Spine
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This is a report of a patient with severe cervical myelopathy due to pseudoarthrosis between the posterior tubercle of the atlas and the spinous process of the axis, associated with diffuse idiopathic skeletal hyperostosis. Radiographs of 170 patients with neck pain were reviewed to identify lesions involving abnormal contact between the atlas and axis. ⋯ In the group with pronounced hyperostosis, pseudoarthrosis or a variant can cause serious problems in the upper cervical spine that should not be overlooked.
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Calf and human cadaveric spines were used to determine motion segment stiffness and laxity after implantation of threaded inserts (the Ray Threaded Fusion Cage, Surgical Dynamics, Inc., Concord, CA), comparing direction of placement, number of implants, shape of the device, and integrity of anterior spine structures. Stiffness and laxity of spines with inserts were compared with those with bone grafts, with and without posterior fixation plates. ⋯ Threaded inserts increase vertebral motion segment stiffness and decrease laxity by distracting intervertebral structures. They are not sensitive to placement, except if vertebral structures are injured during insertion and produce constructs with more consistent mechanical properties than bone grafts.
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This study retrospectively reviewed the outcomes of 11 patients treated for a cervical spine injury with a tracheostomy placed before anterior cervical spine surgery. ⋯ The authors concluded that in patients with cervical cord damage resulting from nonpenetrating trauma, tracheostomy was not found to increase the risk of infection in subsequent anterior cervical surgery. Careful preparation of the skin and placement of the second surgical incision lateral to the tracheostomy site is recommended. Anterior cervical spine surgery remains a viable treatment option in this severely injured patient population.
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Seventy patients (average age, 13.8 years) with adolescent idiopathic right thoracic scoliosis had full assessment of pulmonary functions and radiographic evaluation of spinal and thoracic cage deformities and their flexibilities. ⋯ Deformities in coronal and transverse plane influence changes in pulmonary functions expressed as the percent of predicted values, whereas sagittal plane deformities influence mainly those absolute volumes in which residual volume is a component. It is suggested that rotational flexibility combined with other deformities could be evaluated in future studies on prediction of pulmonary function from the measurements of the deformity.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effects of spinal flexion and extension exercises and their associated postures in patients with acute low back pain.
A prospective randomized clinical trial compared the effects of flexion and extension back exercises and postures among soldiers with acute low back pain. ⋯ There was no difference for any outcomes between the flexion or extension exercise groups. However, either exercise was slightly more effective than no exercise when patients with acute low back pain were treated.