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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Pedicle subtraction osteotomy (PSO) was developed to achieve significant correction of a deformity. It was initially used to correct sagittal plane deformities associated with ankylosing spondylitis, but recently it has also been performed in patients with post-traumatic kyphosis. Our aim was to report a case of a floating spine after PSO for post-traumatic kyphosis. ⋯ This case points out a pitfall of PSO. Although it is a powerful tool for correcting an imbalanced spine, we should recognize its pitfalls and try to avoid them.
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Subacute combined degeneration (SCD) is a potentially reversible neurological complication of a vitamin B12 deficiency; therefore, timely diagnosis and appropriate treatment are of great importance. The study was to evaluate the spine MR imaging features of SCD in a series of patients. ⋯ Symmetric T2-hyperintensity within dorsal column of spinal cord is commonly seen in SCD patients with a linear pattern in the cervical spine and a nodular pattern in the thoracic spine.
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The surgical removal of lateral mass lesions is demanding due to their close anatomical relationship with the vertebral artery, upper spinal cord as well as overlying muscular structures. Usually a dorsal approach will be performed to reach the lateral mass. The disadvantage of this approach is the extensive mobilization of the neck muscles required to allow exposure of the lateral mass, which can be accompanied by severe muscular atrophy due to the damage of the local innervation. Additionally, management of the exposure of the vertebral artery is hindered by the dorsal approach. ⋯ This far lateral approach offers the advantage of direct visualization of the lateral aspect of the upper cervical spine with the opportunity for local stabilization at the center of rotation.
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The sedimentation sign (SedSign) has been shown to discriminate well between selected patients with and without lumbar spinal stenosis (LSS). The purpose of this study was to compare the pressure values associated with LSS versus non-LSS and discuss whether a positive SedSign may be related to increased epidural pressure at the level of the stenosis. ⋯ Patients with LSS have an increased epidural pressure at the level of the stenosis and altered pressure wave characteristics below. We argue that the absence of sedimentation of lumbar nerve roots to the dorsal part of the dural sac in supine position may be due to tethering of affected nerve roots at the level of the stenosis.
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The purpose of the study was to: (1) introduce a new CT-based parameter: free facet area and provide its normative data; (2) standardize the method of measuring isthmus width and height of the axis vertebra; (3) propose a new grading system to predict the difficulty in inserting transarticular and C2 pedicle screws. ⋯ Inserting a transarticular screw was more frequently difficult as compared to pedicle screw. A new CT-based parameter (free facet area) and an efficient grading have been proposed to help surgeons choose the appropriate screw options, appreciate the complex anatomy of this region and compare data across various studies.