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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Comparative Study
CT scans versus conventional tomography in acute fractures of the odontoid process.
Four different radiological diagnostic methods were compared as to their diagnostic relevance in the analysis of odontoid fractures. Thirty-one patients with fresh odontoid fractures were investigated using standard anteroposterior and lateral radiographs, conventional tomography, axial computerized tomography and two-dimensional reconstruction in the sagittal and the coronal planes. As a control, 13 patients without odontoid fractures were examined. ⋯ The coefficients of correlation for the conventional tomography and two-dimensional reconstruction were kappa=0.774 and kappa=0.907, respectively. For conventional radiography and axial computerized tomography (CT), the coefficients were clearly lower, at kappa=0.364 and kappa=0.627, respectively. The less time-consuming CT examination with sagittal and coronal reconstructions is equivalent with respect to diagnostic accuracy and can, therefore, replace conventional tomography in the evaluation fractures.
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This is a prospective cohort study of patients with acute treated severe sciatica. The objectives of the study are, firstly, to describe the recovery of muscle performance by manual and isokinetic muscle testing in patients with acute severe sciatica over 1 year, and secondly, to discuss the potential clinical relevance of the isokinetic testing of the ankle for patients with acute sciatica. In clinical daily practice, muscle performance is evaluated by means of isometric manual tests. ⋯ Isokinetic muscle tests showed a higher prevalence of deficit and a much slower recovery. The manual muscle test is a crude clinical test. For more indepth muscle performance evaluation, additional testing may be necessary, especially for those patients with physically demanding jobs or activities.
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Previous studies have looked at early follow-up of the Graf ligament stabilisation system. We present mid- to long-term results of this procedure. A retrospective review of Graf ligaments inserted since 1993 was undertaken. ⋯ Forty one per cent of the group would choose not to have the operation again. Longer-term results of this technique are not as encouraging as earlier studies. The continued use of this procedure should be viewed with caution.