Journal of neurosurgery. Spine
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As a result of spinal trauma, approximately 12,000 individuals become quadriplegic or paraplegic each year in the US. The cervical spine is the most frequently injured part of the spinal column, and approximately 60% of spinal cord injuries involve the cervical region. The cervical collar remains the best method of prehospital spinal stabilization. Following trauma, difficulty securing an airway, the shielding of life-threatening injuries, and pressure ulcers are just a few of the serious problems that may be encountered in patients placed in cervical collars. The authors' goal was to develop an efficient method of clearing the cervical spine, by incorporating flexion and extension CT scanning with reconstruction (FECTR) into a trauma protocol. ⋯ The authors' initial findings show FECTR to be a safe, effective, and efficient method of posttraumatic cervical spine clearance. In unconscious or obtunded patients, FECTR facilitates cervical spine clearance with a high degree of accuracy. A larger prospective study is needed to confirm these findings.
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Comparative Study
Lumbar spinal stenosis in elderly patients: is a unilateral microsurgical approach sufficient for decompression?
For the treatment of lumbar spinal stenosis, less invasive procedures, which preserve maximal bony and ligamentous structures, have been recommended to reduce associated morbidity. The authors examined the outcome after decompression of spinal stenosis in the elderly by comparing 3 different surgical approaches. Their focus was whether a unilateral microsurgical decompression provided sufficient outcomes in the elderly population. ⋯ Laminectomies did not show any advantage when compared with unilateral transmedian approaches. A unilateral partial hemilaminectomy combined with a transmedian decompression sufficiently treated the stenosis. This method seemed advantageous in minimizing the procedure and associated morbidity in this elderly population. Further investigations with long-term results (> 5 years) are still necessary.