Spine
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The sensitivity of plain radiographs for diagnosing traumatic atlanto-occipital dislocation and its association with craniocervical junction subarachnoid hemorrhage was examined in a retrospective review of seven patients. ⋯ The diagnosis of traumatic atlanto-occipital dislocation is often missed in the emergency department, and current methods for evaluating the integrity of the atlanto-occipital joint on cervical radiographs fail to identify all patients with this injury. Although infratentorial subarachnoid hemorrhage is uncommon in traumatic head injury, craniocervical junction subarachnoid hemorrhage is often associated with atlanto-occipital dislocation and should raise the suspicion of severe craniocervical ligamentous injury. Sagittal computed tomography reconstructions or sagittal magnetic resonance imaging can allow for the diagnosis when plain radiography is inconclusive.
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Review Case Reports
Traumatic spondylopelvic dissociation. A case report and literature review.
A case of traumatic spondylopelvic dissociation and a method of fixation are described. ⋯ The unique fracture pattern described in this patient is presented to offer better insight into management of this complex injury and to delineate it from simpler patterns of injury to the lumbosacral junction.
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Randomized Controlled Trial Clinical Trial
Chronic cervical zygapophysial joint pain after whiplash. A placebo-controlled prevalence study.
The authors developed a diagnostic double-blindfolded survey using placebo-controlled local anesthetic blocks. ⋯ Cervical zygapophysial joint pain is common among patients with chronic neck pain after whiplash. This nosologic entity has survived challenge with placebo-controlled, diagnostic investigations and has proven to be of major clinical importance.
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Comparative Study
Comparison of lumbar sagittal alignment produced by different operative positions.
This study is a prospective evaluation of the effects of commonly used spinal tables on lumbar sagittal alignment. ⋯ When instrumentation is used to augment lumbar fusions, positions incorporating hip flexion should be avoided to ensure maintenance of sagittal plane balance.