Spine
-
A retrospective clinical review of 20 children seen during a 7-year period who had atlantoaxial rotatory subluxation. ⋯ Optimal management of atlantoaxial rotatory subluxation entails early diagnosis with plain cervical radiographs and dynamic computed tomography. Closed reduction with cervical traction followed by rigid immobilization accomplished reduction in 15 of 16 patients (94%) and was curative in 10 of 16 patients (63%). Although reduction was achieved more rapidly and effectively with traction than with a collar, there may be a role for simple immobilization without reduction in patients with a short duration of symptoms. There does not appear to be a correlation between cause of atlantoaxial rotatory subluxation, age, or sex and the likelihood of recurrence.
-
A cross-sectional postal survey of 29,424 people aged 12-41 years obtained from a population-generated panel of twin individuals. ⋯ There is a definite link between smoking and low back pain that increases with the duration and frequency of the low back pain problem, but this link is unlikely to be causal.
-
Case Reports
Fatal cardiac tamponade associated with posterior spinal instrumentation. A case report.
Case report of a fatal complication of pedicle screw instrumentation and review of the literature. ⋯ There are numerous possible intraoperative complications in posterior pedicle screw fixation, such as nerve root and spinal cord injuries. This case of a fatal heart tamponade after transpedicular screw insertion is rare. It shows that the surgeon must be aware of potential risks associated with such a procedure and have a comprehensive three-dimensional understanding of the anatomic structures involved.
-
This prospective study consisted of mechanical stimulation of cervical nerve roots C4 to C8 in patients with cervical radicular symptoms undergoing diagnostic selective nerve root block. ⋯ The current study demonstrates a distinct difference between dynatomal and dermatomal maps.
-
This study assessed the value of using lateral radiographs in evaluating the optimal screw length in transarticular C1-C2 screw fixation. ⋯ This results in this study indicate that a lateral radiograph may not be reliable in determining the optimal screw length, although it is valuable in directing accurate screw angle in the sagittal plane. Preoperative computed tomographic evaluation of the C1-C2 region may be helpful in estimating the location of the screw tip on the lateral radiograph during surgery.