Spine
-
Correlation among previously validated questionnaires. ⋯ Clinically relevant improvements in pain may lead to almost unnoticeable changes in disability and quality of life. Therefore, these variables should be assessed separately when evaluating the effect of any form of treatment for low back pain. The influence of pain and disability on quality of life progresses while they last, and doubles in 14 days. In acute and subacute patients, this increase is not dependent on the previous duration of pain.
-
Subaxial sagittal alignment following atlantoaxial (A-A) posterior fusion was investigated retrospectively in patients with A-A subluxation. ⋯ Surgical fixation of A-A joint in a hyperlordotic position will lead the lower cervical spine to a kyphotic sagittal alignment after surgery. To maintain the physiologic sagittal alignment of the subaxial cervical spine, C1-C2 should not be fixed in a hyperlordotic position.
-
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.
-
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.
-
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A prospective, randomized controlled clinical trial of anterior lumbar interbody fusion using a titanium cylindrical threaded fusion device.
A prospective, randomized, controlled clinical trial comparing a cylindrical threaded titanium cage to a femoral ring allograft control for anterior lumbar interbody fusion. ⋯ Cylindrical threaded titanium cages have a higher fusion rate, comparable improvements in clinical outcome (Oswestry, Low Back Pain Questionnaire, SF-36), and fewer secondary supplemental fixation procedures compared to the femoral ring allograft control.