Journal of spinal disorders & techniques
-
J Spinal Disord Tech · Feb 2015
Immediate reduction under general anesthesia and single-staged anteroposterior spinal reconstruction for fracture-dislocation of lower cervical spine.
Fracture-dislocation of the lower cervical spine is a severe traumatic lesion, most frequently resulting in tetraplegia. Treatment is usually painful and time consuming. This retrospective study evaluated the clinical curative effect of immediate reduction under general anesthesia and single-staged anteroposterior spinal reconstruction for fracture-dislocation of the lower cervical spine. ⋯ The spinal cord function grades according to American Spinal Injury Association after operation were as follows: grade A in 1 case, grade B in 1 case, grade C in 3 cases, grade D in 3 cases, and grade E in 4 cases. All 12 patients showed evidence of stability at the instrumented level on the final follow-up examination (mean follow-up, 3.7 y). Immediate reduction under general anesthesia followed by a single-stage combined anteroposterior spinal reconstruction is a safe and reliable way of treating patients with lower cervical spine fracture-dislocations.
-
J Spinal Disord Tech · Feb 2015
Case ReportsProximal instrumented vertebral body chance fracture after pedicle screw instrumentation in a thoracic kyphosis patient with osteoporosis.
We present a case of proximal vertebral body chance fracture after pedicle screw instrumentation and fusion in a 67-year-old woman with osteoporosis and thoracic kyphosis. ⋯ Chance fracture in osteoporotic bone at the proximal end of a construct due to a pedicle screw is a rare complication but it may result in catastrophic consequences. Early recognition of this complication, reduction of the fraction-dislocation, and an extension of the instrumentation can be utilized for realignment and long-term stabilization.
-
J Spinal Disord Tech · Feb 2015
Clinical application of the "pedicle exposure technique" for atlantoaxial instability patients with a narrow c1 posterior arch.
This was a retrospective study. ⋯ The "pedicle exposure technique" is an effective alternative in patients with the C1 posterior arch measuring <4 mm. In consideration of a high screw entry point on the C1 posterior arch, similar to the C1 posterior arch screw technique, we propose that this new technique can reduce venous plexus and C2 nerve root injury while providing effective biomechanical stability.
-
J Spinal Disord Tech · Feb 2015
Incidental dural tear in cervical spine surgery: analysis of a nationwide database.
This was a retrospective study. ⋯ The incidence of DT in cervical spine surgery was 0.45% in the United States. The risk of DT was highest with a primary diagnosis of the ossification of the posterior longitudinal ligament (58.4 times). DT significantly increased the rate of in-hospital complications and health care burden.
-
J Spinal Disord Tech · Feb 2015
The effect of bone morphogenetic protein-2 injection at different time points on intervertebral disk degeneration in a rat tail model.
Prospective in vivo rat tail model of disk degeneration comparing the effects of recombinant human bone morphogenetic protein-2 (rhBMP-2) injection over various time points and grades of degeneration. ⋯ rhBMP-2 injection of degenerated disks at 4 weeks postpuncture induced a transient improvement in disk grade on MRI and stimulated chondrogenic differentiation. These data suggest rhBMP-2 as a potential therapy for degenerative disk disease.