Journal of neurosurgery. Spine
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The object in this study was to determine whether the presence of systemic inflammatory response syndrome (SIRS) in patients with traumatic spinal cord injury (SCI) on admission is related to subsequent clinical outcome in terms of length of stay (LOS), complications, and mortality. ⋯ A protocol to identify SCI patients with SIRS at admission may be beneficial with respect to preventing adverse outcomes and decreasing hospital costs.
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Neuroblastic tumors can be classified as neuroblastoma, ganglioneuroblastoma (GNB), or ganglioneuroma. Ganglioneuroblastomas consist of small, round, immature neuroblast cells and matured ganglion cells. They are most commonly found in the mediastinum and retroperitoneum; intraspinal GNBs are extremely rare. There are only 5 cases of intraspinal GNB reported in the English literature. The authors report a case of GNB of the filum terminale. The duration of follow-up after the initial treatment is longer than in any other published reports. ⋯ The authors present a rare case of spinal GNB. The duration of follow-up after the initial surgery in 1993 represents the longest description of clinical course after treatment for spinal GNB.
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Case Reports
Open reduction and posterior instrumentation of type 3 high transverse sacral fracture-dislocation: technical note.
The authors describe an open reduction and fixation through a posterior approach of Roy-Camille Type 3 transverse sacral fractures. This technique involves posterior staged reduction of the fracture applying distraction forces to restore the height, followed by posterior translation to restore sagittal alignment. Tips and pearls of this procedure, described for the first time in the literature, are also discussed in this report.
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Cervical laminoplasty is a surgical procedure for cervical compressive myelopathy (CCM), and satisfactory outcomes have been reported. However, few reports have examined the pathophysiology of improvements in spinal cord function. The aim of this study was to investigate the variation in central motor conduction time (CMCT) before and after cervical laminoplasty in patients with CCM. ⋯ These results suggest that cervical laminoplasty improves corticospinal tract function 1 year after surgery, which may be one of the reasons for the JOA score improvements in patients with CCM. The degree of improvement in corticospinal tract function did not correlate with patient age in this case series. The results demonstrated quantitative evidence of the pathophysiology of functional recovery in the corticospinal tract following cervical laminoplasty in patients with CCM.
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The objective of this study was to assess the cross-sectional areas (CSAs) of the superficial, deep flexor (DF), and deep extensor (DE) paraspinal muscles in patients with cervical spondylotic myelopathy (CSM), and to evaluate their correlations with functional status and sagittal spinal alignment changes following central corpectomy with fusion and plating. ⋯ Patients with CSM demonstrate significant atrophy in all the flexor and extensor paraspinal muscles, and also suffer a reduction in the protective effect of a strong DF/DE CSA ratio. Worsening of this ratio significantly correlates with greater segmental kyphotic change in some patients. A physiological mechanism based on DF dysfunction is discussed to elucidate these findings that have implications in preventive physiotherapy and rehabilitation of patients with CSM. Considering that the influence of a muscle ratio was significant only in patients with hypolordosis, a subgroup that is known to have facetal ligament laxity, it may also be postulated that ligamentous support supersedes the influence of paraspinal muscles on postoperative sagittal alignment in CSM.