Spine
-
A retrospective study of patient outcomes after decompression and fusion for degenerative spondylolisthesis, using the SF-36 survey and a functional questionnaire. ⋯ Patients treated with decompression and fusion for degenerative spondylolisthesis had improved functional outcomes, when measured by a disease-specific questionnaire and by widely used instruments.
-
Thirty-four patients with idiopathic scoliosis who underwent anterior spinal surgery as part of the correction of spinal deformity were studied prospectively. Superior and inferior endplates were harvested and examined histologically for evidence of residual growth activity. This was then correlated with Risser grades, chronologic age, and pubertal status. ⋯ The crankshaft phenomenon is reported to occur only in patients with Risser Grade 2 or less, particularly those with open triradiate cartilages. Our findings of significant endplate growth activity, even in patients with Risser Grade 4, make it unlikely that the crankshaft phenomenon is caused purely by longitudinal spinal growth.
-
Comparative Study
Biomechanical analysis of anterior versus circumferential spinal reconstruction for various anatomic stages of tumor lesions.
Spinal reconstruction procedures for metastasis evaluated biomechanically using human cadaver specimens. ⋯ For corpectomy or subtotal spondylectomy, anterior reconstruction alone can provide stiffness equivalent to circumferential reconstruction. However, total spondylectomy significantly reduces the anterior reconstruction stiffness, suggesting the need for combined anterior and posterior procedures.
-
Comparative Study Clinical Trial
Temporary external transpedicular fixation of the lumbosacral spine.
In this study, 133 patients with incapacitating low back pain underwent temporary external transpedicular fixation of the lumbosacral spine in a prospective trial. Of these patients, 67% had undergone one or more spinal procedures in the past. On the basis of temporary external transpedicular fixation, 55 of 133 patients were treated conservatively. With an average follow-up period of 37 months, the clinical results were analyzed. ⋯ In selecting suitable candidates for spinal fusion, temporary external transpedicular fixation (including a placebo trial) can be a valuable test.
-
Comparative Study
Traumatic instabilities of the cervical spine caused by high-speed axial compression in a human model. An in vitro biomechanical study.
Traumatic injury of the cervical spine was produced on human cadavers and evaluated with instability tests and radiographs. ⋯ The injury patterns of the cervical spine were associated with impact energy, and a high level of impact energy could produce either three-column injury or anterior middle-column injury. Instabilities of the cervical spine caused by compressive trauma increased with the level of impact energy. The neutral zone was more sensitive than the range of motion in representing spinal instability, whereas instability testing was more sensitive than radiographs in evaluating traumatic injury of cervical spine.