Spine
-
Comparative Study
COL6A1, the candidate gene for ossification of the posterior longitudinal ligament, is associated with diffuse idiopathic skeletal hyperostosis in Japanese.
Genetic screening of collagen 6A1 gene (COL6A1) in patients with diffuse idiopathic skeletal hyperostosis (DISH) recruited in Japan and the Czech Republic. ⋯ Because COL6A1 could be a susceptibility to the occurrence of DISH and OPLL in the Japanese population, we consider that COL6A1 could be responsible for the hyperostotic state, leading to ectopic bone formation in the spinal ligament.
-
Retrospective chart review. ⋯ Gunshot wounds to the head and neck had a high rate of concomitant cervical spine fracture. Neurologically intact patients have a lower rate of fracture than those presenting with a spinal cord injury or altered mental status. In this small series of patients, the only unstable cervical spine injuries were detected in patients with a spinal cord injury. The data suggest that spinal precautions and/or a hard cervical collar should not be maintained at the expense of delaying or hindering emergent life-saving airway or hemodynamically stabilizing procedures, particularly in awake, neurologically intact patients. However, the cervical collar and spinal precautions should be resumed after such procedures are completed and continued until a more definitive evaluation of spinal stability can be performed.
-
Comparative Study
Cervical pedicle screws: conventional versus computer-assisted placement of cannulated screws.
Prospective clinical study with postoperative radiologic control of pedicle screw placement in the cervical spine. ⋯ Transpedicular screws in the cervical spine and cervicothoracic junction can be applied safely and with high accuracy in a conventional technique. Cannulated screws and the use of separate stab incisions from C3-C6 with a trocar system allow for reduced screw misplacement rates. The CAS system leads to significantly reduced screw misplacement rates. Therefore, because of the potential risk of injury to the vertebral artery and neural elements, the use of a CAS system seems to be beneficial, especially for pedicle instrumentation C3-C6.
-
A new proposed classification system for thoracolumbar (TL) spine injuries, including injury severity assessment, designed to assist in clinical management. ⋯ Although there will always be limitations to any cataloging system, the TLICS reflects accepted features cited in the literature important in predicting spinal stability, future deformity, and progressive neurologic compromise. This classification system is intended to be easy to apply and to facilitate clinical decision-making as a practical alternative to cumbersome classification systems already in use. The TLICS may improve communication between spine trauma physicians and the education of residents and fellows. Further studies are underway to determine the reliability and validity of this tool.
-
A report of 3 cases of upper sacral tumors excised by occluding the abdominal aorta with a balloon dilation catheter (BDC). ⋯ To occlude the abdominal aorta with a BDC may effectively reduce intraoperative hemorrhage, thus assisting the surgeon in the complete and safe resection of upper sacral tumors.