Spine
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Prospective case series study. ⋯ Percutaneous thoracoplasty-only procedure gives significant rib humps correction and satisfactory clinical outcome. However, progression of the curve was observed after surgery. This suggests that the convex ribs function as a buttress for curve progression.
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A cross-sectional survey of spine surgery fellowship educators and trainees. ⋯ Background specialty influenced the perceptions of both fellowship educators and trainees. This study identified potential gaps or perceived deficiencies in the competency of current fellows. Improvements in spine fellowship education should target these areas through developing evidence-based curriculum changes.
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This is a clinical case report with a review of relevant literature. ⋯ Patients with spondyloptosis of the cervical spine can rarely present with chronic neck pain and minimal neurological deficits. An additional pathology, such as atlantoaxial dislocation, can add to the complexity. Circumferential stabilization and fusion would be required in such cases to achieve a good outcome. Larsen syndrome is a rare cause of nontraumatic cervical displacements.
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Case Reports
Aseptic loosening of pedicle screw as a result of metal wear debris in a pediatric patient.
This is a case report. ⋯ Metal wear debris can form in pediatric patients during the healing process after spinal fusions or when pseudarthrosis is present. Clinically, this manifests as back pain with a possible aseptic inflammatory abscess. Hardware removal can achieve resolution of symptoms and regression of inflammation.
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Biomechanical tensile testing of perinatal, neonatal, and pediatric cadaveric cervical spines to failure. ⋯ Cervical spine tensile stiffness-to-failure and load-to-failure increased nonlinearly, whereas normalized displacement at failure decreased nonlinearly, from birth to adulthood. Pronounced ligamentous laxity observed at younger ages in the O-C2 segment quantitatively supports the prevalence of spinal cord injury without radiographic abnormality in the pediatric population. This study provides important and previously unavailable data for validating pediatric cervical spine models, for evaluating current scaling techniques and animal surrogate models, and for the development of more biofidelic pediatric crash test dummies.