Spine
-
Case Reports
Putative risk of substantial venous air embolism during vertebroplasty: a technical observation.
Technical report. ⋯ VAE is a complication with associated morbidity and mortality from percutaneous procedures for the treatment of compression fractures. An understanding of the causes, prevention, identification, and management when it occurs will serve to improve patient care and reduce morbidity.
-
Case report. ⋯ This unique case highlights the value of electrophysiology in the evaluation of a complex spinal disorder in a patient suffering from acquired TDH in the presence of extensive congenital spine and spinal cord abnormalities. Clinical symptoms and signs can be complemented by neurophysiological techniques to improve diagnostic accuracy and improve the basis for treatment recommendations. In cases involving multiple spinal abnormalities, a comprehensive neurophysiological assessment beyond paravertebral electromyography studies, including nerve conduction and somatosensory-evoked potential recordings, is recommended to assist in confirming the diagnosis.
-
Randomized Controlled Trial Multicenter Study
Intramuscular oxygen-ozone therapy in the treatment of acute back pain with lumbar disc herniation: a multicenter, randomized, double-blind, clinical trial of active and simulated lumbar paravertebral injection.
Multicenter randomized, double-blind, simulated therapy-controlled trial in a cohort of patients with acute low back pain (LBP) due to lumbar disc herniation (LDH). ⋯ Treatment of LBP and sciatica is a major concern. Although the natural history of acute LBP is often self-limiting, conservative therapies are not always effective; in such cases, O2O3 intramuscular lumbar paravertebral injections, which are minimally invasive, seem to safely and effectively relieve pain, as well as reduce both disability and the intake of analgesic drugs.
-
Retrospective evaluation of perioperative complications with recombinant human bone morphogenetic protein-2 on an absorbable collagen sponge (rhBMP-2/ACS) versus iliac crest bone graft (ICBG) for instrumented posterior cervical fusion. ⋯ The higher incidence of posterior cervical wound complications in the rhBMP-2/ACS group, although not statistically significant, may be related to an inflammatory response to rhBMP-2. This potential risk must be weighed against the elimination of donor-site complications associated with ICBG harvesting, and considered in light of ultimate clinical outcome. Additional studies are needed to clarify this issue, as well as to determine optimal dosing and carrier for usage in the posterior cervical spine.
-
An anatomic study that describes the relationship of the pedicle center to the mid-lateral pars (MLP) in the lower lumbar spine as a guide to pedicle screw placement. ⋯ The MLP is a reliable anatomic reference point for the center of the pedicle in the lower lumbarspine. Consideration needs to be taken when inserting pedicle screws at L4 and L5 because of the degree of their coronal tilts and unique pedicle footprints. It is important to distinguish a type I from type II L5 pedicle as a type II pedicle is wider, has a more lateral pedicle center relative to the MLP, and has the potential for lateral screw placement while still remaining within the pedicle.