European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Previous experimental studies have shown the effects of acute compression of the spinal cord and peripheral nerve roots. Recently, however, a few studies of chronic compression of the cauda equina in animal models have been reported. The purpose of this study was to determine the long-term electrophysiologic changes resulting from chronic compression of the cauda equina in dogs. ⋯ Dogs in which motor and sensory evoked potentials recovered also showed gradual disappearance of neurologic symptoms and signs. Recovery of motor evoked potentials in particular was associated with complete disappearance of neurologic symptoms and signs. For accurate prognosis in cases of chronic cauda equina compression, a combined diagnostic study of sensory and motor evoked potentials is recommended.
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Case Reports
Suction/irrigation for deep wound infection after spinal instrumentation: a case study.
Deep wound infection after spinal instrumentation is a serious complication that is difficult to treat without removing the instruments and bone graft. Debridement and suction/irrigation is an effective method of treatment in these cases. ⋯ Four patients with early post-operative infection were cured by this method without removing the instruments and bone graft, and two patients with delayed post-operative infection were cured by this method with instrument removal. Debridement and suction/irrigation is a useful method of treatment for both groups of deep wound infection and gives good results when performed soon after infection onset together with additional antibiotic therapy.
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Little is known about the influence of high-performance training on the bone quality of the lumbar spine, in particular, the effects on bone mineral density (BMD) in athletes with high weight-bearing demands on the spine. Measurements were therefore performed in internationally top-ranked high-performance athletes of different disciplines (weight lifters, boxers, and endurance-cyclists). The measurements were carried out by dual-energy X-ray absorptiometry, and the results compared with the measurements of 21 age-matched male controls. ⋯ The results show that training program stressing axial loads of the skeleton may lead to a significant increase of BMD in the lumbar spine of young individuals. Other authors' findings that the BMD of endurance athletes may decrease are confirmed. Nevertheless the 10% BMD loss of cyclists was surprisingly high.
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This prospective study with independent clinical review was set up to monitor the clinical outcome of patients when using serial periradicular/epidural corticosteroid injection techniques in managing cervical radiculopathy. Over a 10 year period, between 1986 and 1995, a consecutive series of 68 secondary referral patients presenting with cervical radiculopathy were entered into the study. There were 57 men (84%) and 11 women (16%) of average age 47 years (range 31-65 years). ⋯ Despite the fact that all 68 patients were potential surgical candidates, they all made a satisfactory recovery without the need for surgical intervention. Forty-eight patients (76%) did not experience any arm pain, and of the 15 patients (24%) who did, this improved from 10 to an average of 2 (range 1-4) on a 10-point pain scale. Thus, patients with cervical radiculopathy make a satisfactory recovery with serial periradicular/epidural corticosteroid injections without the need for surgical intervention.
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We report on two children with tuberculosis of the craniocervical junction. Atlantoaxial instability was evident in both patients due to the destruction of the dens and the atlantoaxial ligaments. ⋯ Despite anti-tuberculosis treatment and immobilization, atlantoaxial instability was evident on flexion/extension views. Successful fusion of C1 and C2 was performed in both patients.