Spine
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Case Reports
Bilateral pedicle stress fractures in a female athlete: case report and review of the literature.
Clinical case report of bilateral stress fractures of the pedicle in a female athlete presenting with back pain. ⋯ In this uncommon case of bilateral stress fractures of the pedicle, circumferential fusion assures full immobilization of the injured motion segment and assures a high probability of successful healing.
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Comparative Study Clinical Trial Controlled Clinical Trial
Characterization of acute whiplash-associated disorders.
An experimental study of motor and sensory function and psychological distress in subjects with acute whiplash injury. ⋯ Acute whiplash subjects with higher levels of pain and disability were distinguished by sensory hypersensitivity to a variety of stimuli, suggestive of central nervous system sensitization occurring soon after injury. These responses occurred independently of psychological distress. These findings may be important for the differential diagnosis of acute whiplash injury and could be one reason why those with higher initial pain and disability demonstrate a poorer outcome.
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Comparative Study
Morphometric comparison of the pedicle rib unit to pedicles in the thoracic spine.
A radiographic study of the pedicle rib unit morphology as compared with measurements of the pedicle in cadaveric thoracic spines. ⋯ This study confirms the marked difference in size of the pedicle rib unit as compared with the pediclein both transverse width and chord length. This allows for a space that accommodates much larger major screw diameters, longer screw lengths, and because of the nature of screw placement, a greater screw convergence. Thus, there is anatomic potential for extrapedicular vertebral body fixation in the thoracic spine. However, care must be taken in placement of screws following precisely our previously described method of extrapedicular screw insertion. Penetration of surrounding structures, most notably the aorta on the left, is a potential risk when deviating from the method. Biomechanical evaluations are presently being conducted to evaluate the use of extrapedicular thoracic screw fixation.
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A case report of bipartite atlas associated with os odontoideum and review of the pertinent literature are presented. ⋯ We described a rare association of an anterior arch aplasia, posterior arch defect and os odontoideum. The natural history of patients with os odontoideum suggests that these people have a potentially precarious existence.
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Brown-Sequard syndrome is an incomplete spinal cord lesion characterized by a clinical picture reflecting hemisection of the spinal cord in the cervical or thoracic region. Brown-Sequard syndrome may be the result of penetrating injury to the spine, but many other etiologies have been described. In particular, cervical disc herniation has been rarely reported as a cause of this syndrome, and including the first article of Stookey in 1928, 9 only 22 cases have been reported. ⋯ A critical review of the pertinent literature is proposed, and the neuroradiologic, therapeutic, and prognostic implications are discussed. Brown-Sequard syndrome produced by a cervical disc herniation is presumably often underdiagnosed, and early surgical intervention is always recommended.