Spine
-
This study retrospectively reviewed consecutive spinal cord injured patients older than 50 years of age. ⋯ Incomplete cervical cord lesions have the best prognosis for return to home and a functional lifestyle. Complete cervical cord injuries in patients older than 50 years of age have a 60% mortality rate. Complete cervical cord injuries in patients over 65 years have a poor prognosis for survival.
-
Review Comparative Study
Anterior cervical discectomy and fusion using a porous hydroxyapatite bone graft substitute.
This study analyzed the use of a coral hydroxyapatite bone substitute for use in ACDF both with and without an anterior cervical plate. ⋯ The use of a coral-based hydroxyapatite bone graft substitute for anterior cervical fusions led to significant rates of implant collapse at 12 weeks but showed excellent biologic compatibility with good early creeping substitution of the implant by host bone. The concomitant use of an anterior cervical plate with the implant prevents extrusion.
-
The authors evaluated transverse atlantal ligament integrity in patients with fractures of the odontoid process of the axis. ⋯ Osteoperiosteal ligamentous avulsion injuries were identified on MR imaging in three patients and were associated with acute and delayed instability and nonunion. The combination of MR imaging, CT, and plain radiographs is useful in evaluating unstable odontoid fractures to facilitate rational treatment planning. Odontoid fractures with transverse ligament injuries should be considered for early surgical stabilization because this combination of injuries is unlikely to heal nonoperatively. Anterior odontoid screw fixation should be avoided when the ligament is injured.
-
Transverse areas of the spinal canal, the dural tube and the spinal cord of the cervical spine of normal adults and patients with cervical spondylotic myelopathy (CSM) were analyzed by magnetic resonance imaging (MRI). ⋯ These results suggest that the narrow area and high ratio of the spinal canal to the spinal cord are responsible for a static factor in CSM.
-
Comparative Study
The use of the percentage change in Oswestry Disability Index score as an outcome measure in lumbar spinal surgery.
A retrospective analysis of the change in the Oswestry Low Back Pain Disability Questionnaire in a heterogeneous group of 144 operatively managed patients was undertaken to examine the change in disability index as an outcome measure. ⋯ The findings indicate that the absolute value and change in these scores after surgery vary from patient to patient, but that their percentage change is likely to be the best marker of outcome when such subjective scoring systems are used.