Spine
-
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.
-
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.
-
Retrospective review. ⋯ The lumbar retroperitoneal transpsoas MIS LIF is a safe alternative to traditional open operations for many spinal conditions. As with most minimally invasive techniques, there is a learning curve to be overcome to minimize the risk of iatrogenic nerve injuries. Our refined technique of the MIS LIF during a 3-year period has led to a significant reduction of the incidence of postoperative numbness of nearly 60% (from 26.1%-10.7%).
-
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.
-
Prospective clinical study of intraoperative transcranial motor-evoked potentials (TcMEP) amplitudes and postoperative motor deficits. ⋯ We determined the cutoff amplitude for predicting postoperative motor deficits in thoracic spine surgery. The results may help establish the alarm criteria for thoracic spine surgery.