Orthopedics
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Axial lumbar interbody fusion is a novel percutaneous alternative to common open techniques, such as anterior, posterior, and transforaminal lumbar interbody fusion. This minimally invasive technique uses the presacral space to access the L5-S1 and L4-L5 disk space. The goal of this study was to examine outcomes following axial lumbar interbody fusion. ⋯ The most common complications were superficial infection and pseudoarthrosis. Other complications were rectal injury, hematoma, and irritation of a nerve root by a screw. Overall, we found the axial lumbar interbody fusion procedure in combination with pedicle screw placement to have good clinical and radiological outcomes.
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Percutaneous kyphoplasty is a minimally invasive technique that has become an effective and routine alternative for managing osteoporotic vertebral compression fractures. This article reports the clinical outcome of a series of 54 cases of osteoporotic thoracolumbar vertebrae compression fractures treated by percutaneous kyphoplasty. Fifty-four patients with confirmed osteoporosis and at least 1 level of thoracolumbar vertebrae compression fracture were retrospectively selected. ⋯ The cement leakage rate was 3.86% (8 of 207 vertebrae) with percutaneous kyphoplasty, but no neurological or other complaints were received. Percutaneous kyphoplasty is a simple and safe procedure in managing osteoporotic vertebrae compression fractures. It relieves pain quickly, restores vertebral height, prevents further fracture, and improves patient quality of life.
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The effects of ipsilateral cervical nerve root transfer on the restoration of the rat upper trunk muscle and nerve brachial plexus root avulsion were studied. After simulated root avulsion of the upper trunk brachial plexus, 120 rats were randomly divided into 4 groups: (A) ipsilateral C7 root transfer group; (B) Oberlin group; (C) phrenic nerve group; and (D) no axillary nerve restoration group. At 3, 6, and 12 weeks postoperatively, Ochiai score, Barth feet overreaching test, Terzis grooming test, and indices of neurotization were determined in 10 rats from each group. ⋯ No significant difference was found between the ipsilateral C7 group and the phrenic nerve and no axillary nerve restoration groups in amplitude recovery rate of musculocutaneous nerve compound muscle action potential. No significant difference was found between the ipsilateral C7 and the Oberlin groups in the early recovery of musculocutaneous nerve compound muscle action potential, but recovery was significantly better in the ipsilateral C7 group at 12 weeks. Ipsilateral C7 root transfer can improve the quality of restoration of muscle and nerve function in the rat upper trunk after brachial plexus root avulsion.
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Facet dislocations in children are rare. This article presents the youngest case of a unilateral facet dislocation described in the pediatric population. A 9-year-old boy sustained a flexion/axial loading injury to his cervical spine while wrestling with his friends, causing a unilateral facet dislocation at C4/5. ⋯ Radiographs revealed a normally aligned cervical spine. Unilateral cervical facet dislocations and subluxations are the result of a distractionflexion force applied to the spine along with a rotational component. These are not uncommon injuries in the adult spine; however, in the young pediatric population, cervical facet dislocations are rare.