Bmc Musculoskel Dis
-
Bmc Musculoskel Dis · Jan 2014
Visually assessed severity of lumbar spinal canal stenosis is paradoxically associated with leg pain and objective walking ability.
Lumbar spinal stenosis (LSS) is the common term used to describe patients with symptoms related to the anatomical reduction of the lumbar spinal canal size. However, some subjects may have a markedly narrowed canal without any symptoms. This raises the question of what is the actual role of central canal stenosis in symptomatic patients. The purpose of this study was to compare radiological evaluations of LSS, both visually and quantitatively, with the clinical findings of patients with LSS. ⋯ There is no straightforward association between the stenosis of dural sac and patient symptoms or functional capacity. These findings indicated that dural sac stenosis is not the single key element in the pathophysiology of LSS.
-
Bmc Musculoskel Dis · Jan 2014
Case ReportsParsonage-Turner syndrome following post-exposure prophylaxis.
The 'Parsonage-Turner syndrome' (PTS) is a rare but distinct disorder with an abrupt onset of shoulder pain, followed by weakness and atrophy of the upper extremity musculature, and a slow recovery requiring months to years. To our best knowledge, this is the first case describing symptoms and signs of PTS following the administration of a post-exposure prophylaxis (PEP) regimen against possible human immunodeficiency virus (HIV) and hepatitis B virus (HBV) infection. ⋯ Parsonage-Turner syndrome is a rare clinical diagnosis. The precise pathophysiological mechanism of PTS remains unclear, but it seems to involve an interaction between genetic predisposition, mechanical vulnerability and an autoimmune trigger. An immunological event, such as - in this case - a vaccination as part of PEP treatment, can trigger the onset of PTS. The clinical presentation is distinctive with acute severe pain followed by patchy paresis, atrophy and sensory symptoms that persist for months to years. No currently available tests can provide a definite confirmation or exclusion of PTS. Routine blood examination, electromyography (EMG), and computed tomography (CT) or magnetic resonance imaging (MRI) serve mainly to exclude other disorders. The recovery can be quite lengthy, non-operative treatment is the accepted practice. Supplementary administration of oral prednisolone could shorten the duration of pain. Although the outcome is typically preferable, a substantial amount of patients are left with some residual paresis and functional impairment.
-
Bmc Musculoskel Dis · Jan 2014
Comparative StudyComparisons of three anterior cervical surgeries in treating cervical spondylotic myelopathy.
Anterior cervical discectomy and fusion (ACDF) was one of the preferred treatments for degenerative cervical spondylosis. However, the motion of adjacent segment was significantly increased after operation. So cervical disc arthroplasty have been suggested to keep the motion of adjacent segment. A new implant named dynamic cervical implant (DCI) has been developed to keep the motion of adjacent segment. ⋯ Three operations are effective therapies for single level cervical spondylotic myelopathy. But each group has respective advantages and disadvantages.
-
Bmc Musculoskel Dis · Jan 2014
Prevalence and risk factors for periprosthetic fracture in older recipients of total hip replacement: a cohort study.
The growing utilization of total joint replacement will increase the frequency of its complications, including periprosthetic fracture. The prevalence and risk factors of periprosthetic fracture require further study, particularly over the course of long-term follow-up. The objective of this study was to estimate the prevalence and risk factors for periprosthetic fractures occurring in recipients of total hip replacement. ⋯ A decade after primary THR, periprosthetic fractures occur annually in 26 per 10,000 persons and are especially frequent in those with prior total knee or revision total hip replacements.
-
Bmc Musculoskel Dis · Jan 2014
Fluoroscopic views for safe insertion of lag screws into the posterior column of the acetabulum.
Percutaneous lag screw fixation is an alternative treatment for non-displaced or minimally displaced posterior column fractures. This study aims to explore new fluoroscopic views of the acetabulum for safe percutaneous insertion of posterior column lag screws. ⋯ The tangential views of both the PCPC and medial wall can be obtained following the aforementioned methods The oblique iliac view and the two tangential views enable safe insertion of posterior column lag screws.