A Schmitz, T Kälicke, P Willkomm, F Grünwald, J Kandyba, O Schmitt
{"title":"Use of fluorine-18 fluoro-2-deoxy-D-glucose positron emission tomography in assessing the process of tuberculous spondylitis.","authors":"A Schmitz, T Kälicke, P Willkomm, F Grünwald, J Kandyba, O Schmitt","doi":"10.1097/00002517-200012000-00016","DOIUrl":"https://doi.org/10.1097/00002517-200012000-00016","url":null,"abstract":"<p><p>Fluorine-18 fluoro-2-deoxy-D-glucose positron emission tomography can be used to quantify the pathologic increase in glucose metabolism of inflammatory processes. Preliminary studies indicate a high level of sensitivity and specificity in detecting and identifying chronic osteomyelitis. This case study shows that positron emission tomography can be used to assess the process of inflammatory activity in tuberculous spondylitis. This technology also has the advantage of higher spatial resolution compared with other nuclear medicine procedures. In addition, it can differentiate between bone and soft tissue infection and allows imaging in the presence of metal implants.</p>","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"13 6","pages":"541-4"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200012000-00016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21954081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Multiple sclerosis with very late onset: a report of a case with onset at age 82 years and review of the literature.","authors":"M Abe, K Tsuchiya, Y Kurosa, O Nakai, K Shinomiya","doi":"10.1097/00002517-200012000-00017","DOIUrl":"https://doi.org/10.1097/00002517-200012000-00017","url":null,"abstract":"<p><p>This is a report of a patient with late-onset multiple sclerosis at age 82 years. The lesion involved was located on the spinal cord. Multiple sclerosis mainly affects young adults, making late onset of multiple sclerosis a rarity, particularly for cases after age 80 years. Common characteristics of late-onset multiple sclerosis reported in other publications are predominant involvement of the spinal cord and a progressively worsening course with a serious prognosis. In this case, magnetic resonance imaging revealed a large area of high signal intensity in the cervical and upper thoracic spinal cord on T2-weighted images. An increased immunoglobulin G level in cerebrospinal fluid also played a diagnostic role in ruling out cervical spondylotic myelopathy. Spontaneous improvement occurred 2 months after the onset. Unlike other patient described in the literature, the clinical course of this man was not as bleak.</p>","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"13 6","pages":"545-9"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200012000-00017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21955284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Aortic thrombosis after lumbar spine surgery.","authors":"F P Castro, R S Hartz, V Frigon, T S Whitecloud","doi":"10.1097/00002517-200012000-00015","DOIUrl":"https://doi.org/10.1097/00002517-200012000-00015","url":null,"abstract":"<p><p>A case of distal aortic occlusion after circumferential lumbar spine surgery is presented. The paradoxical clinical findings are discussed.</p>","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"13 6","pages":"538-40"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200012000-00015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21954080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cervical transfacet versus lateral mass screws: a biomechanical comparison.","authors":"J W Klekamp, J L Ugbo, J G Heller, W C Hutton","doi":"10.1097/00002517-200012000-00009","DOIUrl":"https://doi.org/10.1097/00002517-200012000-00009","url":null,"abstract":"<p><p>The authors directly the compared biomechanical pullout strength of screws placed in the cervical lateral masses to that of screws placed across the facet joints. Posterior cervical fixation with lateral mass plates is an accepted adjunctive technique for cervical spine fusions. Altered anatomy resulting from congenital malformation, tumor, trauma, infection, or failed lateral mass fixation may limit traditional screw placement options. Transfacet screw placement, which has been studied extensively in the lumbar spine, may offer an alternative when posterior cervical fusion is required. Ten fresh human cadaveric cervical spines (postmortem age range, 69 to 91 years) were harvested. On one side, transfacet screws were placed at the C3-4, C5-6, and C7-T1 levels. On the other side, lateral mass screws were placed at the C3, C5, and C7 levels. The screw insertion technique at each level was randomized for right or left. After screw placement, each set of vertebral bodies were dissected and mounted in a custom jig for axial pullout testing using a servohydraulic testing machine. The load-displacement curves were obtained for each screw pullout. The mean pullout strength for the screws placed across the facets was 467 N (range, 192 to 1,176 N). This compares with 360 N (range, 194 to 750 N) for the lateral mass screws (p = 0.008). At each level, transfacet screws exhibited greater pullout resistance compared with the lateral mass placement, but the difference was most pronounced at the C7-T1 level (lateral mass = 373 N, transfacet = 539 N, p = 0.042). Cervical transfacet screw placement provides pullout resistance that is comparable to, if not greater than, lateral mass placement. This type of placement, although technically difficult, may be an alternative to lateral mass screws in cases with unusual anatomy, stripped screws, or when additional intermediate points of fixation are desired.</p>","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"13 6","pages":"515-8"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200012000-00009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21954075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prediction of functional disability, recurrences, and chronicity after 1 year in 180 patients who required sick leave for acute low-back pain.","authors":"T Seferlis, G Németh, A M Carlsson","doi":"10.1097/00002517-200012000-00002","DOIUrl":"https://doi.org/10.1097/00002517-200012000-00002","url":null,"abstract":"<p><p>The aim of the study was to identify factors that predict low-back pain outcome at 12 months and thus to identify patients at risk for poor long-term outcomes. One hundred-eighty patients, all disabled by acute low-back pain, were included. Outcome (dependent) variables were Oswestry disability score, recurrences during the study year, and chronicity defined as 90 or more days off work for low-back pain during the study year, or a disease-specific sick-leave rate (a variable created by the authors) of more than 25%. Stepwise logistic regression analysis was performed. Thirty-three percent of the patients had an Oswestry score greater than 25, indicating moderate disability at the 1-year follow-up evaluation. Pain on coughing at study entry predicted a high likelihood of disability at 1 year, with a threefold risk. Many work days missed as a result of low-back pain in the past 2 years and lack of stimulating work tasks predicted recurrences during the year. A high Oswestry score assessed at study entry was the only factor that predicted chronicity. The factors revealed in the current study should help the clinician to identify patients at risk. The authors propose that the revealed predictors should be investigated extensively at the patient's first visit for acute low-back pain.</p>","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"13 6","pages":"470-7"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200012000-00002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21955393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R Mazzocchio, G B Scarfò, R Cartolari, A Bolognini, A Mariottini, V F Muzii, L Palma
{"title":"Abnormalities of the soleus H-reflex in lumbar spondylolisthesis: a possible early sign of bilateral S1 root dysfunction.","authors":"R Mazzocchio, G B Scarfò, R Cartolari, A Bolognini, A Mariottini, V F Muzii, L Palma","doi":"10.1097/00002517-200012000-00004","DOIUrl":"https://doi.org/10.1097/00002517-200012000-00004","url":null,"abstract":"<p><p>Using routine electrodiagnostic procedures, the authors searched for physiologic evidence of nerve root compromise in patients with chronic mechanical perturbation to the lumbar spine. They examined 37 patients with spondylolisthesis and various degrees of degenerative changes in the lumbar canal. Clinical and neurophysiologic findings were compared with data obtained from 36 healthy persons. The soleus H-reflex appeared to be a sensitive indicator of sensory fiber compromise at the S1 root level, because changes correlated well with the focal sensory signs and preceded clinical and electromyographic signs of motor root involvement. When these occurred, the clinical findings were consistent with a more severe nerve root deficit and with radiographic evidence of neural compression. The greater sensitivity of the soleus H-reflex may be related to the pathophysiologic events that occur at the lesion site.</p>","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"13 6","pages":"487-95"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200012000-00004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21955395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A cost analysis of two anterior cervical fusion procedures.","authors":"F P Castro, R T Holt, M Majd, T S Whitecloud","doi":"10.1097/00002517-200012000-00008","DOIUrl":"https://doi.org/10.1097/00002517-200012000-00008","url":null,"abstract":"<p><p>Multilevel anterior cervical discectomy and fusion (ACDF) remains a difficult problem. A recently described surgical technique for multilevel ACDF has eliminated the morbid complications associated with harvesting iliac crest bone graft (ICBG) while maintaining the advantages of using autologous bone graft. A matched-pairs t test was used to compare the estimated costs of 27 ACDFs using titanium surgical mesh, local autologous bone graft, and anterior plate instrumentation with 27 ACDFs using ICBG and plate fixation. The three variables considered were cage cost, operating time (cost), and hospitalization cost. The estimated costs for the two surgical procedures were not significantly different. Thus, the time saved by not harvesting an ICBG was comparable to the cost of the cage. Harvesting ICBG also increased the morbidity rate by 22%.</p>","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"13 6","pages":"511-4"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200012000-00008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21954074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O Boachie-Adjei, F P Girardi, M Bansal, B A Rawlins
{"title":"Safety and efficacy of pedicle screw placement for adult spinal deformity with a pedicle-probing conventional anatomic technique.","authors":"O Boachie-Adjei, F P Girardi, M Bansal, B A Rawlins","doi":"10.1097/00002517-200012000-00005","DOIUrl":"https://doi.org/10.1097/00002517-200012000-00005","url":null,"abstract":"<p><p>A prospective study of 50 adults treated with fusion, realignment, and segmental spinal instrumentation for spinal deformity was conducted to assess the safety, accuracy, and efficacy of the free-hand pedicle screw placement technique. Postoperative computed tomographic scans were performed to evaluate the placement of 282 screws and were correlated with patients' clinical outcomes. Five screws were placed at T12, 26 at L1, 39 at L2, 48 at L3, 73 at L4, 35 at L5, and 50 at S1. Nine screws (3%) were misplaced and included three screws (1.06%) that violated the medial wall with no clinical sequelae or revision surgery needed. There were no neurologic deficits related to screw placement. The free-hand technique is a safe and cost-effective method for pedicular screw placement during surgery for adult spine deformities.</p>","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"13 6","pages":"496-500"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200012000-00005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21955396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K Fujiwara, H Owaki, M Fujimoto, K Yonenobu, T Ochi
{"title":"A long-term follow-up study of cervical lesions in rheumatoid arthritis.","authors":"K Fujiwara, H Owaki, M Fujimoto, K Yonenobu, T Ochi","doi":"10.1097/00002517-200012000-00010","DOIUrl":"https://doi.org/10.1097/00002517-200012000-00010","url":null,"abstract":"<p><p>To determine the natural history of cervical lesions in rheumatoid arthritis, 161 patients who had been followed for a minimum of 5 years were enrolled in this study. The average follow-up period was 10.2 years (range, 5 to 20 years). The severity of the rheumatoid arthritis was classified into three types based on the multiplicity of peripheral joint rheumatoid involvement: a least erosive subset, a more erosive subset, and a mutilating disease subset. Ninety-two patients (57%) had upper cervical involvement, which progressed in the order of anterior atlantoaxial subluxation, anterior atlantoaxial subluxation combined with vertical subluxation, and vertical subluxation alone. Subaxial subluxation was found in 18 patients (11%). In 17 of these 18 patients, upper cervical lesions were also noted. The incidence of cervical involvement in each disease subset was 39% in the least erosive group, 83% in the more erosive group, and 100% in the mutilating disease group. Fifty percent of the patients with cervical involvement had neck pain, and the remaining patients were asymptomatic. Neural involvement occurred in 10 patients. In 7 of these 10 patients, vertical subluxation of the atlas was responsible for the neural deficit. Six patients required surgical intervention because of progressive myelopathy.</p>","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"13 6","pages":"519-26"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200012000-00010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21954076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}