Spine
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Comparative Study
Comparison of lumbar sagittal alignment produced by different operative positions.
This study is a prospective evaluation of the effects of commonly used spinal tables on lumbar sagittal alignment. ⋯ When instrumentation is used to augment lumbar fusions, positions incorporating hip flexion should be avoided to ensure maintenance of sagittal plane balance.
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The sensitivity of plain radiographs for diagnosing traumatic atlanto-occipital dislocation and its association with craniocervical junction subarachnoid hemorrhage was examined in a retrospective review of seven patients. ⋯ The diagnosis of traumatic atlanto-occipital dislocation is often missed in the emergency department, and current methods for evaluating the integrity of the atlanto-occipital joint on cervical radiographs fail to identify all patients with this injury. Although infratentorial subarachnoid hemorrhage is uncommon in traumatic head injury, craniocervical junction subarachnoid hemorrhage is often associated with atlanto-occipital dislocation and should raise the suspicion of severe craniocervical ligamentous injury. Sagittal computed tomography reconstructions or sagittal magnetic resonance imaging can allow for the diagnosis when plain radiography is inconclusive.
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Comparative Study
The effectiveness of various cervical orthoses. An in vivo comparison of the mechanical stability provided by several widely used models.
The amount of motion allowed by various cervical orthoses was compared with the amount of unrestricted neck motion in vivo. ⋯ Although cervical orthoses can be helpful for other reasons, they do not provide a high level of mechanical restriction of motion. Additionally, the restriction they do provide can vary widely between people. Prescribing physicians should consider the relative merits of the various orthoses before deciding whether they will meet a patient's needs. The differences between the collars tested may not be enough to justify one of the more expensive or less comfortable collars.
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The authors analyzed motor-evoked potentials using transcranial electrical cortical stimulation during spinal surgery in 40 patients under conditions of partial neuromuscular blockade. ⋯ The authors support the utility of recording transcranial electrical motor-evoked potentials in spinal surgery under partial neuromuscular blockade. Recovery of lost motor-evoked potentials was not associated with postoperative motor deficits, whereas non-recovery of lost motor-evoked potentials was.
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The present study evaluated the cervical nerve groove and intervertebral foramen using dried vertebrae and cadaveric cervical spine. ⋯ These data may enhance understanding of the important bony elements associated with the cervical spinal nerves and roots as they pass through the cervical nerve groove and the intervertebral foramen.