete.
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Comparative Study Clinical Trial Controlled Clinical Trial
Feasibility of ultrasound examination in posterior ligament complex injury of thoracolumbar spine fracture.
A prospective study of 12 patients with thoracolumbar spinal fractures was conducted. ⋯ This study demonstrated the excellent diagnostic ability of ultrasound to detect the status of the supraspinous and interspinous ligaments, especially in patients who undergo surgery. Although ultrasound examination appears to be less sensitive than MRI in predicting ligament status, the cost effectiveness of ultrasound and its use as an alternative to MRI in special situations (i.e., patients with pacemaker, ferromagnetic implant, or severe claustrophobia) should be emphasized. More clinical data concerning the sensitivity, specificity, and accuracy of ultrasound examination should be addressed in future studies.
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A retrospective radiographic study was conducted to analyze 50 consecutive adolescents with thoracolumbar-lumbar scoliosis treated with single solid-rod anterior instrumentation and either rib strut or morsellized interbody bone grafting technique. ⋯ Although the rib strut grafting technique improves the pseudarthrosis rate, as compared with morsellized graft, it did not affect the maintenance of correction or sagittal alignment. Adjunctive measures to provide truly structural interbody support (fusion cages, allograft rings, two-rod construct) appear to be required to address the shortcomings of anterior single-rod instrumentation.