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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Currently, the diagnosis of pedicle screw (PS) loosening is based on a subjectively assessed halo sign, that is, a radiolucent line around the implant wider than 1 mm in plain radiographs. We aimed at development and validation of a quantitative method to diagnose PS loosening on radiographs. ⋯ The angle between the PS axis and the cranial endplate showed good ability to change in PS loosening. A change of this angle of at least 2° had a relatively high sensitivity and specificity to diagnose screw loosening.
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Sleep apnea is a multi-factorial disease with a variety of identified causes. With its close proximity to the upper airway, the cervical spine and its associated pathologies can produce sleep apnea symptoms in select populations. The aim of this article was to summarize the literature discussing how cervical spine pathologies may cause sleep apnea. ⋯ Pathologies of the cervical spine present significant additional etiologies for producing obstructive sleep apnea in select patient populations. Knowledge of these entities and their pathophysiologic mechanisms is informative for the clinician in diagnosing and managing sleep apnea in certain populations.
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Comparative Study
Computed tomography morphometric analysis of C2 translaminar screw fixation of Wright's technique and a modified technique in the pediatric cervical spine.
To establish reference data on the dimensions of C2 lamina to guide the use of translaminar screws with Wright's technique and a modified technique for pediatric patients in different age groups. ⋯ Our investigation provides insight into the anatomy of C2 lamina in six pediatric age groups. Compared to adults, the benefits of C2 translaminar screws fixation are more obvious in the pediatric spine which has a large C2 lamina. Compared to Wright's technique, the modified technique should insert a screw with bigger insert angle and shorter screw length.
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Lumbar intra-spinal canal stenosis is characterized by leg pain that intensifies during walking and intermittent claudication, while leg pain at rest is a characteristic neurological symptom of lumbar disc herniation. Until now, a correlation between leg pain at rest and symptomatic foraminal stenosis has not been reported. This is a prospective and comparative study of unilateral leg pain from L5 nerve root compression due to spinal canal stenosis to determine clinical characteristics of lumbar foraminal stenosis. ⋯ Leg pain at rest is characteristic of L5-S1 foraminal stenosis.
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To determine the reliability of pedicle screws placed in children younger than 7 years of age, and to evaluate the effect of pedicle screw insertion on further growth of the vertebra and spinal canal. ⋯ Pedicle screw instrumentation does not cause a retardation effect on the development of vertebral bodies and the spinal canal in children at an early age. It is a safe and reliable procedure to achieve a stable fixation.