Journal of spinal disorders最新文献_第3页

Improving the pullout strength of pedicle screws by screw coupling. 通过螺钉联轴器提高椎弓根螺钉的拉拔强度。

Journal of spinal disorders Pub Date : 2001-10-01 DOI: 10.1097/00002517-200110000-00005

T. Suzuki, E. Abe, K. Okuyama, K. Sato

{"title":"Improving the pullout strength of pedicle screws by screw coupling.","authors":"T. Suzuki, E. Abe, K. Okuyama, K. Sato","doi":"10.1097/00002517-200110000-00005","DOIUrl":"https://doi.org/10.1097/00002517-200110000-00005","url":null,"abstract":"The objective of this study was to determine the effect of pedicle screw coupling on the pullout strength of pedicle screws in the osteoporotic spine. The vertebral bone mineral density (BMD) of 33 cadaveric lumbar vertebrae were measured by quantitative computed tomography. Pedicle screws were inserted into each pedicle. The pullout strength and displacement of the screws, without coupling and with single or double couplers, were studied, and the relationship between pullout strength and BMD was analyzed. The average pullout strength of the pedicle screws without screw coupling was 909.3 +/- 188.6 N (n = 9), that coupled with a single coupler was 1,409.0 +/- 469.1 N (n = 9), and that with double couplers was 1,494.0 +/- 691.6 N (n = 9). The pullout strength of the screws coupled with single or double couplers was significantly greater than that of screws without couplers (p < 0.01); however, there was no significant difference between the groups of single and double couplers. The improvement of pullout strength by screw coupling was significant in a test group with BMD of more than 90 mg/ml (p < 0.01), but was not in the group with BMD less than 90 mg/ml (p = 0.55). These results suggest that the coupling of pedicle screws improves pullout strength; however, the effect tends to be less significant in severely osteoporotic spines.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 5 1","pages":"399-403"},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200110000-00005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61370186","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}

引用次数: 35

Cauda equina syndrome in ankylosing spondylitis (the CES-AS syndrome): meta-analysis of outcomes after medical and surgical treatments. 强直性脊柱炎的马尾综合征(CES-AS综合征):药物和手术治疗后结果的荟萃分析

Journal of spinal disorders Pub Date : 2001-10-01 DOI: 10.1097/00002517-200110000-00009

N. Ahn, U. Ahn, L. Nallamshetty, B. Springer, J. Buchowski, Levi Funches, Elizabeth S. Garrett, J. Kostuik, K. Kebaish, P. Sponseller

{"title":"Cauda equina syndrome in ankylosing spondylitis (the CES-AS syndrome): meta-analysis of outcomes after medical and surgical treatments.","authors":"N. Ahn, U. Ahn, L. Nallamshetty, B. Springer, J. Buchowski, Levi Funches, Elizabeth S. Garrett, J. Kostuik, K. Kebaish, P. Sponseller","doi":"10.1097/00002517-200110000-00009","DOIUrl":"https://doi.org/10.1097/00002517-200110000-00009","url":null,"abstract":"The cauda equina syndrome in ankylosing spondylitis (the CES-AS syndrome) is marked by slow, insidious progression and a high incidence of dural ectasia in the lumbosacral spine. A high index of suspicion for this problem must be maintained when evaluating the patient with ankylosing spondylitis with a history of incontinence and neurologic deficit on examination. There has been disagreement in the literature as to whether surgical treatment is warranted for this condition. A meta-analysis was thus performed comparing outcomes with treatment regimens. Our results suggest that leaving these patients untreated or treating with steroids alone is inappropriate. Nonsteroidal antiinflammatory drugs may improve back pain but do not improve neurologic deficit. Surgical treatment of the dural ectasia, either by lumboperitoneal shunting or laminectomy, may improve neurologic dysfunction or halt the progression of neurologic deficit.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 5 1","pages":"427-33"},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200110000-00009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61370666","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}

引用次数: 72

C2 dens fractures: treatment options. C2齿突骨折:治疗方案。

Journal of spinal disorders Pub Date : 2001-10-01 DOI: 10.1097/00002517-200110000-00015

R. Sasso

引用次数: 71

Roentgenographic evaluation of ossification and calcification of the lumbar spinal canal after intradiscal betamethasone injection. 椎间盘内倍他米松注射后腰椎管骨化和钙化的x线评价。

Journal of spinal disorders Pub Date : 2001-10-01 DOI: 10.1097/00002517-200110000-00010

S. Ito, Hideki Usui, Koji Maruyama, T. Muro

{"title":"Roentgenographic evaluation of ossification and calcification of the lumbar spinal canal after intradiscal betamethasone injection.","authors":"S. Ito, Hideki Usui, Koji Maruyama, T. Muro","doi":"10.1097/00002517-200110000-00010","DOIUrl":"https://doi.org/10.1097/00002517-200110000-00010","url":null,"abstract":"There have been reports of lumbar spinal canal ossification and calcification after triamcinolone intradiscal injection therapy. Our objective was to observe the roentgenographic changes after betamethasone intradiscal injection therapy for lumbar disc diseases. The subjects were 183 patients (498 discs; 130 men and 53 women) who underwent discography and betamethasone intradiscal injection therapy and were followed for a mean of 5 years and 7 months. Ossification and calcification appeared de novo (three patients, three discs) or enlarged (four patients, five discs) in the outer layer of the posterior annulus fibrosus or posterior longitudinal ligament in eight discs among seven patients (3.8%). The incidence and degree of ossification and calcification in our patients were significantly lower than those reported in previous studies, and a long time elapsed before ossification and calcification appeared or enlarged. Intradiscal injection of betamethasone did not appear to confer any incremental relative risk for lumbar spinal canal ossification and calcification based on review of follow-up roentgenographs.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 5 1","pages":"434-8"},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200110000-00010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61370684","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}

引用次数: 12

Treatment of osteoporotic late collapse of a vertebral body of thoracic and lumbar spine. 胸腰椎椎体骨质疏松性晚期塌陷的治疗。

Journal of spinal disorders Pub Date : 2001-10-01 DOI: 10.1097/00002517-200110000-00004

J. Mochida, E. Toh, M. Chiba, K. Nishimura

{"title":"Treatment of osteoporotic late collapse of a vertebral body of thoracic and lumbar spine.","authors":"J. Mochida, E. Toh, M. Chiba, K. Nishimura","doi":"10.1097/00002517-200110000-00004","DOIUrl":"https://doi.org/10.1097/00002517-200110000-00004","url":null,"abstract":"Although osteoporotic late collapse of a vertebral body is a common infirmity of old age, it has not been well studied, and no consensus regarding treatment of this condition has been reached. Forty-five patients with osteoporotic late collapse of a vertebral body were classified into six types based on the appearance on the lateral projection of a radiograph and the presence or absence of neurologic symptoms and were evaluated on imaging and clinical outcome. We concluded that the treatment of osteoporotic late collapse of a vertebral body can be individualized based on several factors such as the presentation of the fracture and neurologic condition. Conservative treatment can be selected in patients without neurologic involvement who have the concave type with anterior spur or sclerotic change or flat type with uniform compression of collapse. If the patients in those types of collapse show neurologic involvement, decompression and reconstruction through a posterior approach, including an eggshell procedure and the short segment pedicle screw system, are more suitable. Anterior decompression with anterior strut bone graft and anterior spinal instrumentation should be done for wedged type of collapse regardless of neurologic status.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 5 1","pages":"393-8"},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200110000-00004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61370138","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}

引用次数: 84

Effect of stimulation parameters on intraoperative spinal cord evoked potential monitoring. 刺激参数对术中脊髓诱发电位监测的影响。

Journal of spinal disorders Pub Date : 2001-10-01 DOI: 10.1097/00002517-200110000-00013

Y. Hu, K. Luk, Y. Wong, W. Lu, J. Leong

{"title":"Effect of stimulation parameters on intraoperative spinal cord evoked potential monitoring.","authors":"Y. Hu, K. Luk, Y. Wong, W. Lu, J. Leong","doi":"10.1097/00002517-200110000-00013","DOIUrl":"https://doi.org/10.1097/00002517-200110000-00013","url":null,"abstract":"The purpose of this study was to investigate the effects of the stimulus parameters on spinal cord evoked potential (SCEP) and to recommend a practical epidural stimulation protocol for intraoperative spinal cord monitoring. This prospective study compared the latencies and amplitudes of SCEP obtained on epidural stimulation of 30 patients with scoliosis under anesthesia using different stimulus pulse duration and stimulation rates. SCEP was found to be undetectable with shorter stimulus duration (<0.05 ms). The SCEP latencies did not show any significant difference among different stimulation parameters. However, the SCEP amplitude showed significant changes with differing stimulus durations. The SCEP amplitudes were found to significantly decrease when the pulse durations become shorter than 0.2 ms. Stimulus parameters showed significant effects on SCEP amplitude but not latency. Stimulus rates in the range of 21 to 61 Hz are equivalent for quick and reliable detection of SCEP. Considering the short latency of SCEP, a pulse duration of 0.2 ms is recommended for SCEP using epidural stimulation.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 5 1","pages":"449-52"},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200110000-00013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61370299","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}

引用次数: 7

Long-term disability assessment after surgical treatment of low grade spondylolisthesis. 轻度椎体滑脱手术治疗后的长期残疾评估。

Journal of spinal disorders Pub Date : 2001-10-01 DOI: 10.1097/00002517-200110000-00007

S. Louisia, P. Anract, A. Babinet, B. Tomeno, M. Revel, S. Poiraudeau

{"title":"Long-term disability assessment after surgical treatment of low grade spondylolisthesis.","authors":"S. Louisia, P. Anract, A. Babinet, B. Tomeno, M. Revel, S. Poiraudeau","doi":"10.1097/00002517-200110000-00007","DOIUrl":"https://doi.org/10.1097/00002517-200110000-00007","url":null,"abstract":"The aim of this study was to determine whether assessment of back surgery with disability scores is relevant. We also attempted to answer the question of whether this evaluation should be conducted by a surgeon or a medical doctor. This retrospective study analyzes the long-term outcome (average follow-up 7 years, range: 3-12) of 40 patients (mean age: 46.2 years) treated by posterior surgical decompression, posterolateral arthrodesis, with or without instrumentation, for symptomatic low-grade spondylolisthesis. All patients were interviewed postoperatively and examined the same day by an orthopedic surgeon, who was not involved in the patients' treatment, as well as by a medical doctor rehabilitation specialist. Impairment was assessed by a standardized clinical examination and by visual analog scales (VAS) of pain. Disability was assessed using two scales: the Quebec disability scale and the Beaujon scale. Anxiety and depression were assessed with a validated specific questionnaire (HAD). Patient's perceived handicap was assessed on a 100-mm VAS. Our results show that the scores of the two disability scales were highly correlated with the patient's overall satisfaction ( r = 0.73 and 0.77 for the Quebec scale and the Beaujon scale, respectively). The intraclass correlation coefficient showed very good or excellent correlation between the data collected by the surgeon and the rehabilitation specialist, ranging from 0.8 to 0.97. This finding clearly demonstrates that interview by a surgeon who is not involved in the patient's treatment does not influence the patient's assessment in terms of impairment, disability, or handicap. Moreover, our results suggest that disability scales are the most relevant outcome measures in the assessment of spine surgery.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 5 1","pages":"411-6"},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200110000-00007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61369750","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}

引用次数: 5

Evaluation of thoracic myelopathy by transcranial magnetic stimulation. 经颅磁刺激对胸椎脊髓病的评价。

Journal of spinal disorders Pub Date : 2001-10-01 DOI: 10.1097/00002517-200110000-00011

T. Misawa, S. Ebara, M. Kamimura, Y. Tateiwa, T. Kinoshita, K. Takaoka

引用次数: 13

Journal of spinal disorders Pub Date : 2001-10-01 DOI: 10.1097/00002517-200110000-00008

M. Boucher, M. Bhandari, D. Kwok

{"title":"Health-related quality of life after short segment instrumentation of lumbar burst fractures.","authors":"M. Boucher, M. Bhandari, D. Kwok","doi":"10.1097/00002517-200110000-00008","DOIUrl":"https://doi.org/10.1097/00002517-200110000-00008","url":null,"abstract":"Management of lumbar burst fractures remains controversial. Surgical reduction/stabilization is becoming more popular; however, the functional impact of operative intervention is not clear. The purpose of this study was to assess health-related quality of life and functional outcome after posterior fixation of lumbar burst fractures with either posterolateral or intrabody bone grafting. Twenty-four subjects were included. Radiographs and computed tomography scans were evaluated for deformity (kyphosis, vertebral compression, lateral angulation, lateral body height, and canal compromise) postoperatively, at 1 year, and at final follow-up (mean 3.2 years). Patients completed the SF 36 Health Survey and the Oswestry Low Back Pain Disability Questionnaire at final follow-up. Significant improvement was noted in midsagittal diameter compromise, vertebral compression, and kyphosis. The difference observed between the respondents mean scores on the SF 36 was not significantly different from those presented as the U.S. national average (p = 0.053). Data from the Oswestry questionnaire indicated a similarly high level of function. Overall, we found posterior spinal instrumentation to correlate with positive functional outcome based on both general health (SF 36) and joint-specific outcome scales (Oswestry). Posterior instrumentation provides sound canal decompression, kyphotic reduction, and maintains vertebral height with minimal transgression and long-term sequelae. In cases of severe initial deformity and neurologic compromise, intrabody bone grafting is most certainly indicated; the additional support provided by a posterolateral graft may also prove beneficial as an adjunct.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 5 1","pages":"417-26"},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200110000-00008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61370653","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}

引用次数: 20

Computed tomography assessment of sacroiliac screw placement relative to the first sacral neuroforamen. 骶髂螺钉相对于第一骶神经孔放置的计算机断层扫描评估。

Journal of spinal disorders Pub Date : 2001-08-29 DOI: 10.1097/00002517-200108000-00008

P. Rose, B. Goldberg, R. Lindsey, C. Foglar, T. D. Hedrick, T. Miclau, J. Haddad, M. Khan

{"title":"Computed tomography assessment of sacroiliac screw placement relative to the first sacral neuroforamen.","authors":"P. Rose, B. Goldberg, R. Lindsey, C. Foglar, T. D. Hedrick, T. Miclau, J. Haddad, M. Khan","doi":"10.1097/00002517-200108000-00008","DOIUrl":"https://doi.org/10.1097/00002517-200108000-00008","url":null,"abstract":"The radiographic interpretation of sacroiliac screws relative to the S1 neuroforamen is difficult for orthopedic surgeons and radiologists. Computed tomography (CT) with axial images alone or combined with multiplanar reconstructions are often used to assess screw position. The reliability, reproducibility, and accuracy of orthopedist and radiologist interpretations of axial CT images with and without multiplanar reconstructions was determined using 24 cadaveric hemipelves with known sacroiliac screw position. Interobserver reliability of determining screw position was fair for orthopedists and slight for radiologists regardless of imaging modality or screw composition. Intraobserver reproducibility was moderate for orthopedists regardless of imaging modality or screw type. Reproducibility among radiologists was moderate using axial images of titanium screws and substantial with addition of multiplanar reconstructions. Overall accuracy was similar for orthopedists and radiologists. CT images with multiplanar reconstructions improve accuracy in determining sacroiliac screw position, but not significantly. Current imaging modalities are limited by large inaccuracies and by interobserver and intraobserver variation.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 4 1","pages":"330-5"},"PeriodicalIF":0.0,"publicationDate":"2001-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200108000-00008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61369870","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}

引用次数: 2