Spine
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To establish the diagnosis of dural penetration on preoperative computed tomographic studies of the cervical spine in patients with ossification of the posterior longitudinal ligament (OPLL). ⋯ The double-layer computed tomographic sign is more pathognomonic for dural penetration than the single-layer sign. The smooth-layer sign, indicating a clean dural plane, is more typical in North American patients.
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A retrospective clinical study was performed. ⋯ Because of the disappointing results from this study, the authors cannot recommend the additional transpedicular cancellous bone grafting as an interbody fusion technique after posterior stabilization in cases of complete or incomplete burst injury to the vertebral body.
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A biomechanical study was designed to assess relative rigidity provided by anterior, posterior, or combined cervical fixation using cadaveric cervical spine models for flexion-distraction injury and burst fracture. ⋯ This study showed that the posterior plating with interbody grafting is biomechanically superior to anterior plating with locked fixation screws for stabilizing the one-level flexion-distraction injury or burst injury. More rigid postoperative external orthoses should be considered if the anterior plating is used alone for the treatment of unstable cervical injuries. It was also found that combined anterior and posterior fixation may not improve the stability significantly as compared with posterior grafting with lateral mass screws and interbody grafting.
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Forty-one cases of aneurysmal bone cyst of the mobile spine were retrospectively reviewed. ⋯ If confirmed on larger series, selective arterial embolization seems to be the first treatment option for spine aneurysmal bone cyst, because of the low cost-to-benefit ratio. Diagnosis must be certain, based on pathognomonic radiographic pattern or on histologic study.- In case of neurologic involvement, pathologic fracture, technical impossibility of performing embolization, or local recurrence after at least two embolization procedures, complete intralesional excision would be the therapy of choice.
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Repeated measures for intratester reliability were performed. ⋯ Inclinometer and lumbar rotameter measurements with the use of a pelvic restraint device are reliable for measuring lumbar spine range of motion. Use of the inclinometer technique to record lumbar lordosis also is a reliable measure.