European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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This study retrospectively reviews 20 sequential patients with thoracolumbar burst fractures without neurologic deficit. All patients were treated by indirect reduction, bisegmental posterior transpedicular instrumentation and monosegmental fusion. Clinical and radiological outcome was analyzed after an average follow-up of 6.4 years. ⋯ Therefore, posterolateral fusion alone does not prevent disc space collapse. Nevertheless, clinical long-term results are favorable. However, if disc space collapse has to prevented, an interbody disc clearance and fusion is recommended.
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Despite the advantages that new derotation-based systems have brought to the treatment of scoliosis, the debate continues, especially regarding adolescent idiopathic scoliosis. Problems like decompensation, junctional kyphosis, and insufficient sagittal plane alignment are met with new proposals. We now are using a technique and system, the Ibn-I Sina Spinal System (IBS), that we think is able to overcome these problems. ⋯ IBS has proved easy and successful in scoliosis treatment, especially with lordotic rigid curves. We encountered no neurologic injury or instrument failure. In addition to these advantages, ease of preoperative planning and application, decreased operation time, easy removal or revision, and versatility and safety of the system has made the Ibn-I Sina Spinal System (IBS) a treatment of choice, especially for adolescent idiopathic scoliosis cases, in some centers in Turkey.
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We present the case of a 44-year-old female patient, who sustained an odontoid fracture after a minor trauma (uncomplicated fall). The radiologic evaluation revealed a skeletal tumor of the second cervical vertebra together with a fracture line at the base of the odontoid process of the axis. The patient underwent surgery, the tumor was resected and the odontoid was stabilised using an autologous cortico-cancellous bone graft and a halo fixator. Histologic examination revealed benign fibrous histiocytoma, which is reported to be a very rare skeletal tumor.
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Case Reports
Delayed focal neurological deficit secondary to a cervico-thoracic spinal cord epidural haematoma.
This is a report of an elderly woman who developed focal neurological deficit in association with a cervico-thoracic spinal epidural haematoma. Symptoms developed several days after the initial injury and subsequently resolved without surgical intervention. The unusual features of this presentation are discussed.
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The degree of calcification as well as the structural changes of the elastic fibres in the ligamentum flavum in patients with degenerative lumbar spinal stenosis were evaluated and the results were compared to those of patients without spinal stenosis. In 21 patients (13 male, 8 female) with lumbar spinal stenosis the ligamentum flavum was removed, histologically processed and stained. The calcification, the elastic/collagenous fibre ratio as well as the configuration of the fibres were evaluated with an image analyzing computer. ⋯ In the control group we only found minimal calcification in 3 of 20 segments (average 0.015%). No relevant fibrosis was found and the configuration of elastic fibres showed no pathologic changes. The results of this study illustrate the important role of histological changes of the ligamentum flavum for the aetiology of lumbar spinal stenosis.