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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In internal posterior fixation of thoracolumbar fractures combined with transpedicular cancellous bone graft and posterior fusion of the intervertebral facet joints at the level of the destroyed end plate it is still uncertain as to whether significant vertebral body collapse and loss of correction of the regional angle (RA) and the intervertebral angle (IVA) occur (after removal of the implants). These questions were investigated in a retrospective study of 183 consecutive patients, 18-65 years old, with a spinal fracture between the 9th thoracic and the 5th lumbar vertebral body (inclusive), treated operatively between 1988 and 1996 (27% had objective neurological deficit, 37% had multiple injuries). According to the Comprehensive Classification, 128 type A, 32 type B and 21 type C fractures were identified preoperatively. ⋯ Correction of the RA was statistically significant before implant removal, but the RA 2 years after surgery had become almost the same as the preoperative values. Changes at the level of the intervertebral space, occurring after implant removal, contributed to the loss in the RA. Broken pedicle screws (10.9% of the patients) resulted in significant changes in the AWA and RA before implant removal, but did not influence the IVA.
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This study was carried out to identify the distinguishing features of brucellosis on magnetic resonance imaging (MRI). MRI examinations were performed in 14 patients with spinal brucellosis. A 1-T Magnetom (Erlangen, Siemens) was used to obtain T1-weighted (TR/TE 500/30) and T2-weighted (TR/TE 2000/80/20) spin echo sequences, in both sagittal and axial planes. ⋯ Seven facet joints of five patients with discitis displayed signal increase after contrast enhancement. Vertebral body signal changes without morphologic changes marked signal increase in the intervertebral disc on T2-weighted and contrast-enhanced sequences, and soft tissue involvement without abscess formation can be accepted as specific MRI features of brucellar spondylitis. The facet joint signal changes following contrast enhancement is another MRI sign of spinal brucellosis, which has not been mentioned so far.
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Scoliosis among children and adolescents is a persistent problem. Worldwide, it afflicts between 0.3 to 15.3% of the population. One of the treatment methods of this disorder is to administer lateral electrical surface stimulation (LESS) for 9 h/day; unfortunately, however, this results in side-effects. ⋯ The degree of scoliotic deformity (according to the Cobb method) ranged from 21 degrees to 410 degrees (mean, 31.2 degrees) and from 23 degrees to 330 degrees (mean, 30 degrees) in groups 1 and 2, respectively. LESS resulted in spinal deformity to a similar degree in the rabbits treated for either 9 or 2 h/day over a 3-month period. Short LESS therapy (2 h/day) significantly reduced detrimental effects associated with the treatment on internal organs of laboratory animals.