The spine journal : official journal of the North American Spine Society
-
Case Reports
Catastrophic intramedullary hematoma following Kümmell's disease with large intravertebral cleft.
Kümmell's disease is defined as avascular osteonecrosis and occurs after delayed posttraumatic vertebral collapse. Devastating cord injury with Kümmell's disease is rare except in advanced cases with kyphosis and posterior cortex breakage. ⋯ An increasing awareness of the delayed vertebral collapse with cord injury attached to an osteoporotic spine fracture, as well as a periodic follow-up and treatment are essential for preventing catastrophic neurological impairment.
-
Elucidation of the factors responsible for symptomatic failure of spinal instrumentation has been a keen interest for many investigators. ⋯ Failure to correct sagittal plane deformity intraoperatively predisposes patients to SIF regardless of age, level of surgery, or indication of surgery.
-
With lumbar arthroplasty gaining popularity, limited data are available highlighting changes in adjacent-level mechanics after multilevel procedures. ⋯ Our results indicate no significant adjacent-level biomechanical changes between arthroplasty and control groups. In contrast, significant alterations in ROM and IDP were recorded both proximally (ROM=LB & AR; IDP=AR, FE, LB) and distally (ROM=LB; IDP=AR & LB) after circumferential arthrodesis. Therefore, two-level lumbar arthroplasty maintains a more favorable biomechanical environment at the adjacent segments compared with the conventional transpedicular fixation technique. This, in turn, may have a positive effect on the rate of the transition syndrome postoperatively.