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 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.
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We retrospectively investigated the radiographic findings in patients with atlanto-axial subluxation (AAS) due to rheumatoid arthritis, and clarified the effect of reduction of the atlanto-axial angle (AAA) on the cranio-cervical and subaxial angles. ⋯ A proper reduction of the AAA did not affect the cranial angles or induce kyphotic malalignment of the subaxial region after atlanto-axial arthrodesis. However, if we can obtain a significant and large reduction of AAA in patients showing kyphosis before surgery, then this reduction will be offset in the atlanto-occipital joint and we should therefore pay special attention to its morphology after surgery.
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Case Reports
Iliac artery perforation and treatment during lumbar disc surgery by simple balloon tamponade.
Although vascular injury during lumbar disc surgery is quite rare, it may be life threatening if not recognized and treated immediately. ⋯ This case differs from those published in the literature as we used a single balloon inflation and subtotal occlusion without the need for a covered stent.
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To investigate the clinical and radiological outcomes of multilevel minimally invasive transforaminal lumbar interbody fusion (MITLIF) in multilevel degenerative lumbar diseases. ⋯ Regardless of the number of fused levels, satisfactory clinical and radiological outcomes of MITLIF were seen in patients with spinal stenosis, which suggests that the said surgical procedure may be useful even for patients with multilevel spinal stenosis.
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We describe a male patient, who was seen for the first time at the age of 8 years because of short trunk dwarfism. Spine radiographs showed platyspondyly with irregular areas of increased and decreased mineralization (irregular spotted appearance within lytic lesions located along the posterior vertebral bodies of the entire spine). ⋯ At the age of 17, progressive spine stiffness associated with stooping posture developed. 3DCT scanning showed pathological transformation of the spinal enchondromas into generalized ossification and thickening of the posterior vertebral elements (vertebral laminae, supraspinal, and interspinal ligaments, respectively) causing effectively the development of a diffuse posterior spinal ankylosis. We report what might be a unique subtype of spondyloenchondrodysplasia (Spranger type IV).