Spine
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This study analyzed anatomic characteristics of cervical ventral rootlets. After total vertebrectomy, detailed morphology of the ventral rootlets was studied from the anterior. ⋯ Short C5 ventral rootlets appeared to become taut and easily injured by hemilateral anterior compression. Spinal cord lesion resulting from localized anterior compression at the single disc level might not play as important a role in the pathogenesis of dissociated motor loss of the deltoid muscle because of the wider spinal segments of C5 and C6.
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The histologic and histochemical changes in back muscle were studied in virgin surgery patients with lumbar spine disorders and in patients who underwent repeat posterior lumbar surgery. ⋯ Histologic damages of back muscle due to previous surgical intervention were long-lasting. To avoid permanent muscle injury, the retraction time and pressure should be shortened or the pressure on the back muscle should be monitored during posterior surgery.
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A double, contiguous disc herniation in the thoracic spine (T7-T8, T8-T9) in a 44-year-old man is reported. The patient complained of intermittent episodes of weakness and numbness in the lower extremities, paraesthesias radiating to the anterior and medial surfaces of the thigh and the leg (mostly on the left side), and mild sexual and urinary dysfunction. ⋯ In this case, a transthoracic approach was safe and effective for disc excision and cord decompression via hemicorporectomy.
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Comparative Study
The effect of neck and leg flexion and their sequence on the lumbar spinal cord. Implications in low back pain and sciatica.
Fresh cadavers of five baboons were used to assess lumbar spinal cord movement. Window dissection at the L3 level was performed to observe the relative displacement of the cord to bony landmark, when the neck and hip were moved. ⋯ These findings would advocate that a test that comprises both neck and hip movements would be more sensitive in assessing nerve root movements than one that only uses neck or hip movements. Such a test should also consider the use of various sequences of neck and hip movements.