Spine
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A case of a 3-part fracture of the axis combining an odontoid dens and a hangman fracture is reported. ⋯ This single time procedure was able to achieve primary stability of the fractures of the axis and offers the possibility of an early mobilization of the patient with a good outcome. This approach allowed a better preservation of the cervical range of motion compared with a classic posterior fusion.
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Comparative Study
In vivo analysis of atlantoaxial motion in individuals immobilized with the halo thoracic vest or Philadelphia collar.
In vivo biomechanical comparison of the halo thoracic vest (HTV) and the Philadelphia collar (PC). ⋯ Under the extremes of flexion and extension bendings, the current study demonstrated that there was no significant difference in restriction of sagittal motion at C1-C2 when using the PC instead of the HTV in a group of 20 young normal adults. In light of the current biomechanical data and a selected review of literature, it is concluded that the use of a PC is sufficient for the treatment of stable odontoid fractures.
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A retrospective study of a consecutive series of all patients with pyogenic spinal infections treated at a single institution over a 10-year period. ⋯ The current data suggest that chronic liver failure and the presence of a distant nonspinal infection are possible risk factors for neurologic involvement in patients with pyogenic spinal infections. These risk factors have not been previously described. This knowledge warrants closer surveillance for neurologic deficit in patients with these conditions.
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Pedicle involvement in spinal tuberculosis (TB), the prevertebral abscess formation, severity of vertebral body, and disc collapse were evaluated from magnetic resonance imaging (MRI) of the patients. ⋯ The posterior spinal element, specifically the pedicle is not uncommonly involved in spinal TB. Pedicle involvement is part of the disease process and usually associated with relatively severe vertebral body and disc destruction, wide prevertebral abscess, and severe kyphosis. Pedicle involvement can be detected early from MRI and need to be documented as it may influence the treatment strategy.