Spine
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Comparative Study
A stronger bicortical sacral pedicle screw fixation through the s1 endplate: an in vitro cyclic loading and pull-out force evaluation.
The insertion torque and pull-out force after cyclic loading of the bicortical sacral pedicle screw through the S1 endplate were tested using human cadaveric specimens. ⋯ In sacral pedicle screw fixation, screw trajectory through the S1 endplate was significantly stronger than screws penetrating the anterior sacral cortex. Insertion torque was a good intraoperative indicator of screw pull-out force after cyclic loading.
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Clinical study of injection pressure during vertebroplasty. ⋯ High injection pressures approaching 20 atmospheres are reached during conventional vertebroplasty. Widening the syringe tip diameter did not significantly change injection pressures, whereas elapsed time did. Further research is needed to improve injection equipment and materials for vertebroplasty.
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Comparative Study
Non-fusion surgery for degenerative spondylolisthesis using artificial ligament stabilization: surgical indication and clinical results.
A retrospective study. ⋯ Artificial ligament stabilization did not improve the vertebral slip but maintained lordosis and preserved segmental motion in 80% of patients. This procedure is an effective alternative to spinal arthrodesis in the treatment of symptomatic degenerative spondylolisthesis (Grade I) with minimal disc space narrowing and coronal facet tropism.
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Case Reports
Atlanto-occipital dislocation with traumatic pseudomeningocele formation and post-traumatic syringomyelia.
A case report of traumatic atlanto-occipital dislocation complicated by the development of anterior and posterolateral pseudomeningoceles and the late development of syringohydromyelia is presented. ⋯ Atlanto-occipital dislocation is rarely survivable, and delayed diagnosis can negatively affect long-term clinical outcome. This case illustrates how, despite early signs of improvement, post-traumatic syringomyelia may occur months or even years after spinal trauma and should always be considered in patients who experience late neurologic deterioration after atlanto-occipital dislocation.