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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The study design included an in vivo laboratory study. The objective of the study is to quantify the kinematics of the lumbar spinous processes in asymptomatic patients during un-restricted functional body movements with physiological weight bearing. Limited data has been reported on the motion patterns of the posterior spine elements. ⋯ During flexion the ISP distances were not significantly different than those measured in the MRI position at all segments. Going from the left to right twist positions, the L4-5 segment had greater amounts of ISP rotation, while all segments had similar ranges of translation in the transverse plane. The interspinous process distances were dependent on body posture and vertebral level.
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A resorbable composite material (40% PLLA and 60% beta TCP) with a high breaking strength and capacity to withstand plastic and elastic strain has been developed for cervical interbody fusion. This is a prospective study to evaluate clinical and radiological results of 20 patients implanted with 27 cages (mean follow-up, 27 months). Clinical (neck disability index, VAS, neurological evaluation) and radiological (anteroposterior, lateral, bending X-rays) data were assessed before and after surgery. ⋯ This demonstrates a biological activity and changing bone mineral content of this tissue. The new composite cage under investigation provides long-term fusion without loss of correction or inflammatory reaction. The ceramic block guarantees the maintenance of the disc height and its slow resorption allows long-term fusion and stability with good and reliable clinical and radiological outcomes.
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Comparative Study
Symptom profile of persons self-reporting whiplash: a Norwegian population-based study (HUNT 2).
The aetiology of chronic whiplash associated disorder (WAD) is unclear and the condition has been perceived both as a chronic pain disorder, based on the injury to the neck, and as a functional somatic disorder. Based on the hypothesis that chronic WAD should be perceived as a functional somatic syndrome, we compared the symptom profile of persons with chronic WAD with the profile of persons with a functional somatic disorder, and with the profile of persons with an organic pain disorder. A sample of 55,046 persons participating in a Norwegian population-based health study (HUNT 2) was divided into four study groups: chronic WAD, fibromyalgia, rheumatoid arthritis, and controls (none of these disorders). ⋯ The fibromyalgia group had an even higher prevalence of all symptoms, while the rheumatoid arthritis group showed an increase in the prevalence of particularly pain and stiffness symptoms and also a minor increase in the prevalence of other symptoms compared to the control group. We conclude that this study provide evidence in favour of the hypothesis that chronic WAD should be perceived as a functional somatic syndrome. Persons with chronic WAD had a symptom profile more similar to people with a functional somatic disorder than an organic pain disorder, consisting of a wide array of symptoms, not only predominantly pain symptoms.
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Case Reports
Staged corrective surgery for complex congenital scoliosis and split cord malformation.
Congenital scoliosis associated with split cord malformation raises the issue on how to best manage these patients to avoid neurologic injury while achieving satisfactory correction. We present the case of a 12-year-old girl who first presented when she was 11-year old with such combination but without much physical handicap or neurological deficit. The corrective surgery offered at that time was refused by the family. ⋯ In this grand round case, we discuss all the different option of treatment of congenital scoliosis associated with split cord malformation. In a medical environment where spinal cord monitoring is lacking, we recommend an initial release followed by skull and bifemoral traction over several days to monitor the neurologic status of the patient. Once optimal correction is achieved with the traction, a posterior instrumentation can be safely done.