Spine
-
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.
-
This study correlates the mRNA and protein levels of large and small proteoglycans with the morphologic grade of degeneration. ⋯ Cells of the anulus fibrosus and nucleus pulposus react to tissue degeneration differently. Decreased mRNA expression by nucleus pulposus cells and declining protein content of the matrix make the nucleus more vulnerable to degeneration than the anulus. The cells in the anulus fibrosus respond to early degeneration by upregulating biosynthetic processes. However, in heavily degenerated tissues, the decline in the synthesis of aggrecan and the increase in the concentrations of small proteoglycans may be responsible for the failure of the repair processes.
-
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.
-
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.
-
A case of a perirectal urinoma from a ureteral injury incurred during spinal surgery is reported. ⋯ Although ureteral injury after abdominal surgery is not so uncommon, it is very rarely incurred during spinal surgery. Because symptoms are usually nonspecific, the radiologist should be aware of this possible complication, and should perform CT with intravenous contrast material and with delayed scans because a rapid-sequence helical CT may not yet show opacification of the fluid present in the abdomen. This is the hallmark of the diagnosis.