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 a rare fourth atlanto-axial joint. ⋯ A unique case with an anatomically proven fourth atlantoaxial joint is reported. This anomaly can lead to misdiagnosis. CT scan coupled with MRI can facilitate accurate diagnosis.
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The thoracic spine is considered a rigid region because it is restricted by the rib cage. Previously, we reported functional alignments and range of motion (ROM) at all segmental levels. The purpose of this study was to investigate dynamic changes of the dural sac and spinal cord in the thoracic spine using a multidetector-row computed tomography (MDCT). ⋯ The thoracic spine showed some dynamic changes of the dural sac and spinal cord in the axial plane within functional motion. Segmental kyphotic angle, rather than segmental ROM, was the more important factor affecting dimensions of the dural sac and spinal cord.
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A fabricated mesh cage and/or posterior occipitocervical instrumentation alone has been used for reconstruction of ventral defect of the upper cervical spine. However, using a trimmed mesh cage it was hard to achieve optimal clival screw purchase and it migrated or broke. A specific instrumentation at the craniovertebral junction (CVJ) should incorporate the morphology of the CVJ and biomechanical validation. The purpose of the present study was to develop an innovative clivus plate integrated with the clinical anatomy of CVJ and to evaluate the stability of the clivus plate fixation (CPF), stand-alone or combined with a posterior occipitocervical fixation (POCF). ⋯ This study demonstrated screw purchase in the adult clivus and developed an innovative clivus plate fixation for reconstructing an extensive ventral defect in the upper cervical spine. The clivus plate fixation combined a posterior instrumentation ensuring reliable upper cervical stability.
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Osteoblastoma (OBL) is a benign bone tumor with considerable recurrence potential. Resection is the mainstay for the treatment of Enneking stage 3 (st. 3) OBL. This retrospective study aimed to verify the appropriate surgical strategy for st. 3 lesions in the mobile spine. ⋯ Intralesional total vertebrectomy might be an appropriate choice for intact st. 3 OBL spine lesions. More cases with longer follow-up periods should be recruited in the future to better understand the treatment options available for this disease.
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Degenerative lumbar scoliosis (DLS) is a spinal deformity that typically develops in adults over 50 years old. Although its etiology is unclear, asymmetric degeneration of the spine is the main cause. Individuals with DLS may experience no symptoms of the deformity, mild symptoms, or severe disability. Most patients with DLS receive conservative treatment, while a small number of patients receive surgery for severe DLS with back pain and/or progressive neurological symptoms. A variety of surgical procedures have emerged. However, a systemic comparison of these surgical procedures is currently unavailable. This study reviews the main outcomes and complications of surgical treatments. ⋯ Despite a high rate of complications, this review demonstrates that surgery is an effective and reasonable treatment intervention for severe DLS and ultimately improves spine function and deformity. This review also suggests that large scale, high quality studies with long term follow-up are needed to provide more reliable evidence for future evaluation.