Spine
-
A retrospective review involving 307 consecutive cases of lumbar disc herniation managed by posterolateral endoscopic discectomy was conducted. ⋯ The surgical outcome of posterolateral endoscopic discectomy for lumbar disc herniation is comparable with that for the traditional open transcanal microdiscectomy. Intracanal and extracanal herniations, reherniations, and incidental lateral recess stenosis can be addressed by the same approach.
-
A case of combined odontoid and Jefferson fracture is reported. ⋯ This is only the second reported case of a child with a combined Jefferson and odontoid fracture. This diagnosis should be considered in the evaluation of a child with neck pain and torticollis from a fall on the top of the head.
-
A systematic review was conducted for studies of any design. ⋯ Reviewed studies indicate promising results from dorsal root entry zone lesioning for the treatment of central neuropathic pain in selected patients with traumatic spinal cord injury. However, the strength of the evidence provided by the studies was poor in terms of study design, outcome measures, reports on the severity of adverse effects, patient selection criteria, and patient description. For these reasons, the evidence is weak for the use of dorsal root entry zone lesioning to relieve central neuropathic pain in patients with traumatic spinal cord injury.
-
A 12-week bovine survival study of tethering anterior spine growth that included untethered control subjects. ⋯ Anterolateral tethering of the spine creates kyphosis and scoliosis in this rapidly growing bovine model. The spinal tether limited motion primarily in lateral flexion. However, total lateral bending motion returned to levels comparable with control motion segments after removal of the tether. This method of spine growth modulation may provide a possible treatment for the correction of spine deformities without arthrodesis in patients who are skeletally immature. The exact mechanisms of growth modulation and the effects of tethering on disc function and integrity are unknown and deserve further study.
-
Comparative Study
Biomechanical analysis of anterior scoliosis instrumentation: differences between single and dual rod systems with and without interbody structural support.
Nondestructive biomechanical testing was performed on bovine lumbar spines instrumented with multilevel scoliosis type anterior spine constructs. ⋯ Dual rod constructs were stiffer in torsion and flexion-extension loading than single rod constructs. Neither the number of rods nor the use of structural mesh interbody support had any effect on lateral bending stiffness. However, in a single rod system, the addition of interbody support increased stiffness in flexion. The use of structural support in dual rod constructs may be helpful in "setting" the desired lordosis, but adds little to construct stiffness.