Spine
-
Fifty-seven patients with dens fractures were identified from 1986 to 1996 at the authors' institution. Forty-six were available for reevaluation by two independent observers with a mean follow-up period of 26 months. ⋯ Patients over 60 years of age with a dens fracture had a higher complication rate and lower cervical range of motion when treated conservatively with a halo. Final functional outcome and overall pain levels, however, did not differ significantly by age group or treatment modality.
-
A retrospective clinical study of patients with vertebral osteomyelitis of the lumbar spine necessitating surgical treatment. All patients underwent sequential (same-day) or simultaneous anterior decompression and posterior stabilization of the involved vertebrae. ⋯ Patients with lumbar osteomyelitis necessitating surgery can undergo combined, same-day surgery either in a sequential or simultaneous manner. This is a safe and efficient way to control the infection and stabilize the affected segments, allowing for early mobilization of these sick elderly patients.
-
Fifteen specimens of the first cervical vertebra were tested by the application of pure tensile forces to failure. Seven specimens had intact transverse ligaments, and eight had transection of the transverse ligament before testing. Specimens were tested to failure by the rapid application of laterally directed tensile force to the ring; this force then was exerted through the lateral masses to simulate the mechanism of injury for this fracture as proposed by Jefferson. ⋯ The results of this study show that fractures of the C1 ring of greater than two parts can occur with pure tensile loading. The ring will fracture with as little as 1 mm of deformation.
-
Randomized Controlled Trial Clinical Trial
Can it be predicted which patients with chronic low back pain should be offered tertiary rehabilitation in a functional restoration program? A search for demographic, socioeconomic, and physical predictors.
A prospective clinical trial was conducted that involved six groups of patients with chronic low back pain selected from a large cohort (N = 816). ⋯ Different factors can be identified as predictive of outcome in a functional restoration program, but most of these factors were also shown to predict success for shorter control outpatient programs or of no treatment.
-
Comparative Study
Dynamic motion study of the whole lumbar spine by videofluoroscopy.
Dynamic lumbar flexion-extension motion was assessed by videofluoroscopy. ⋯ Segmental instability influences the whole lumbar motion in patients with degenerative spondylolisthesis. The patients with chronic low back pain did not show a significant difference when compared with the volunteers.