Spine
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Computer tomography (CT) presents a method of determining longitudinal axis vertebral rotation and vertebral, spinal, and rib case deformity. Different rotation angles, distances, and indexes are defined and discussed. ⋯ This accuracy was lost if the vertebrae were tilted 20 degrees in both the frontal and the sagittal plane. Computer tomography can be used for evaluation of the vertebral rotation in the frontal plane.
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To analyze the effect of the Harrington compression system on the rib hump in thoracic idiopathic scoliosis, intraoperative measurements were made on 21 cases during correction with the distraction system and after addition of the compression system. The data show that the compression system makes a major contribution to the correction of total rib deformity in over two-thirds of the patients, and the correction of the rib valley is much more significant than correction of the rib hump. Analysis of postoperative spine roentgenograms seems to indicate that the extent of the rib correction does not correlate with spine derotation as measured by the system of Nash and Moe. The improvement in rib correction achieved by addition of the compression system appears to result from changes centered about the costovertebral joints.
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This review examines, in a condensed manner, many of the major achievements related to spinal cord injury research during the last quarter century. Most of the advances have been made within the past 10 years. They include such basic and clinical tools as evoked potentials, regional and local spinal blood flows, neurophysiologic monitoring systems, and methods that detail the morphology and contents of cord tissue. ⋯ Such work has exposed significant aspects in the biochemistry and vascular mechanics associated with trauma to the cord. A growing and intriguing area of spinal injury research lies in probing the factors related to neuronal plasticity and regeneration of the cord tissue. This review also examines the role of experimental animal models as well as the clinical and experimental therapies available for acute and chronic spinal cord injury.
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The anatomy of the lumbar mamillo-accessory ligament (MAL) was studied by gross dissection in six cadavers. The MAL bridges the mamillary and accessory processes of each lumbar vertebra and encloses the medial branch of the dorsal ramus in an osseofibrous tunnel. The tunnel maintains the proximal course of the medial branch in a constant relationship to bone. ⋯ The MAL morphologically appears to represent remnants of transversospinal elements in the lumbar region, and is ossified in over 10% of lower lumbar vertebrae. Ossification may interfere with some percutaneous denervation techniques. The MAL may be a site of entrapment of the medial branch and may be a source of low-back pain.