Spine
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A case report. ⋯ This report raises awareness for the need of a thorough evaluation of the cervical spine to determine patients at high risk for craniovertebral dislocation and atlantoaxial rotatory subluxation, primarily in the context of KFS or other congenital conditions. Three-dimensional CT and MR imaging are ideal radiographic methods to determine the presence and extent of craniovertebral dislocation, AARF, and of abnormal vertebral anatomy/malformations. In addition, the authors propose a modification to the Fielding and Hawkins classification of AARF to include variants and subtypes that account for abnormal anatomy and congenital anomalies/malformations.
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Pre-post intervention study using outcome measure design. ⋯ Vertebral wedge osteotomy is potentially an effective treatment option for paralytic scoliosis. At 2-year follow-up, there was no loss of function as measured by the PODCI and FIM, and there was improvement in the COPM. Cobb angle measurements were either improved or maintained in 12 of 13 patients. Although 2 patients required fusion, they had an average of 2.5 years of subsequent growth before surgery.
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We describe an innovative single-stage reduction and stabilization technique using modern cervical instrumentation. ⋯ In this article we will discuss the clinical cases and review the background of craniocervical junction abnormalities in Down's syndrome patients. We hypothesis modern instrumentation has made more aggressive surgical corrections possible and has reduced the need for transoral resection of the odontoid and traction reduction in children with basilar invagination.
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Computer modeling using patient computed tomography (CT) exposure data. ⋯ Precise CT technique of the spine, covering the smallest area necessary to answer the clinical question, has a dramatic effect on the estimated cancer risk for individual patient. Cancer risks are summative, so spine CT imaging needs to be considered in the light of the total radiation risk to the patient over their lifetime.
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Neck-pain and control group comparative analysis of conventional and virtual reality (VR)-based assessment of cervical range of motion (CROM). ⋯ Neck pain is significantly associated with reduced CROM as demonstrated by both VR and conventional assessment methods. The VR method provides assessment of functional CROM and can be used for CROM enhancement. Assessment by VR has greater sensitivity than conventional assessment and can be used for the detection of true symptomatic individuals.