Spine
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A retrospective analysis of 32 rotationally unstable cervical fractures treated by brace, halo vest, or posterior surgical constructs plus fusion is compared with a second, prospective study of 18 similar fractures treated by early anterior discectomy, fusion, and plating. ⋯ Although posterior bony injury is the usual radiographic finding, the anterior disc and anterior longitudinal ligament disruption are the more significant injuries and lead to late collapse and kyphotic deformity. Early anterior fusion is recommended in compression- extension Stage 1 cervical spine injuries.
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Comparative Study
Segmental stability and compressive strength of posterior lumbar interbody fusion implants.
Human cadaveric study on initial segmental stability and compressive strength of posterior lumbar interbody fusion implants. ⋯ The biomechanical data did not suggest any implant construct to behave superiorly either as a stand-alone or with supplemental posterior fixation. The PLIF Allograph Spacer is biomechanically equivalent to titanium cages but is devoid of the deficiencies associated with other cage technologies. Therefore, the PLIF Allograft Spacer is a valid alternative to conventional cages.
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Comparative Study
Effects of core body temperature on changes in spinal somatosensory-evoked potential in acute spinal cord compression injury: an experimental study in the rat.
Acute spinal cord injury was induced by a clip compression model in rats to approximate spinal cord injury encountered in spinal surgery. Spinal somatosensory-evoked potential neuromonitoring was used to study the electrophysiologic change. ⋯ Systemic cooling may protect against the detrimental effects of aggressive spinal surgical procedures. There is still not enough published information available to establish statistically and ethically acceptable intraoperative neuromonitoring warning and intervention criteria conclusively. Therefore, an urgent need exists for further investigation. Although a reduction of more than 50% in evoked potential still seems acceptable as an indicator of impending neural function loss, maintenance of more than 50% of baseline evoked potential is no guarantee of normal postoperative neural function, especially at lower than normal temperatures.
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Review Case Reports
Idiopathic spinal cord herniation: report of three cases and review of the literature.
Three case reports and a literature review are presented. ⋯ Because idiopathic spinal cord herniation is out of the concept of "compression myelopathy," this condition may be a pitfall in the diagnosis. Idiopathic spinal cord herniation should be recognized as one of the treatable causes for thoracic myelopathy.