Spine
-
Comparative Study
Radiographic assessment of segmental motion at the atlantoaxial junction in the Klippel-Feil patient.
A retrospective review of 33 consecutive Klippel-Feil syndrome (KFS) patients at a single institution. ⋯ Hypermobility of the atlantoaxial junction, as indicated by increased AADI on flexion-extension radiographs, is not necessarily associated with an increased risk for the development of symptoms or neurologic signs in the KFS patient. Occipitalization plays an integral role in the degree of motion at the atlantoaxial region. Greatest AADI values were in patients with occipitalization and a fused C2-C3 segment. The presence of symptoms was not related to the degree of AADI change. Evaluation of the PADI provides additional information for identifying patients at risk for developing symptoms. Nonetheless, KFS patients remain largely asymptomatic.
-
A retrospective analysis of patients who had magnetic resonance imaging (MRI) of the thoracic spine, comparing those with a normal straight spine and those with a right thoracic adolescent idiopathic scoliosis (AIS). ⋯ It is important to understand the relationship of the rib head to the vertebral body to provide-excellent screw purchase within the vertebral body without risking penetration into the spinal canal. In both normal and AIS groups, the relationship of the rib head to the vertebral body and spinal canal changes so that the rib head is positioned more anteriorly in the cephalad-thoracic spine and more posteriorly in the caudal thoracic spine. When placing anterior thoracic screws, at the cephalad- thoracic spine (T4, T5, T6, and T7), removal of rib heads is recommended to allow for good screw purchase. However, at the caudal thoracic spine (T10-T12), staying anterior to the rib head is important to avoid penetration into the spinal canal.
-
A retrospective chart and radiographic review of patients with a Fontan physiology who underwent surgical correction of their scoliosis. ⋯ Operative treatment of scoliosis in these patients may be successful; however, complications are frequent and significant.
-
Review Meta Analysis
School-based interventions for spinal pain: a systematic review.
Systematic review. ⋯ The poor quality of the reviewed studies limits the conclusions that can be made regarding the effectiveness of school-based spinal health interventions.