Spine
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Comparative Study
Adjacent-level range of motion and intradiscal pressure after posterior cervical decompression and fixation: an in vitro human cadaveric model.
This in vitro human cadaveric study measured adjacent-level kinematics after posterior cervical decompression and fixation. ⋯ For C3-C6 laminectomy, instrumentation to C7 significantly decreased flexion/extension ROM and intradiscal pressure at C6-C7 without significantly increasing either measure at C2-C3 or C7-T1 relative to C3-C6 fixation. In the setting of a C3-C7 laminectomy, when instrumenting to either C2 or T2, consideration should be given to including both levels within these constructs.
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Retrospective database review. ⋯ Decompressive procedures performed later in the day carry a higher risk for postoperative infection. No similar trend was shown for fusion procedures. Our results identify potential modifiable risk factors contributing to infection rates in spinal procedures. Specific risk factors, although not defined in this study, might be related to contamination of the operating room, cross-contamination between health care providers during the course of the day, use of flash sterilization, and mid-day shift changes.
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Case Reports
Delayed formation of a devastating granulomatous process after metal-on-metal lumbar disc arthroplasty.
A case report. ⋯ Metal-on-Metal TDA devices can induce a tumor-like growth with devastating consequences. The reduction of device motion by posterior stabilizing surgery does not seem to stop the growth of the granulomatous mass. The device has to be removed.
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Retrospective, case-control study. ⋯ The results of this study indicate that LOVBH greater than 50% and LK greater than 20° are not predictive of PLC injury in thoracolumbar burst fractures. Translation greater than 3.5 mm was associated with PLC injury. The PLC and neural elements should be directly assessed with magnetic resonance imaging if there is clinical concern.
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STUDY DESIGN.: Prospective in vivo randomized study. OBJECTIVE.: To evaluate the safety and efficacy of a distraction-based magnetically controlled growing rod (MCGR) in a porcine model. SUMMARY OF BACKGROUND DATA.: A high number of complications related to frequent surgical rod lengthenings has been a generally accepted outcome in growing rod surgery for early-onset scoliosis. ⋯ CONCLUSION.: The MCGR provided 80% of predicted spinal height by noninvasive remote distraction in this animal model. The accelerated increase in spinal height of the experimental animals after implant removal was an unexpected finding which requires additional research to better understand the effect of distraction on spinal growth. This study establishes a foundation for future research in an attempt to use a less invasive technique in distraction-based correction of early-onset scoliosis.