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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This cadaver study evaluated the value of MR images for detection of acute intervertebral disc damage associated with fractures of the thoracolumbar spine. Damage to the intervertebral disc may be a major contributor to chronic instability in non-operative treatment or failure of fixation and recurrence of deformity in posterior fixation methods. MR imaging can help us to understand the injury patterns and their prognostic significance. ⋯ These were all detected on the corresponding MR images. The study showed that MRI is able to detect acute, macroscopic injury to the intervertebral disc. It is therefore justified to use MR for the study of acute disc damage associated with thoracolumbar fractures.
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The radiographic and clinical outcomes and complications among two groups of adolescent patients treated for idiopathic thoracic scoliosis with dorsal instrumentation using a unified implantation system (Universal Spinal System) were compared retrospectively. A total of 69 patients were included in the study. In 30 patients an intraoperative correction of the scoliosis was performed by translation and segmental correction (translation group, Helsinki). ⋯ Neurological complications did not occur. In both patient groups an increase in the non-instrumented lumbar curve was noted, in two cases each. In three patients from the rod rotation group the instrumentation had to be removed due to a late infection with negative microbiological results.
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This study was designed as a cross-sectional questionnaire-based survey of low back pain (LBP) in 13- to 16-year-old Danish school children. The cohort consisted of 671 boys and 718 girls in eighth and ninth grade in 46 municipal schools in three counties of Sealand. All the pupils filled in a questionnaire with LBP as the main topic and were at the same time examined by the school doctors. ⋯ This was positively correlated to female gender, BMI more than 25 kg/m(2), competitive sport for boys, poor physical fitness, daily smoking, heavy jobs in leisure time, increased use of the health system and reduced life quality. Stepwise logistic regression analysis indicates that female gender, daily smoking and heavy jobs are important associated factors for severe LBP in adolescents, with an observed probability of 46% if all factors are present. We don't know yet whether these factors are of any causal importance in the development of severe LBP.
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We present the case of a 44-year-old female patient, who sustained an odontoid fracture after a minor trauma (uncomplicated fall). The radiologic evaluation revealed a skeletal tumor of the second cervical vertebra together with a fracture line at the base of the odontoid process of the axis. The patient underwent surgery, the tumor was resected and the odontoid was stabilised using an autologous cortico-cancellous bone graft and a halo fixator. Histologic examination revealed benign fibrous histiocytoma, which is reported to be a very rare skeletal tumor.
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Case Reports
Delayed focal neurological deficit secondary to a cervico-thoracic spinal cord epidural haematoma.
This is a report of an elderly woman who developed focal neurological deficit in association with a cervico-thoracic spinal epidural haematoma. Symptoms developed several days after the initial injury and subsequently resolved without surgical intervention. The unusual features of this presentation are discussed.