Spine
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Comparative Study
Facet joint orientation difference between cephalad and caudad portions: a possible cause of degenerative spondylolisthesis.
A case-control study. OBJECTIVE.: To measure the orientation of the facet joints at both cephalad and caudad portions and to compare them between patients with degenerative spondylolisthesis (DS) and patients with lumbar spinal stenosis (LSS, controls). ⋯ In this study, we confirmed that the cephalad portion of the facet joints were more sagittally oriented and that the caudad portion of the facet joints were more coronally oriented in patients with DS. These findings were observed not only at L4-L5 but also at the uninvolved L3-L4 level in patients with DS at the L4-L5 level.
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Randomized Controlled Trial Multicenter Study
The effect of electrical stimulation on lumbar spinal fusion in older patients: a randomized, controlled, multi-center trial: part 2: fusion rates.
Randomized, controlled, multi-center trial. ⋯ Thin slice CT revealed very high nonunion rates after uninstrumented spinal fusion in older patients. DC-stimulation was not effective in increasing fusion rates in this patient population. The achievement of a solid fusion was associated with superior functional outcome.
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Comparative Study
2009 ISSLS Prize Winner: Does discography cause accelerated progression of degeneration changes in the lumbar disc: a ten-year matched cohort study.
Prospective, match-cohort study of disc degeneration progression over 10 years with and without baseline discography. Objectives. To compare progression of common degenerative findings between lumbar discs injected 10 years earlier with those same disc levels in matched subjects not exposed to discography. Summary of Background Data. Experimental disc puncture in animal and in vivo studies have demonstrated accelerated disc degeneration. Whether intradiscal diagnostic or treatment procedures used in clinical practice causes any damage to the punctured discs over time is currently unknown. ⋯ Modern discography techniques using small gauge needle and limited pressurization resulted in accelerated disc degeneration, disc herniation, loss of disc height and signal and the development of reactive endplate changes compared to match-controls. Careful consideration of risk and benefit should be used in recommending procedures involving disc injection.
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Case report and literature review. ⋯ Delayed neurologic deterioration after spinal surgery is uncommon. Epidural arteriovenous fistulas with secondary intradural drainage, which are rare, should be considered.
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Case Reports
Malignant pleural mesothelioma presenting as low back pain: diagnosed by bone scan coordinating with F-18 FDG PET/CT.
Case report. ⋯ The present case highlights both the value of a Tc-99m MDP bone scan when MPM presents, unusually, as low back pain, and the importance of carefully interpreting bone scan images, especially for photopenic defects. It also indicates the usefulness of F-18 FDG PET/CT study in MPM in a difficult histopathological diagnosis.