The spine journal : official journal of the North American Spine Society
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Unilateral facet disruptions are relatively common in the cervical spine; however, the spectrum of injury is large, and little is known regarding the magnitude of instability expected to be present in an isolated posterior osteoligamentous injury. ⋯ The PLC and facet complex are dominant stabilizers for FE and AR, respectively. The overall changes in both ROM and NZ were relatively small but consistent with an isolated posterior osteoligamentous complex injury of the Stage I flexion-distraction injury.
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There have been several reports describing the usage of subaxial cervical laminar screws. However, the anatomic feasibility of placing such screws has not been thoroughly evaluated yet. ⋯ The relatively high success rate at C7, particularly of unilateral placement, suggests that laminar screw placement can be a sound alternative method for fixation at this level. However, careful preoperative CT scan evaluation and patient selection are required, particularly for bilateral fixation in women. At C3 and C6, unilateral screw placement can be considered in approximately 30% of patients after careful selection using preoperative CT scans. At C4 and C5, neither unilateral nor bilateral screw fixation is recommended for most patients.
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Experimental studies suggest that catastrophizing may worsen the prognosis of low back pain (LBP) and LBP-related disability and increase the risk of chronicity. ⋯ In routine practice, assessing the baseline score for catastrophizing does not help clinicians to predict the evolution of LBP and disability at 3 months.
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The craniocervical region is an osteoligamentous complex that provides structural stability and movement by means of numerous ligaments. Fundamental knowledge of these ligaments is important for physicians who treat patients with disorders of this region to reduce morbidity and mortality. There is a paucity of data in the literature regarding the morphology, function, and classification of the transverse occipital ligament (TOL). ⋯ Our data suggest that the TOL is not an anatomic variant and can be classified into three types. Future biomechanical studies can be designed to investigate the function of the TOL, although we hypothesize that it may act as a fulcrum during flexion and extension of the head because it is located between the apical ligament and superior crus of the cruciform ligament. Anteroposterior open-mouth digital radiographs revealed the location of the TOL with respect to the upper two cervical vertebrae. Future research should investigate the radiologic characteristics of the TOL using magnetic resonance imaging.