Spine
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Comparative Study Clinical Trial
Endplate degeneration observed on magnetic resonance imaging of the lumbar spine: correlation with pain provocation and disc changes observed on computed tomography diskography.
One hundred and three lumbar intervertebral discs (L3/4-L5/S1) of 36 patients with low back pain were examined with computed tomography (CT) diskography and magnetic resonance imaging (MRI). ⋯ This study showed a stronger association between endplate degeneration and disc degeneration than between endplate degeneration and disc rupture. The results indicate that the contrast injection during diskography reflects mainly pain of discogenic origin, whereas the possible pain associated with endplate damage cannot be depicted by CT diskography.
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Retrospective patient identification and prospective data collection were performed. ⋯ Anterior cervical diskectomy and fusion appears to be quite effective for discogenic cervical headache, but should be reserved for patients who are extremely impaired and refractory to all other treatments.
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The case of a 14-year-old boy who sustained simultaneous fractures of every cervical vertebra in a high-energy snowmobile accident is reported. ⋯ This case report is the first to describe a patient of any age who sustained simultaneous fractures of every cervical vertebra. Treatment with a halo vest was successful in protecting the cervical spine until healing was complete.
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Comparative Study Clinical Trial
An in vivo comparison of the potential for extravertebral cement leak after vertebroplasty and kyphoplasty.
A prospective in vivo study was conducted during the performance of kyphoplasty for the treatment of osteoporotic vertebral compression fractures, comparing extravertebral contrast extravasation with kyphoplasty and vertebroplasty. ⋯ The findings showed less vascular and transcortical extravasation of injected contrast with kyphoplasty than with vertebroplasty. Although leakage of contrast may not correlate precisely with polymethylmethacrylate leakage, the authors believe this study highlights the relative safety of these procedures.
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Case Reports
Polysegmental spondylodiscitis and concomitant aortic aneurysm rupture: case report with 3-year follow-up period.
A case report describing a patient with spondylodiscitis of the thoracic and lumbar spine complicated by rupture of an abdominal aortic aneurysm and aggravation of neurologic symptoms is presented. ⋯ In older patients, spondylodiscitis may be complicated by other underlying diseases. Pain and neurologic symptoms may occur secondarily to concomitant illnesses instead of being caused by the inflammation itself. Minimally invasive therapy is shown to be an effective alternative to surgery in older and multimorbid patients with spondylodiscitis and contained aortic aneurysm rupture.