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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This case report illustrates three learning points about cervical fractures in ankylosing spondylitis, and it highlights the need to manage these patients with the neck initially stabilised in flexion. We describe a case of cervical pseudoarthrosis that is a rare occurrence after fracture of the cervical spine with ankylosing spondylitis. ⋯ The myelopathic symptoms resolved, and the patient had a good result at 18 months. We conclude that any increased movement of the spine after trauma in ankylosing spondylitis must be considered suspect and fully investigated.
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Case Reports
Multiple myeloma of the thoracic spine developed at the previous trauma site: case report.
The precise nature of the underlying plasma cell dyscrasias is not well understood. Even today, no causative factor has been found for this disease. ⋯ This is a report of a 62-year-old man who initially had a T7 compression fracture and developed a multiple myeloma two years later at that site and at the adjacent vertebral level (T7-T8), respectively. Although the notion that trauma would initiate such a malignancy is speculative, the preceding trauma may be a causative factor in plasma cell dyscrasias.
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Randomized Controlled Trial
Single-blinded prospective randomized study comparing open versus needle technique for obtaining autologous cancellous bone from the iliac crest.
One of the most frequent complications of cervical anterior discectomy with fusion is pain at the donor site, usually the iliac crest. Despite the advent of new materials, autologous bone is still the "gold standard" for fusion procedures. A prospective, single blinded, randomized study was performed to evaluate the effect of a minimal invasive technique to obtain autologous bone from the iliac crest on pain. ⋯ Obtaining autologous cancellous bone through a large needle for filling a cervical cage (even multiple cages) is safe and evidently less painful than through a classical open procedure. If pain exists it does not last very long. Generally, the pain is resolved within 2 weeks.