Spine
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Retrospective clinical study. ⋯ Nonsurgical derived spinal hematomas are rare. In this series, most cases were spontaneous and located in the cervical or cervicothoracic region producing severe neurologic deficit and pain. Treatment should be surgical evacuation in the majority. As most hematomas are of great extension, alternating hemilaminectomy suffices for evacuation of extradural hematomas and supports the stability of the spinal segments. Outcome is highly dependent from initial neurologic status.
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A radiographic review of 87 patients with either unilateral or bilateral facet dislocations or fracture/dislocations treated with anterior cervical discectomy, fusion, and plating. ⋯ Loss of postoperative alignment occurred in 13% of facet fracture subluxations treated with anterior cervical discectomy, fusion, and plating. Concern regarding mechanical failure of flexion/distraction injuries should be high when they are associated with fractures of either the facets or of the endplate. Endplate fracture was associated with both mechanical failure and pseudarthrosis.
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Three-dimensional intervertebral motions of the subaxial cervical spine during head rotation were investigated in healthy volunteers using three-dimensional magnetic resonance imaging (MRI). ⋯ We investigated intervertebral motions of the subaxial cervical spine during head rotation using a three-dimensional imaging system, and obtained the first accurate depictions of in vivo coupled motion. These findings will be helpful as the basis for understanding abnormal conditions.
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Case Reports
Fracture of the posterior margin of the lumbar spine: case report after an acute, unique, and severe trauma.
Case report. ⋯ An acute and severe spine trauma in a nonathlete adolescent with no previous history of lumbar pain can lead to posterior vertebra margin fracture. Neurologic deficiency may appear, and it can be directly related to the posterior displacement of bone fragment or to a compressive peridural hematoma. Radiographs and computed tomograph scans are used for diagnosis. Magnetic resonance imaging is accurate to visualize disc space and for the diagnosis of peridural hematoma. Treatment is surgical and consists of laminectomy, hematoma drainage, and excision of bone fragment. Discectomy and arthrodesis are to be considered in relation to age, magnetic resonance imaging findings, and type of bone lesions.
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Clinical Trial
Intraoperative Iso-C C-arm navigation in cervical spinal surgery: review of the first 52 cases.
Fifty-two study participants underwent cervical spine surgery using intraoperative Iso-C imaging with or without spinal navigation. ⋯ Iso-C intraoperative fluoroscopy is an accurate and rapid way to perform CT-quality image-guided navigation in cervical spinal surgery. In most cases, it obviates the need for postoperative imaging.