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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Gait impairment in cervical spondylotic myelopathy (CSM) is characterised by a number of kinematic and kinetic abnormalities. Surface electromyography (EMG) can evaluate the contributions of individual muscles to a movement pattern and provide insight into the underlying impairments that characterise an abnormal gait. This study aimed to analyse EMG signals from major lower limb muscles in people with CSM and healthy controls during gait. ⋯ The results provide evidence for paresis as a contributory factor to gait impairment in CSM, indicated by impaired amplitude and the need for proximal co-activation to compensate for lack of distal power generation. Poor proprioception may have contributed to prolonged activation of tibialis anterior. Analysis of muscle responses to lengthening suggested that spasticity was not an important contributor. These findings have implications for the assessment and rehabilitation of gait impairment in CSM.
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Gunshot wounds are one of the commonest causes of spinal injury. Management of these patients differs from other blunt trauma injuries to the spine. We present a case of a gunshot wound to the lumbar spine that occurred in 1985 which was treated non-operatively. ⋯ The purpose of this paper is to show a case of a gunshot wound to the spine that ultimately caused plumbism and required surgery. Technical aspects of the surgery are described as well as pre- and post-procedural imaging. Recommendations for the general management of spine gunshot wounds are also described.
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Comparative Study
Disc prosthesis replacement and interbody fusion in the treatment of degenerative cervical disc disease: comparative analysis of 176 consecutive cases.
The purpose of this retrospective analysis is to determine whether disc prosthesis replacement can be equivalent or superior compared with the disc interbody fusion. ⋯ Our experience demonstrates that the use of disc prosthesis is a safe and effective alternative to interbody fusion.
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To evaluate the clinical and radiological outcomes of elderly (>75 years old) patients who underwent spinal instrumented fusion surgery. ⋯ Spinal fixation and fusion in patients older than 75 years old grants good results in terms of quality of life but the rate of morbidity is higher than standard spine surgery. Rate of fusion especially is still a critical point.
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Sagittal imbalance is a predictor of failure after surgery for lumbar degenerative pathology. For this reason, specialists advocate correction of sagittal deformity and systematically perform preoperative standing whole spine films. Such diagnostic investigations expose patients to significant doses of radiation. The authors propose an easier radiographic investigation helpful as a screening test to identify patients likely to have sagittal imbalance. ⋯ This study preliminarily suggests that the SLLP film can be a useful screening test for sagittal balance abnormalities.