Spine
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Randomized Controlled Trial
Looking away from whiplash: effect of head rotation in rear impacts.
Twenty healthy volunteers in a laboratory were subjected to rear-end impacts 4.4, 7.9, 10.9, and 13.1 m/s acceleration, with head rotation to the right and left. ⋯ If the head is rotated out of neutral posture at the time of rear impact, the injury risk tends to be greater for the sternocleidomastoid muscle contralateral to the side of rotation. Measures to prevent whiplash injury may have to account for the asymmetric response because many victims of whiplash are expected to be looking to the left or right at the time of collision.
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Comparative Study
Standardized provocation of lumbar spine mobility: three methods compared by radiostereometric analysis.
By radiostereometric analysis (RSA), the intervertebral mobility was measured for the 3 most distal lumbar disc levels in 12 patients at 3 types of standardized provocation: changing body position from supine to standing, supine to standing with load, and supine to sitting. ⋯ The intervertebral mobility response provided in the lumbar spine when changing position from supine to sitting is more pronounced than both to standing and to standing with a 20 kg load. By the supine to sitting provocation, mean lumbar mobility is increased, and mobility can be revealed in some cases being stable in the other 2 situations. Combined with RSA, the method brings a refined possibility for studying lumbar spine kinematics.
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A case study of a patient with Ewing sarcoma of T8 and T9 with paravertebral and chest wall involvement, who underwent neoadjuvant chemotherapy and subsequent multilevel en bloc spondylectomy and chest wall excision using a simultaneous anterior and posterior approach. ⋯ Multilevel en bloc spondylectomy and chest wall excision performed using a simultaneous anterior and posterior approach is a safe and effective technique that may be used to achieve adequate margins in select patients with malignant tumors involving the thoracic spine and chest wall. This technique can eliminate the need for radiation therapy in patients with Ewing sarcoma and probably decreases the risk of local recurrence compared with radiation therapy alone.
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An original study was performed evaluating the information presented on existing web sites for the topic of lumbar disc herniation. ⋯ The quality of internet information on lumbar disc herniation is variable. Less than 10% of relevant web sites were determined to be of high-quality. The vast majority of sites were of poor informational value and more than one-third sought secondary commercialgain. The rank list of high quality sites generated from ourinformational quality score should prove useful to patients seeking information on the internet pertaining to lumbar disc herniation.
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A histological evaluation of biopsies obtained from presumed osteoporotic vertebral compression fractures (VCF) to confirm possible osteomalacia after tetracycline labeling. ⋯ The majority of biopsies from this series of patients revealed findings consistent with various stages of fracture healing. Osteoid seams were increased in 30 patients, representing either increased bone remodeling or osteomalacia. More cases with tetracycline labeling will help elucidate the true incidence of osteomalacia in this population. As we confirmed 4 cases of plasma cell dyscrasia, we advocate a biopsy during each first-time vertebral augmentation procedure.