Spine
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A retrospective study evaluating early halo immobilization of Types II and IIA hangman's fractures. ⋯ Early halo immobilization after traction reduction of Type II and IIA hangman's fractures is an effective method of management. Type II fractures with an angulation of greater than or equal to 12 degrees may require an extended period of traction to ensure adequate long-term fracture alignment.
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Comparative Study Clinical Trial
Endplate degeneration observed on magnetic resonance imaging of the lumbar spine: correlation with pain provocation and disc changes observed on computed tomography diskography.
One hundred and three lumbar intervertebral discs (L3/4-L5/S1) of 36 patients with low back pain were examined with computed tomography (CT) diskography and magnetic resonance imaging (MRI). ⋯ This study showed a stronger association between endplate degeneration and disc degeneration than between endplate degeneration and disc rupture. The results indicate that the contrast injection during diskography reflects mainly pain of discogenic origin, whereas the possible pain associated with endplate damage cannot be depicted by CT diskography.
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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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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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Case Reports
Polysegmental spondylodiscitis and concomitant aortic aneurysm rupture: case report with 3-year follow-up period.
A case report describing a patient with spondylodiscitis of the thoracic and lumbar spine complicated by rupture of an abdominal aortic aneurysm and aggravation of neurologic symptoms is presented. ⋯ In older patients, spondylodiscitis may be complicated by other underlying diseases. Pain and neurologic symptoms may occur secondarily to concomitant illnesses instead of being caused by the inflammation itself. Minimally invasive therapy is shown to be an effective alternative to surgery in older and multimorbid patients with spondylodiscitis and contained aortic aneurysm rupture.