Journal of spinal disorders & techniques
-
J Spinal Disord Tech · Aug 2009
Cervical spine imaging using mini--C-arm fluoroscopy: patient and surgeon exposure to direct and scatter radiation.
Direct and scatter radiation was measured during cadaveric cervical spine imaging with a mini-C-arm fluoroscope. ⋯ Although using a mini-C-arm unit may reduce exposure levels, substantial exposure to both patient and staff is still achievable. Use of a mini-C-arm for cervical spine imaging reduces exposure to the surgeon more effectively than to the patient. To lower the risk of radiation exposure in the cadaver laboratory, a mini-C-arm should be used in each instance that offers appropriate visualization. In the operating room, all appropriate radiation dose-reducing measures should be strictly enforced by supervising physicians to minimize risk to patients, medical staff, and themselves.
-
J Spinal Disord Tech · Aug 2009
The pedicle screw fixation with vertebroplasty augmentation in the surgical treatment of the severe osteoporotic spines.
Retrospective clinical study. ⋯ In patients requiring spine surgery due to neurologic deficit and having no sufficient time for the medical treatment of severe osteoporosis, pedicle screw fixation with vertebroplasty augmentation and vertebroplasty in segments proximal and distal to the instrumented segments can be good alternative methods to provide well fixation and fusion while preventing proximal and distal junctional fractures. One should be careful about pulmonary cement embolism after such kind of procedures.
-
J Spinal Disord Tech · Aug 2009
Comparative StudyComparative reliability of 3 thoracolumbar fracture classification systems.
Prospective study of 3 spine surgeons, 3 spine fellows, 3 nonspine orthopedists, and 12 orthopedic residents classifying 97 thoracolumbar fractures using the Denis, Association for Osteosynthesis (AO), and Thoracolumbar Injury Severity Score (TLISS) systems and reclassifying them 3 months later. ⋯ As a management tool, the TLISS seems to be an acceptably reliable system when compared with the Denis and AO systems. There is a base level of knowledge and familiarity necessary for the application of the system at reliable levels.
-
J Spinal Disord Tech · Aug 2009
Case ReportsTranscorporeal approach for disc herniation at the C2-C3 level: a technical case report.
The authors describe a less invasive approach for a disc herniation at the high cervical region. A 68-year-old female patient presented with posterior neck and shoulder pain, and tingling sensation and numbness in the left hand after she fell down stairs 2 months before presentation. On neurologic examination, the power of flexion and extension of the left elbow and grasping of the left hand was decreased. ⋯ At 7-month follow-up, she completely recovered from her neurologic symptoms. Compared with the other approaches to high cervical lesion, the current approach was straightforward and less invasive. If there is no need to stabilize the spinal motion segment, this transcorporeal approach can be a useful surgical option as it decreases the extent of tissue dissection of the submandibular retropharyngeal area that might increase the risk of neurovascular injury.
-
J Spinal Disord Tech · Aug 2009
Removal of posterior longitudinal ligament in anterior decompression for cervical spondylotic myelopathy.
The clinical and radiologic results of the patients with removed posterior longitudinal ligament (PLL) were compared with those of the patients with preserved PLL in the treatment of cervical spondylotic myelopathy (CSM). ⋯ Removal of PLL was generally safe and helpful to get more decompression in anterior approach for CSM, although more technically demanding.