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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Despite the advantages of modern instrumentation techniques, the treatment of severe rigid idiopathic scoliosis could be very demanding. Traction can provide better, safer correction and minimize complications related to forceful intra-operative maneuvers; however, several side effects are associated with prolonged periods of traction. The aim of this work is to review the clinical and radiographic results of limited perioperative halo-gravity traction in severe rigid curves analyzing its efficacy, advantages and possible complications and comparing it to classic two staged corrections performed without traction. ⋯ Limited halo-gravity traction is an efficient, safe modality in the treatment of severe rigid adolescent scoliosis. The application of gradual traction over a limited period of 2 weeks led to better correction, shorter operative time with no significant complications.
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Multicenter Study Comparative Study Clinical Trial
Effects of lumbar artificial disc design on intervertebral mobility: in vivo comparison between mobile-core and fixed-core.
Although in theory, the differences in design between fixed-core and mobile-core prostheses should influence motion restoration, in vivo kinematic differences linked with prosthesis design remained unclear. The aim of this study was to investigate the rationale that the mobile-core design seems more likely to restore physiological motion since the translation of the core could help to mimic the kinematic effects of the natural nucleus. In vivo intervertebral motion characteristics of levels implanted with the mobile-core prosthesis were compared with untreated levels of the same population, levels treated by a fixed-core prosthesis, and normal levels (data from literature). ⋯ Furthermore, some physiologic mechanical behaviors seemed to be maintained: the VT was higher at implanted the L4L5 level than at the implanted L5S1 level, and the CT appeared lower at the L4L5 level than at the L5S1 level. ROM and motion distribution were not different between the mobile-core prosthesis and the fixed-core prosthesis implanted levels. This study validated in vivo the concept that a mobile-core helps to restore some physiological mechanical characteristics of the VT at the implanted L4L5 level, but also showed that the minimizing effect of core mobility on the VT was not sufficient at the L5S1 level.
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The purpose of this review is to elucidate the metabolic processes involved in the pathogenesis of adolescent idiopathic scoliosis (AIS) in light of research by the present authors as well as current literature. ⋯ Current evidence supporting these models individually or in combination is discussed.
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Review Case Reports
Surgical treatment of spontaneous intracranial hypotension secondary to degenerative cervical spine pathology: a case report and literature review.
A rare cause of intracranial hypotension is leakage of cerebrospinal fluid (CSF) through a dural breach from degenerative cervical spine pathology. To our knowledge there have been only four cases described in the English literature. Treatment is challenging and varies from case to case, with complete symptom resolution reported for only one patient. Herein we review the literature and describe our surgical management of a 46-year-old woman with symptomatic intracranial hypotension from the penetration of the cervical thecal sac. ⋯ Two months after this novel surgical blood patch procedure the patient was asymptomatic and follow-up imaging demonstrated complete resolution.