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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Randomized Controlled Trial Comparative Study Clinical Trial
The use of plate fixation in anterior surgery of the degenerative cervical spine: a comparative prospective clinical study.
The method of anterior mono- or bisegmental cervical spine fusion is a well-established procedure for degenerative conditions of the cervical spine. While the early reports promote fusion with bone graft alone, recent studies report superior results with the addition of anterior plating. The objective of this study was to evaluate the influence of using plates in anterior cervical spine fusion in a prospective study. ⋯ There was no significant difference between the groups for fusion rating, but graft quality (graft height) was significantly better in the plated group. We conclude that the overall data do not suggest better results with plating in mono- or bisegmental anterior spine fusions. Indications for additional internal fixation are restricted to special conditions with increased instability, insufficient bone quality or inappropriate graft placing.
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Cardiac transplant surgery is being performed with increasing frequency as a treatment for end-stage heart disease. In addition to the well-known post-surgical problems of rejection and infection, these patients may present at a future date with other medical problems which require surgical treatment, including orthopaedic pathology. ⋯ Several cases of cholecystectomy performed in heart transplant recipients have been described, but to our knowledge no orthopaedic procedures have been reported in such patients. We report on a 15-year-old patient who underwent successful corrective surgery for idiopathic scoliosis 14 months after heart transplant.
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Gordon's Syndrome is described as an autosomal dominant condition with the characteristics of short stature, a stiff spine, camptodactyly (89%), cleft palate (27%) and club feet (73%). The authors present a case report of a patient with this rare entity complicated by an unusual complex spinal deformity. There are no prior reports in the literature concerning operative or nonoperative management of deformity in this patient population. Scoliosis in Gordon's Syndrome shares the characteristics of an arthrogrypotic neuromuscular curve and demands extensive soft tissue release for optimal correction.
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We investigated 112 patients [mean age 39.5 +/- 10.5 years, 59% women (n=66)] with chronic posttraumatic headache following cranio-cervical acceleration/deceleration trauma after an average time interval of 2.5 +/- 1.9 years from trauma. Headache following minor head injury or whiplash is one of the most prominent problems in neurotraumatology. Previous research is inconclusive regarding the symptomatic approach of this type of headache. ⋯ In 104 patients (93%), neck pain was associated in time with headache. Each of the diagnosed headache types in this study may require specific treatment strategies based upon empirical studies of non-traumatic headache types. For these reasons a detailed analysis of headache following cranio-cervical acceleration/deceleration trauma is necessary.
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Since the introduction of the technique of vertical open-configuration systems, efforts have been made to obtain functional lumbar spinal magnetic resonance (MR) images. The purpose of this study was to determine the relation between facet joint orientation and flexion patterns in the lower lumbar spine. Thirty-four normal subjects (18 women, 16 men) were examined in a vertical open 0.5-T MR scanner with T1-weighted gradient echo (GE) sequences. ⋯ There were no significant differences between the three groups at L3/L4. The three different flexion patterns in normal subjects and their relation to facet joint orientation have not been described previously. Knowledge of these patterns may lead to a better understanding of physiological spinal movement as a base for future investigations in low back pain patients.