Spine
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A case of a late infantile atlantoaxial rotatory fixation is reported for which transoral anterior release was performed. ⋯ The authors suggest that careful transoral anterior release of the atlantoaxial joint permits successful reduction in a case of chronic fixed atlantoaxial rotatory fixation combined with cord compression.
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Eighteen patients with lumbar instability from fractures, postlaminectomy syndrome, or infection were treated prospectively with minimally invasive retroperitoneal lumbar fusions. ⋯ This preliminary study of 18 patients illustrates that endoscopic techniques can be applied effectively through a retroperitoneal approach with the patient in the lateral position. Unlike the patients who had undergone transperitoneal procedures described in previous reports, in these preliminary 18 patients, there were no cases of retrograde ejaculation, injury to the great vessels, or implant migration.
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Case Reports
Compression of the upper cervical spinal cord causing symptoms of brainstem compromise. A case report.
A case is reported in which a flexion-induced compression of the upper cervical spinal cord caused symptoms of brainstem compromise in the absence of radiographic evidence of osseous instability. ⋯ Instability of the cervical spine may result in symptoms of brainstem dysfunction, even in the absence of hindbrain herniation. This instability is explained by the differential movement between the bony structures and neuraxis in the upper cervical region. Diagnosis and adequate management of this instability alleviates the neurologic symptoms and prevents possible hazardous complications.
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Sequential study of magnetic resonance images of the lumbar spine. ⋯ The distribution of conus location in a large adult population was shown to range from the middle third of T12 to the upper third of L3.
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An anatomic study of the peripheral nerves innervating the occipital region. ⋯ The results of this study suggest that optimal locations for blockade techniques should be reconsidered. The acquired knowledge concerning greater auricular and minor occipital nerves behind the sternocleidomastoid muscle may aid in preventing intraoperative injuries.