The spine journal : official journal of the North American Spine Society
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Plain radiographic assessment of posterolateral fusion has been reported as accurate in only two thirds of patients who were found to be healed at surgical exploration. Plain radiographic techniques for fusion assessment of interbody fusion with radiolucent cages are reported to be accurate. A helical computed tomography (CT) scan shows a high sensitivity for pseudarthrosis compared with plain radiography. ⋯ Fusion assessment with plain X-ray films and helical CT scans showed equal accuracy after posterior lumbar interbody fusion confirmed by surgical exploration. Our results indicate that when plain X-ray films show strong evidence of fusion or pseudarthrosis, the helical CT is unlikely to provide useful new information.
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Comparative Study
Use of navigation-assisted fluoroscopy to decrease radiation exposure during minimally invasive spine surgery.
Minimally invasive surgery decreases postoperative pain and disability. However, limited views of the surgical field require extensive use of intraoperative fluoroscopy that may expose the surgical team to higher levels of ionizing radiation. ⋯ The use of navigation-assisted fluoroscopy is feasible and safe for minimally invasive spine surgery. Radiation exposure is decreased to the patient as well as the surgical team.
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Although halo-vest immobilization remains a common form of treatment for type II odontoid fractures, nonunion and C1-2 instability may be the result in up to 20% to 40% of patients. ⋯ Obtaining both supine and upright lateral X-ray films during the follow-up period may identify patients at risk for failure of halo-vest treatment as early as 2 weeks after initiation of treatment. A change in fracture angulation > or =5 degrees suggests an increased risk of treatment failure and the potential benefit of early surgical stabilization.
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Case Reports
Aseptic meningitis after microdiscectomy: description of a case and review of the literature.
Aseptic meningitis has rarely been described after spinal surgery. No reports of aseptic meningitis exist after microdiscectomy in the literature. ⋯ Presentation of aseptic meningitis after microdiscectomy is a rare but important diagnosis to consider. Examination of CSF is an important procedure to rule out the more dangerous diagnosis of bacterial meningitis.
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Magnetic stimulation (MS), which is used to evaluate motor pathways, is helpful in evaluating cervical spinal cord compression (cervical myelopathy [CM]). Previous studies have shown that the central motor conduction time (CMCT), which is the time taken for the nerve impulses to reach the cervical spinal roots after the stimulation of the motor cortex, is prolonged in CM. However, the duration of motor-evoked potentials (MEPs) in CM has not been studied in detail. ⋯ This study shows that in addition to the CMCT, the duration of MEPs is also useful in evaluating patients with CM using MS.