Journal of spinal disorders & techniques
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J Spinal Disord Tech · Apr 2005
Clinical TrialLimited clinical utility of pain drawing in assessing patients with low back pain.
The aim of this study was to assess the use of pain drawing by studying its ability to identify patients with low back pain and abnormal psychological profile. The intraevaluator repeatability of the penalty point method of scoring of pain drawing was also evaluated. ⋯ Though there are differences in anxiety and depression scores in patients with normal and abnormal pain drawing, the performance characteristics of pain drawing are less than acceptable and therefore limit its use in clinical practice.
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We report three cases of tectorial membrane injury in children. An increased interspinous ratio was identified on cervical spine radiographs. ⋯ The three children were restrained passengers in high-speed motor vehicle accidents, and all sustained polytrauma. Two children with partial tears of the tectorial membrane were immobilized in a halo, and one with a longitudinal tear of the tectorial membrane had an occiput-to-C2 fusion.
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J Spinal Disord Tech · Apr 2005
Comparative StudyNatural history of patients with lumbar disc herniation observed by magnetic resonance imaging for minimum 7 years.
The aim of this work was to elucidate the relation between the clinical course and morphologic changes of lumbar disc herniation on magnetic resonance imaging (MRI). ⋯ Clinical outcome did not depend on the size of herniation or the grade of degeneration of the intervertebral disc in the minimum 7-year follow-up.
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J Spinal Disord Tech · Apr 2005
Lumbar synovial cysts of the spine: an evaluation of surgical outcome.
Our aim was to study the outcomes and results of surgically treated patients with synovial cysts of the lumbar spine in our institution. ⋯ Spinal cysts are commonly found at the L4-L5 level, the site of maximum instability. MRI is the tool of choice for diagnosis. The etiology is still unclear, but underlying spinal instability has a strong association for formation of spinal cysts and worsening symptoms. Synovial cysts resistant to conservative therapy should be treated surgically. Resection and decompression with fusion remain an appropriate option. The optimal approach for patients with juxtafacet cysts remains unclear. The best surgical treatment approach for each particular individual appears to remain speculative.
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J Spinal Disord Tech · Apr 2005
Vertebral rotation and thoracic torsion in adolescent idiopathic scoliosis: what is the best radiographic correlate?
As a result of the increased appreciation of the three-dimensional nature of scoliosis and modern spinal instrumentation's improved corrective capabilities, there has been renewed interest in the correction and measurement of vertebral rotation. Computed tomography (CT), the gold standard for accuracy, is limited in its clinical utility owing to cost, radiation exposure, and the effects of postural changes on scoliosis curves and vertebral rotation. Consequently, the Perdriolle and Nash-Moe techniques remain the standard measurements for providing a reasonable estimate of pre- and postoperative vertebral rotation because of their simplicity. However, these techniques have considerable interobserver variability, and pedicle screw instrumentation obscures the landmarks necessary for utilizing these techniques for postoperative vertebral rotation assessment. The purpose of the present study was to assess the utility of alternate radiographic measures to assess vertebral rotation and thoracic torsion when compared with conventional measures on pre- and postoperative radiographs and CT evaluation. ⋯ The RH, AVB-R, and the ARSD-measures of thoracic torsion-demonstrated moderate to good overall correlation with the main thoracic curve Cobb angles, apical Perdriolle rotation, and apical CT rotation. These should be useful as clinical measures for assessing three-dimensional deformity correction on plane radiographs, especially for the intraoperative evaluation of vertebral derotation and thoracic symmetry restoration.