Spine
-
Case Reports
Failure of standard imaging to detect a cervical fracture in a patient with ankylosing spondylitis.
Retrospective case study of 38-year-old male with ankylosing spondylitis who presented with a Brown-Séquard syndrome following a fall and an occult fracture on initial spinal imaging studies. ⋯ Occult fractures in ankylosing spondylitis may not be apparent on routine plain radiographic and MRI studies. In the setting of ankylosing spondylitis, a high index of suspicion must be maintained in all patients presenting with spinal pain following even minor trauma. High-resolution multidetector CT imaging appears to be more sensitive and accurate in the diagnosis of fractures in this patient subgroup than other contemporary imaging methods.
-
A porous tantalum implant (Hedrocel, Implex Corp., Allendale, NJ), designed to assist interbody lumbar fusion, was tested biologically in an experimental model. A total of 11 female Danish landrace pigs received 3 levels of anterior lumbar interbody fusion at L2-L3, L4-L5, and L6-L7. Each level was randomly assigned one of the procedures: (1) implantation of PT-ring with pedicle screw fixation (PSF), (2) implantation of a porous tantalum ring (PT-ring) stabilized anteriorly with staples, or (3) implantation of carbon fiber cage (CF-cage) stabilized anteriorly with 2 staples. Each implant was filled with autogenous iliac crest bone graft. ⋯ Interbody fusion using a PT-ring cage packed with autologous bone achieved higher interface healing and more reliable fusion when fixated with supplementary pedicle screws than did fixated anteriorly with 2 staples. A lesser amount of bone graft was required, and bone remodeling was enhanced in the PT-ring when compared to the CF-cage.
-
To analyze patient outcomes and risk factors associated with proximal junctional kyphosis (PJK) in adults undergoing long posterior spinal fusion. ⋯ Incidence of proximal junctional kyphosis was high, but SRS-24 scores were not significantly affected in patients with PJK. The sagittal C7 plumb was not significantly more positive in PJK patients. No patient, radiographic, or instrumentation variables were identified as risk factors for developing PJK.
-
Retrospective study. ⋯ PVCR is an effective alternative for severe rigid scoliosis. It is a highly technical procedure and should only be performed by an experienced surgical team.
-
Comparative Study
Variability in Cobb angle measurements using reformatted computerized tomography scans.
Survey of intraobserver and interobserver measurement variability. ⋯ Reformatted CT images may be used for manual measurement of coronal Cobb angles in idiopathic scoliosis with similar variability to manual measurement of plain radiographs.