Spine
-
First published report of a child with an aneurysmal bone cyst (ABC) of the first cervical vertebrae treated successfully with intralesional injection of calcitonin and methylprednisolone. ⋯ Percutaneous intralesional injection of an ABC of the first cervical vertebrae with calcitonin and methylprednisolone in a child via CT guidance was a safe and effective treatment. This is a promising treatment for surgically inaccessible aneurysmal bone cysts.
-
Magnetic resonance imaging of symptomatic herniated lumbar discs was investigated longitudinally and prospectively for the presence of tear in the posterior longitudinal ligament (PLL). ⋯ Transligamentous extension of herniated disc materials through the ruptured PLL is more important to its reduction in size than is the initial size of the herniated disc. Decrease in herniation ratio of more than 20% seems to correspond to successful clinical outcome.
-
Case Reports
Atlantoaxial rotatory subluxation in patients with Marfan syndrome. A report of three cases.
This is a retrospective case series of three patients, ages 9 1/2, 13, and 20 years old, with Marfan syndrome treated for atlantoaxial rotatory subluxation. In the first two cases, acute torticollis was noted postoperatively, following pectus excavatum repair. The diagnosis was made in the third patient after she presented to the emergency room with a week-long history of unresolved neck pain following minor trauma. ⋯ The cervical bony and ligamentous abnormalities seen in patients with Marfan syndrome may slightly increase their risk for atlantoaxial rotatory instability. Special attention to intubation and positioning, both intraoperatively and postoperatively, may be necessary in patients with Marfan syndrome. Additionally, rotatory subluxation should be included in the differential diagnosis for Marfan patients with neck pain after injury.
-
Randomized Controlled Trial Multicenter Study Clinical Trial
The use of rhBMP-2 in interbody fusion cages. Definitive evidence of osteoinduction in humans: a preliminary report.
A prospective randomized controlled human clinical pilot trial. ⋯ The arthrodesis was found to occur more reliably in patients treated with rhBMP-2-filled fusion cages than in controls treated with autogenous bone graft, although the sample size was limited. There were no adverse events related to the rhBMP-2 treatment. This study is one of the first to show consistent and unequivocal osteoinduction by a recombinant growth factor in-humans.
-
A study using a validated viscoelastic finite-element model of a L2-L3 motion segment to identify the load sharing among the passive elements at different loading rates. ⋯ Consideration of the time-dependent material properties of passive elements is essential to improving understanding of motion segment responses to dynamic loading conditions. Higher loading rate markedly reduces the safety margin of passive spinal elements. When the dynamic tolerance limits of tissues are available, the results provide bases for the guidelines of safe dynamic activities in clinics or industry.