Spine
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A case of combined odontoid and Jefferson fracture is reported. ⋯ This is only the second reported case of a child with a combined Jefferson and odontoid fracture. This diagnosis should be considered in the evaluation of a child with neck pain and torticollis from a fall on the top of the head.
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A 12-week bovine survival study of tethering anterior spine growth that included untethered control subjects. ⋯ Anterolateral tethering of the spine creates kyphosis and scoliosis in this rapidly growing bovine model. The spinal tether limited motion primarily in lateral flexion. However, total lateral bending motion returned to levels comparable with control motion segments after removal of the tether. This method of spine growth modulation may provide a possible treatment for the correction of spine deformities without arthrodesis in patients who are skeletally immature. The exact mechanisms of growth modulation and the effects of tethering on disc function and integrity are unknown and deserve further study.
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Comparative Study
Biomechanical analysis of anterior scoliosis instrumentation: differences between single and dual rod systems with and without interbody structural support.
Nondestructive biomechanical testing was performed on bovine lumbar spines instrumented with multilevel scoliosis type anterior spine constructs. ⋯ Dual rod constructs were stiffer in torsion and flexion-extension loading than single rod constructs. Neither the number of rods nor the use of structural mesh interbody support had any effect on lateral bending stiffness. However, in a single rod system, the addition of interbody support increased stiffness in flexion. The use of structural support in dual rod constructs may be helpful in "setting" the desired lordosis, but adds little to construct stiffness.
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Patients with idiopathic scoliosis who had undergone posterior fusion by means of posterior multisegmented hook instrumentation were studied retrospectively. ⋯ The Cotrel-Dubousset technique ensures considerable sagittal correction of the spine. In the course of scoliosis correction, it is possible to preserve the normal preoperative sagittal profile of the spine, to correct the slightly flattened thoracic kyphosis, to increase materially the kyphosis of the frankly hypokyphotic spine, to preserve or restore normal lumbar lordosis in a considerable percentage of the cases, to avoid angular segmental hyperlordosis at the level of the first disc below the fusion, and to avoid retrolisthesis of the last fused vertebra.
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A systematic review was conducted for studies of any design. ⋯ Reviewed studies indicate promising results from dorsal root entry zone lesioning for the treatment of central neuropathic pain in selected patients with traumatic spinal cord injury. However, the strength of the evidence provided by the studies was poor in terms of study design, outcome measures, reports on the severity of adverse effects, patient selection criteria, and patient description. For these reasons, the evidence is weak for the use of dorsal root entry zone lesioning to relieve central neuropathic pain in patients with traumatic spinal cord injury.