Journal of spinal disorders & techniques
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The sacral perineural cyst was first described by Tarlov in 1938 as an incidental finding at autopsy. There are very few data in the literature regarding the role of Tarlov cysts in causing symptoms, however. Most studies report low numbers, and consequently, the recommendations for treatment are vague. Our aim, therefore, is to present further detail regarding the clinical relevance of Tarlov cysts and to identify whether or not they are a cause of lumbosacral spinal canal stenosis symptoms. ⋯ The majority of Tarlov cysts are incidental findings on MRI. Where confusion exists as to the clinical relevance of a Tarlov cyst, treatment of the primary pathology (ie, non-Tarlov lesion) is usually sufficient. Tarlov cysts may, however, be responsible for a patient's symptoms; possible mechanisms by which this may occur and treatment strategies are discussed.
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J Spinal Disord Tech · Feb 2005
Comparative StudyA cross-cultural comparison between Canada and Germany of symptom expectation for whiplash injury.
Symptom expectation for whiplash injury has been shown to be low in countries with low rates of chronic whiplash when compared with countries like Canada, where chronic whiplash is common. The objective of the current study is to compare the frequency and nature of expected "whiplash" symptoms in Germany with that in Canada. ⋯ In Germany, despite the documented occurrence of neck sprain symptoms in individuals following motor vehicle collisions, there is a very low rate of expectation of any sequelae from this injury. The current or previous aspects of society that underlie this remain uncertain. This lack of expectation of chronicity in Germany may, in part, determine the low prevalence of the chronic whiplash syndrome there. Further studies of symptom expectation as an etiologic factor in the chronic whiplash syndrome are needed.
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J Spinal Disord Tech · Feb 2005
Case ReportsReversal of anterior cervical fusion with a cervical arthroplasty prosthesis.
This case report describes a 38-year-old-man who initially underwent a C5-C6 anterior cervical decompression and interbody fusion and plating for a right C6 radiculopathy. Within a few months of his surgery, he developed bilateral C7 radiculopathies, with imaging confirming adjacent segment foraminal stenosis. Repeat imaging suggested some subsidence of the original interbody graft but no overt pseudoarthrosis, and flexion/extension films showed no evidence of movement at the fused level. ⋯ The old fusion was removed at the C5-C6 level and remobilized, and an arthroplasty was performed. At discharge, the patient's neck pain and hand symptoms had improved, and he had motion demonstrable on radiologic imaging at C5-C6. This is the first reported case of reversal of a cervical fusion with re-establishment of motion and represents an alternate acceptable management of pseudoarthrosis or recent spinal fusion.