Spine
-
Normal and spondylolytic pediatric spine movements with reference to instantaneous axis of rotation.
A radiologic study of lumbar kinematics in the pediatric spine was conducted. ⋯ The instantaneous axis of rotation deviated cranially as the stage of pars defects advanced, and as the wedge deformity increased. Kinematic alteration of the lumbar spine in pediatric patients with spondylolysis may affect chondrocytes of the endplate, perhaps contributing to the consequent spine deformities occurring secondarily to spondylolysis.
-
A useful modification of the Kerrison rongeur is reported. ⋯ The design of the chip collector fully met the expectations for the modification: no clogging of resected bone material, easy clinical use, and shorter operating times. The modified rongeur, available in two lengths (190 and 290 mm) and three sizes of the chip collector (diameter of 4, 6, and 8 mm) proved to be useful in clinical applications.
-
Comparative Study Clinical Trial
The reliability of the Shuttle Walking Test, the Swiss Spinal Stenosis Questionnaire, the Oxford Spinal Stenosis Score, and the Oswestry Disability Index in the assessment of patients with lumbar spinal stenosis.
The Shuttle Walking Test (SWT), the Swiss Spinal Stenosis (SSS) Questionnaire, the Oxford Claudication Score (OCS), and the Oswestry Disability Index (ODI) were administered to patients with lumbar spinal stenosis and neurogenic claudication. ⋯ Fluctuations in a patient's symptoms result in wide individual confidence intervals. Performance on the SSS, OCS, and ODI questionnaires are broadly similar, the most precise being the condition-specific SSS. The SWT gives a snapshot of physical function, which is acceptable for group analysis. Use of the SWT for individual assessment after surgery is feasible.
-
The essence of congenital vertebral displacement Type A pathology is a congenital structure defect including a vertebral or intervertebral disc with instant curvature of the spinal canal in the sagittal plane. Clinically this defect assumes the shape of kyphosis or kyphoscoliosis. A retrospective review of 11 patients with this congenital deformity was conducted. ⋯ The findings showed that only extensive vertebrectomy and anterior stabilization using a cylindric cage or fibula graft combined in one operative procedure, preceded or followed by posterior fusion, ensures patients against progression of neurologic deficits and deformity of spine.
-
A retrospective study of blood transfusion practices after posterior lumbar spine surgery was performed. ⋯ Autologous blood donations are indeed advantageous in decreasing allogeneic blood usage of patients undergoing fusion, but additional methods of blood conservation (intraoperative salvage and preoperative erythropoietin) seem necessary to diminish the allogeneic blood requirements further, especially in those patients undergoing instrumented lumbar fusion.