Journal of spinal disorders
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Sixty-eight patients with neuromuscular spine deformity were treated by posterior spine fusion with Luque-Galveston instrumentation between 1982 and 1986. The minimum follow-up was 4 years. Diagnoses included cerebral palsy in 34 patients and other neuromuscular diseases in another 34 patients. ⋯ Three patients had minor neurologic deficits, all transient. The "windshield-wiper" sign was defined as any radiolucency of 2 mm or greater. Twenty-six patients had this sign at follow-up, and this group had a higher percentage of complications, but the existence of this sign did not necessarily indicate a problem.
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In 10 fresh cadaveric specimens of occiput (C0) to C3, six pure moments (maximum 1.5 Nm) were applied and the resulting physiological motions were studied. We determined the quantitative three-dimensional relative translations of two specific midsagittal points on C0 and C1: the anterior (point A) and posterior (point B) margins of the foramen magnum of C0, and the posteroinferior margin of anterior arch (point C) and the anteroinferior margin of posterior arch (point D) of C1. In flexion/extension, translational movements of these four points were mainly in the sagittal plane. ⋯ In these situations, point C moved to the left, and point D moved to the right and anterior. The vertical translation had two phases: superior translational phase, followed by inferior translational phase. We presented the quantitative translations but, because of large standard deviations between the specimens, it was difficult to define translational thresholds for instability.
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To observe anatomical or pathological changes in lumbar intervertebral discs, discography and computed tomography-discography (CTD) were performed on fresh human cadavers. The results of discograms and CTD were compared with histological findings of cross sections of discs. Preoperative CTD of lumbar disc herniation was investigated based on these results. ⋯ As disc degeneration progressed, circumferential rupture tended to coexist with radial rupture in many cases. In CTD cases of lumbar disc herniation, most images of ruptures of the annulus fibrosus showed a posterior radial rupture, which was the route for herniated nucleus. The greater the degree of degeneration, the more the images tended to show radial ruptures coexisting with circumferential ruptures.
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Case Reports
Airway compromise as a result of retropharyngeal hematoma following cervical spine injury.
Mechanical airway obstruction secondary to prevertebral hematoma following cervical spine injury is a life-threatening emergency. We present eight cases of mechanical airway obstruction from prevertebral hematomas in patients with cervical spine injury. ⋯ To date, this phenomenon has not been reported in injuries below C6. Additionally, because symptoms may take hours to develop, initial cervical radiographs may not show evidence of retropharyngeal swelling and impending airway obstruction.