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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Case Reports Comparative Study
Comparison of different operative modalities in post-traumatic syringomyelia: preliminary report.
Post-traumatic syringomyelia (PTS) is a relatively rare, but potentially disastrous, complication of spinal cord injury. Operative treatment by shunting procedures often shows only a short-term improvement, and the rate of recurrence of syringomyelia is high, so different treatment modalities have been used in the last years. The various results are discussed in this analysis. ⋯ Our experience is that shunting procedures often show a neurological improvement only in the short term; the rate of recurrence of typical shunting complications is high. The performance of a pseudomeningocele is an encouraging new step in the treatment of PTS. Further long-term follow-up studies are necessary to assess the benefits of this new method.
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The decision to opt for a particular internal fixation procedure of a traumatized unstable lower cervical spine should be based on analysis and implementation of scientific and clinical data on the biomechanics of the intact, the unstable and the implant-fixed spine. The following recommendations for surgical stabilization of the lower cervical spine seem, therefore, to be justified. Firstly, the surgical procedure should be to bring about decompression, realignment, and stability. ⋯ Fourthly, combined techniques are indicated for highly unstable or particularly complex injuries. On the cervicothoracic junction, or in cases of Bechterew's disease, the decision is justifiably made in favor of this technique, which can be performed as a one-stage or two-stage operation. Finally, whenever possible, selection of the implant should take into account the foreseeable developments in diagnostic procedures, and therefore, in view of the modern imaging techniques likely to be used in any follow-up examinations required later, the implant chosen should be made of titanium.
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A longitudinal study was undertaken to analyse the development of posture and spinal mobility during growth and its relationship to low back pain and sports activities. A total of 90 children were examined at 5-6 years of age and re-examined at 15-16. Sagittal configuration and mobility were measured using Debrunner's kyphometer. ⋯ The results of the study showed that kyphosis and lordosis increased and mobility decreased in the 90 children who were examined both at age 5-6 and 15-16 years. The relationship between kyphosis and lordosis decreased in girls but not in boys. Occasional low back pain was reported by 38% of the children at the age of 15-16 years, but back pain was not related to posture, spinal mobility or physical activity.