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 objective of this study was to evaluate the reproducibility of the cervical range of motion device when measuring both active and passive range of motion in a group of individuals with sub-acute Whiplash Associated Disorders (WAD). ⋯ The CROM device has proven to be a reproducible measurement method for a symptomatic WAD population using the measurement protocol described and can be used with confidence to differentiate individuals according to a single measurement.
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We report our experience and literature review concerning surgical treatment of neurological burst fractures of the fifth lumbar vertebra. ⋯ The L5 burst fractures are rare and mostly due to axial compression. Cauda and/or nerve root injuries are absolute indications for surgery. If an anterior approach is technically difficult, laminectomy can allow for decompression, and it can be easily combined with transpedicular screw fixation. Posterior instrumented fusion, also performed with the aim to restore sagittal profile, when associated with an accurate spinal canal exploration and decompression, may be looked at as an optimal treatment for neurological L5 burst fractures.
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Fluoroscopy-guided percutaneous access to thoracic vertebrae is technically demanding due to the complex radiological anatomy and close proximity of the spinal cord, major vessels and pleural cavity. There is a trend towards computed tomography (CT) guidance due to a perceived reduction in the risk of spinal canal intrusion by instrumentation causing neurological injury. Due to limited access to CT guidance, there is a need for safe fluoroscopy-guided percutaneous access to the thoracic spine. ⋯ Percutaneous access to the thoracic spine using fluoroscopic guidance is safe. The crucial step of the protocol is not to advance the tool beyond the medial pedicle wall on the anterior-posterior projection until the tip of the instrument has reached the posterior vertebral cortex on the lateral projection.
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Technical report on the surgical technique of asymmetric osteotomy of the spine for coronal imbalance. ⋯ Satisfactory correction of coronal deformity can be achieved with APSO from an isolated posterior approach. In contrast to sagittal osteotomies, blunt dissection along the anterior cortex is necessary to allow safe resection of anterior cortical bone for closure of the wedge.
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A retrospective review of a case series. ⋯ Anterior decompression using a mini-transthoracic approach provides sufficient exposure for microsurgical decompression of giant thoracic disc herniations without disrupting the stability of the spine. Microsurgical decompression without instrumentation does not appear to lead to vertebral collapse or spinal malalignment.