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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Case Reports
Congenital costo-vertebral fibrous band and congenital kyphoscoliosis: a previously unreported combination.
Congenital kyphoscoliosis (CKS) results from abnormal vertebral chondrification. Congenital fibrous bands occur in several locations with variable impact on vertebral development. ⋯ We also describe the therapeutic approach, consisting of surgical excision of the fibrous band and postoperative fulltime bracing, with a 7-year follow-up. We recommend a high index of suspicion in any unusual presentation of CKS and insist on case by case management in such cases.
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The aims of the present study were to compare the biomechanical effects on the adjacent segments after mono-segmental floating fusion with posterior semi-rigid or rigid stabilization, and to evaluate the effect of the amount of fusion mass on the biomechanical differences. ⋯ Posterior instrumentation with semi-rigid rods may lower the incidence of disk and facet degeneration in the upper adjacent segment compared to rigid rods. On the other hand, the possibility of facet degeneration will be similar for all instrumentation devices in the lower adjacent segment in the long-term. The stiffness difference between rigid and semi-rigid rods on the changes in the adjacent motion segments was more crucial than amount of fusion mass.
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To investigate the effects on evoked thalamic neuronal activity of application of notochordal cells and chondrocyte-like cells derived from nucleus pulposus (NP) onto a dorsal root ganglion (DRG) and to compare these effects with a previously reported increased thalamic activity induced by NP. ⋯ Separate exposure of the DRG to the two NP-derived cell populations induced different effects on evoked thalamic activity, but none of the tested cell samples induced an increase in neuronal activity similar to that previously observed with NP. This indicates a high complexity of the interaction between NP and nervous tissue.
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Case Reports
Anatomical changes in occipitalization: is there an increased risk during the standard posterior approach?
The purpose of this study was to examine the anatomic changes in a case of occipitalization of the atlas. ⋯ In our case, occipitalization considerably changed the anatomy of the upper cervical spine and craniocervical junction. Special care must be taken when using the posterior approach to avoid neurovascular injury in cases with occipitalization.
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To quantify the dimensions of the atlas pedicles and to analyze the relationship between extra medullary height (EMH) with intra medullary height (IMH) of the atlas pedicle. ⋯ The EMH and the IMH of the atlas pedicles were measured by using CT images of the atlas, providing anatomic parameters for surgery. They showed a certain correlation but with a high variability. C1 pedicle screw fixation was well performed when the medullary canal was ≥1 mm, but the surgical procedure should be careful when it was between 0 and 1 mm, and avoided when there was no medullary canal in the atlas pedicle! So 3D CT reconstruction should be conducted to obtain data and establish individualized fixation strategy preoperatively.