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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To report the results of coccygectomy for coccygeal spicule. ⋯ Surgical treatment for coccygeal spicules that are causing coccygodynia and are resistant to conservative treatment gives satisfactory outcomes, similar to those obtained from surgery for instability of the coccyx.
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To determine whether particulate debris is present in periprosthetic tissue from revised Dynesys(®) devices, and if present, elicits a biological tissue reaction. ⋯ This is the first study to evaluate wear accumulation and local tissue responses for explanted Dynesys(®) devices. Polymer wear debris and an associated foreign-body macrophage response were observed in three of five cases.
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Case Reports
Nontraumatic posterior atlantooccipital dislocation associated with atlantoaxial instability.
Nontraumatic posterior atlantooccipital dislocation has only been rarely reported. In the current study, the authors reported an extremely rare case of nontraumatic posterior atlantooccipital dislocation associated with atlantoaxial instability. ⋯ To our knowledge, this lesion has not been reported previously. Anomalies of upper cervical spine may have induced this instability.
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Septic cervical facet joints arthritis is a rare pathology, usually revealed by fever and neck pain. As symptoms may be indolent, a high index of suspicion needs to be maintained. Magnetic resonance imaging (MRI) is effective for early diagnostic, looking for local spread and guiding potential preoperative planning. We present a case exhibiting an uncommon pathology with possible significant morbidity if misdiagnosed. ⋯ Atlantoaxial septic arthritis is an under reported and severe infection. Early use of MRI should avoid delayed diagnosis and would guide the practitioner in choosing an appropriate therapy. Early surgical treatment for uncontrolled sepsis is also a critical element of the prognosis.
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While correction surgery for syringomyelia-associated scoliosis frequently results in an elongation of the spine and may potentially influence the natural history of syringomyelia, a paucity of data exists regarding the syrinx behavior in the postoperative course. This study aimed to investigate the natural evolution of syrinx in patients undergoing one-stage posterior instrumented spinal fusion for treatment of scoliosis associated with idiopathic syringomyelia (IS). ⋯ For treatment of scoliosis associated with IS in the setting of minimal neurological deficits, one-stage spinal fusion with a lengthening of the vertebral column provides an effective coronal and sagittal correction without neurologic complications. Following surgery, the vast majority (95.5%) of syringes shrank or remained stable, indicating that deformity correction did not exert a deleterious effect on the natural evolution of syringomyelia.