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
Brucellosis of the spine with a synchronous Staphylococcus aureus pyogenic elbow infection.
Staphylococcus aureus osteomyelitis and pyogenic arthritis has a different pattern in the elderly than in the young. The axial skeleton is the most frequent site of infection and treatment is usually by intravenous antibiotics. We report a case of Staph. aureus septic arthritis of the elbow with concomitant osteomyelitis of the spine that was thought to be due to Staph. aureus, but culture of debrided material from the lesion grew Brucella in culture. We suggest that in the elderly it is advisable to obtain a tissue culture diagnosis and not to instigate therapy based on positive blood cultures or a concomitant infection.
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Angiogenesis is essential in tissue growth and regeneration. There are several factors that are able to stimulate vascular endothelial cell growth, including platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF). Disc herniation tissue (DHT) contains vascular ingrowth, which promotes granulation tissue formation. ⋯ In all age groups it was higher than 80%. Thus capillaries in disc herniation tissue are evidently newly formed and our results demonstrate that PDGF and VEGF participate in the neovascularization process. The presence of PDGF in fibroblasts and in disc cells suggests that this growth factor regulates the function of these cells, possibly the proliferation of the cells and the production of extracellular matrix components.
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Seventy-eight patients were treated with closed reduction and transpedicular fixation for 82 spine fractures. The fractures were localised in the lower third of the spine and were all, according to the Denis classification, considered unstable. Eighteen patients had neurological deficiencies. ⋯ The complication rate of the transpedicular fixation method used reported by other authors could not be confirmed in our material. Iatrogenic neurological damage was not observed. A partial loss in the correction of the traumatic kyphosis was observed after removal of the implant in 11 patients.
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Multiple hereditary osteochondromatosis is a genetically transmitted disorder consisting of multiple projections of bone capped by cartilage, which are called exostoses. Spinal cord compression due to expansion of a laminar osteochondroma is rare but well recognized. Surgical decompression usually improves the patient's neurological status but, in cervical exostosis, post-laminectomy kyphosis and instability problems, especially in the high-risk adolescent group, form the most significant potential difficulties in the postoperative period. We report a case of cervical laminar exostosis that was treated by anterior stabilization and fusion and discuss the benefits of this technique.
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The availability of human cadaveric spine specimens for in vitro tests is limited and the risk of infection is now of vital concern. As an alternative or supplement, calf spines have been used as models for human spines, in particular to evaluate spinal implants. However, neither qualitative nor quantitative biomechanical data on calf spines are available for comparison with data on human specimens. ⋯ Biomechanical similarities were observed between the calf and reported human data, most notably in axial rotation and lateral bending. Range of motion in the lumbar spine in flexion and extension was somewhat less in the calf than that typically reported for the human, though still within the range. These results suggest that the calf spine can be considered on a limited basis as a model for the human spine in certain in vitro tests.