Journal of spinal disorders & techniques
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J Spinal Disord Tech · Apr 2009
Case ReportsLow body mass index: a risk factor for superior mesenteric artery syndrome in adolescents undergoing spinal fusion for scoliosis.
Five cases of superior mesenteric artery (SMA) syndrome occurred at our institution over a 4-year period in adolescents undergoing spinal fusion surgery for scoliosis. All patients had in common a very slender body habitus. The measurement of body mass index (BMI) was low in all patients and an age-matched control group of patients undergoing similar surgery without this complication was assessed with this Index to determine its utility as a screening tool for this postoperative condition. ⋯ Patients undergoing spinal fusion surgery for scoliosis with a BMI of less than 18 are at risk to develop SMA syndrome postoperatively.
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J Spinal Disord Tech · Apr 2009
Neurogenic intermittent claudication in lumbar spinal canal stenosis: the clinical relationship between the local pressure of the intervertebral foramen and the clinical findings in lumbar spinal canal stenosis.
The clinical relationship between the local pressure of the intervertebral foramen and the clinical findings in lumbar spinal canal stenosis were evaluated. ⋯ The present study suggests that the genesis of neurogenic intermittent claudication in lumbar spinal canal stenosis may be greatly affected by the variation of the dynamic mechanical stress on the spinal nerve roots of the lumbar spine, rather than the static mechanical stress on the spinal nerve roots with each posture. Moreover, 2-level lumbar spinal canal stenosis patients demonstrated radicular symptoms with relatively less external stress on their spinal nerve roots in the vertebral foramen than that observed in 1-level lumbar spinal canal stenosis patients.
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J Spinal Disord Tech · Apr 2009
Relaxation of forces needed to distract cervical vertebrae after discectomy: a biomechanical study.
In vitro and in vivo biomechanical stress measurements are made of the intervertebral disc segment distraction force during anterior cervical discectomy. ⋯ A sharp reduction in the strain across the intervertebral space occurs after distraction. The removal of the cervical intervertebral disc significantly reduces the viscoelastic response of the cervical motion segment. The long-term force used to stabilize intervertebral grafts or implants is less than what is achieved at the time of distraction. The exact magnitude of the resultant force on graft or device at a given distraction force is unknown and would depend also upon fit.
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J Spinal Disord Tech · Feb 2009
Comparative StudyMonosegmental transpedicular fixation for selected patients with thoracolumbar burst fractures.
A prospective cohort study on selected consecutive patients. ⋯ For selected thoracolumbar burst fractures, MSPI can provide the same or better fixation and preserve more motion segments than other methods of posterior pedicle instrumentation. With preoperative evaluation using the spinal LSC system, MSPI is effective and reliable for the treatment of thoracolumbar burst fractures when properly indicated.
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J Spinal Disord Tech · Feb 2009
Comparative StudyDirect lateral lumbar interbody fusion for degenerative conditions: early complication profile.
A community hospital prospective, nonrandomized chart review. March 2004 to December 2006, 58 patients were treated. Adverse events: new complaints and increasing length of stay limit early mobilization and require consultation with other physicians or reoperation. These formed the focus of the study. ⋯ Major adverse events approximated 8.6% with approach-related complaints of nerve irritation nearing 3.4%. Mild complications occurred in 13.7% of patients. Meralgia paresthetica was a primary approach-related complaint. Most complaints significantly reduced by first postoperative visit. One patient (1.7%) had symptoms lasting over a year that did not adversely affect function. Significant finding related to exposure, that is, 1-versus 2-level cases. Overall morbidity reduction noted by EBL is considerably less compared with the historical cohort. Direct lateral lumbar interbody fusion has proven to be of value.