Journal of spinal disorders最新文献

{"title":"Surgical therapy for dialysis-related spondyloarthropathy: review of 30 cases.","authors":"Etsuji Shiota, Masatoshi Naito, Kuniyoshi Tsuchiya","doi":"10.1097/00002517-200104000-00012","DOIUrl":"https://doi.org/10.1097/00002517-200104000-00012","url":null,"abstract":"Surgical therapy for dialysis-related spondyloarthropathy was investigated regarding its spinal manifestation. Between August 1985 and May 1998, 31 operations were performed on 16 male and 14 female patients; of these, 17 had cervical and 13 had lumbar spinal disorders. The average patient age was 59 years. The average period of hemodialysis was 14.8 years. Twenty-eight of 30 patients had cystic bone lesions and 24 had carpal tunnel syndrome. Four major postoperative complications occurred: death from paralysis and respiratory distress, severe kyphosis from the collapse of the grafted bone, deep infection from instrumentation, and wire breakage and bone fusion failure. Postoperative results with an average follow-up period of 2.7 years were good in 19 cases (63%), fair in 8 cases (27%), and poor in 3 cases (10%). As yet, surgical intervention for dialysis-related spondyloarthropathy is still regarded as a noncurative treatment; furthermore, the anterior approach to the cervical spine has a high risk for postoperative complications.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 2 1","pages":"165-71"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200104000-00012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61369616","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":"Traumatic subluxation of the axis after hyperflexion injury of the cervical spine in children.","authors":"M. Matsumoto, Y. Toyama, K. Chiba, Y. Fujimura, Y. Fukui, K. Kobayashi","doi":"10.1097/00002517-200104000-00013","DOIUrl":"https://doi.org/10.1097/00002517-200104000-00013","url":null,"abstract":"Six cases of children (four boys and two girls, mean age 11 years) who had traumatic subluxation of the axis (C2) were reviewed retrospectively. Initial radiographs demonstrated no detectable vertebral fracture in any of the children. However, a slight anterior subluxation of C2 was observed in three of the patients. Radiographs, taken at 1 month after injury in all but one patient, revealed a progression of the subluxation and a local kyphosis in all of the patients. Four of the children were treated conservatively with a cervical brace, and an improvement of both the kyphosis and the anterior slippage of C2 was obtained accompanied by an anteroposterior growth of the C3 vertebral body. The kyphosis of two of the patients became severe and, ultimately, these patients underwent fusion surgery. At the follow-up, none of the patients presented with any significant symptom. For the correct diagnosis of traumatic subluxation of C2, sequential radiographs to confirm the progression of subluxation and local kyphosis are mandatory. Conservative treatment rather than early surgical treatment may be chosen for this injury, because mild and moderate kyphosis can be corrected spontaneously by remodeling of the cervical spine.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 2 1","pages":"172-9"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200104000-00013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61369629","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":"Containment and stabilization of bone graft in anterior lumbar interbody fusion: the role of the Hartshill Horseshoe cage.","authors":"S. Madan, N. Boeree","doi":"10.1097/00002517-200104000-00003","DOIUrl":"https://doi.org/10.1097/00002517-200104000-00003","url":null,"abstract":"The Hartshill Horseshoe cage is a titanium implant that is inserted after removal of the disc in anterior lumbar interbody fusion. The authors use corticocancellous iliac crest graft, which is contained within the confines of the implant. The cage and the motion segment are stabilized by inserting screws into the adjacent vertebral bodies through holes in the implant. Between 1995 and 1997, 27 patients had this implant inserted. Minimum follow-up was 2.1 years (mean: 2.9 years). Patients were assessed using the Oswestry disability index, a core set of six questions, a pain drawing, and psychometrically using the Zung Depression Scale and the Modified Somatic Perception Questionnaire. The patients' subjective assessment was also obtained. Twenty-one patients (77.8%) improved significantly on the Oswestry disability index and 22 patients (81.5%) improved by subjective assessment using the \"core set\" of six questions. There was no evidence of pseudarthrosis, loosening, or osteolysis around the implant or the screws. The cage prevents graft extrusion, collapse, or sinkage through the endplates. The normal lumbar lordosis is restored and, by restoring normal intervertebral disc space height, the Horseshoe opens up the neural foraminae. This cage stabilizes the motion segments and secures the graft, preventing micromotion at the graft vertebral body interface and providing a conducive environment for fusion.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 2 1","pages":"104-8"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200104000-00003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61369414","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":"Effectiveness of transfixation and length of instrumentation on titanium and stainless steel transpedicular spine implants.","authors":"P. Korovessis, A. Baikousis, D. Deligianni, Y. Mysirlis, P. Soucacos","doi":"10.1097/00002517-200104000-00004","DOIUrl":"https://doi.org/10.1097/00002517-200104000-00004","url":null,"abstract":"This study compares the effectiveness of transfixation on the stiffness of two pedicle screw-rod constructs of different manufacture, implant design, and alloy, applied in one-and two-level instability. Four screws composed of either stainless steel or Titanium were assembled in pairs to two polymethylmethacrylate blocks to resemble one-and two-level corpectomy models and the construct underwent nondestructive torsional, extension, and flexion loading. In every loading test, each construct was tested using stainless steel or titanium rods of 4.9-mm diameter in two different lengths (short, 10 cm; long, 15 cm), not augmented or augmented with different transfixation devices or a pair of devices. The authors compared the stiffness of stainless steel and titanium constructs without cross-link with the stiffness of that reinforced with single or double Texas Scottish Rite Hospital (TSRH) cross-link, closed new-type cross-link (closed NTC), or open new-type cross-link (open NTC). The results showed that augmentation or no augmentation of short rods conferred significantly more stiffness than that of long rods of the same material in all three loading modes. The closed NTC provided the greatest increase of torsional, extension, and flexion stiffness, and single TSRH provided the least amount of stiffness. Torsional stiffness of short stainless steel rods augmented or not augmented was significantly greater than that of their titanium counterparts. Torsional stiffness of long titanium rods was always greater than that of their stainless steel counterparts. Extension stiffness of short nonaugmented titanium rods was superior to that of long titanium rods, whereas extension stiffness of nonaugmented short and long stainless steel rods was similar. Nonaugmented short titanium rods showed greater flexion stiffness than that of long titanium rods. Long stainless steel rods displayed significantly greater flexion stiffness than did their titanium counterparts. This nondestructive study showed that cross-links increase the torsional stiffness significantly but less so the flexion and extension stiffness of both titanium and stainless steel posterior transpedicular constructs. This increase was proportional to the cross-sectional diameter of the cross-link. Titanium constructs showed more torsional stiffness when used in two-level instability and steel showed more torsional stiffness in one-level instability, particularly when they are reinforced. Stainless steel constructs showed greater flexion stiffness when they were used in two-level and titanium showed greater flexion stiffness in one-level instability, particularly when they were reinforced with stiff cross-links. The effect of transfixation on extension forces was obvious when thick cross-links were used.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"35 1","pages":"109-17"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200104000-00004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61369422","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":"Comparison of biomechanical response to surgical procedures used for cervical radiculopathy: posterior keyhole foraminotomy versus anterior foraminotomy and discectomy versus anterior discectomy with fusion.","authors":"Bohua H. Chen, R. Natarajan, H. An, G. Andersson","doi":"10.1097/00002517-200102000-00004","DOIUrl":"https://doi.org/10.1097/00002517-200102000-00004","url":null,"abstract":"The objective of this study was to compare the change in flexibility of C5-C6 caused by three procedures using a three-dimensional nonlinear finite element model: posterior foraminotomy (keyhole procedure), anterior foraminotomy with discectomy, and anterior discectomy with fusion. The keyhole procedure produced a minor increase in motion. The anterior foraminotomy and discectomy produced one to two times greater motion. Anterior discectomy with fusion produced 50% to 100% reduction in motion. The posterior keyhole foraminotomy has a much lesser effect on the stability of the cervical spine segment than does an anterior procedure, and fusion is a requisite part of the anterior decompression procedure.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 1 1","pages":"17-20"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200102000-00004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61369181","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":"Assessment of clinical articles.","authors":"T. Ducker","doi":"10.1097/00002517-200102000-00001","DOIUrl":"https://doi.org/10.1097/00002517-200102000-00001","url":null,"abstract":"","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 1 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61369109","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":"Anterior and posterior allografts in symptomatic thoracolumbar deformity.","authors":"G. Buttermann, P. Glazer, Serena S. Hu, D. Bradford","doi":"10.1097/00002517-200102000-00009","DOIUrl":"https://doi.org/10.1097/00002517-200102000-00009","url":null,"abstract":"The radiographic and clinical results of 105 patients with symptomatic spinal deformities were categorized retrospectively based on surgical approach and type of bone autograft or allograft used for each patient's fusion surgery into seven different groups and compared with one another. The three bone autograft control groups were posterior autograft only (n = 20), anterior autograft only (n = 6), and combined anterior and posterior autograft (n = 12). The allograft groups were posterior morcellized allograft (n = 7), posterior morcellized allograft and anterior autograft (n = 11), anterior structural interbody allografts and posterior mixture of allograft and autograft (n = 37), and anterior strut allograft with posterior mixture of allograft and autograft (n = 12). Radiographs revealed high pseudoarthrosis rates for adults with a posterior-only allograft and with anterior strut allografts spanning four or more levels. Results of the self-assessment outcomes questionnaire, at a mean follow-up period of 52 months, revealed less pain and improved cosmesis for all groups, and improved function in patients who had undergone combined anteroposterior fusion. The authors conclude that posterior cancellous allograft is a poor substitute for autograft bone and that strut allografts spanning more than four levels require technique modifications to enhance their effectiveness. In general, anterior structural allografts are effective in maintaining correction, result in fusion rates comparable to those of autografts, and correlate to improved outcomes.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 1 1","pages":"54-66"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200102000-00009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61368842","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":"Kinematic evaluation of atlantoaxial joint instability: an in vivo cineradiographic investigation.","authors":"H. Yoshimoto, K. Abumi, M. Ito, M. Kanayama, K. Kaneda","doi":"10.1097/00002517-200102000-00005","DOIUrl":"https://doi.org/10.1097/00002517-200102000-00005","url":null,"abstract":"Although range of motion has been considered the best parameter to quantify atlantoaxial instability, no other kinematic parameters have been determined for dynamic quantification. The objectives of this study were to investigate the kinematics of the normal and pathologic atlantoaxial joints by cineradiography and to determine the in-vivo kinematic parameters, if any, for the quantification of atlantoaxial instability. Sagittal plane motion of the atlantoaxial joints was analyzed by cineradiography in 12 healthy volunteers and 15 patients with atlantoaxial subluxation. In both flexion and extension, C1-C2 sagittal rotation and C1 translation in the sagittal plane were measured continuously to determine the time-displacement curves for both parameters. All patients with atlantoaxial subluxation and seven of the volunteers had the sigmoid pattern in their time-displacement curves in sagittal rotation. In these cases, atlantoaxial motion showed different points of the onset of rapid increase in motion in their sigmoid curves between flexion and extension. The discrepancy between these points was more significant in the patients than in the volunteers. In most of the patients who had atlantoaxial instability, subluxation occurred when the atlantoaxial joints were still in a more extended position and they were reduced when they were still in more flexed position. The discrepancy showed characteristics similar to those of the neutral zone observed during in vitro investigations, suggesting that it becomes a good indicator of in vivo atlantoaxial instability.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 1 1","pages":"21-31"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200102000-00005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61369197","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":"Spinal epidural gas after cardiac surgery.","authors":"K. Yucesoy, H. Çakmakçı, S. Naderi, A. Kovanlikaya","doi":"10.1097/00002517-200102000-00012","DOIUrl":"https://doi.org/10.1097/00002517-200102000-00012","url":null,"abstract":"The authors describe a patient with severe lower back and left leg pain in the early postoperative period after cardiac surgery. Radiologic examination revealed gas in the spinal epidural space at the level of L4-5. The pain could not be relieved with analgesics and the patient underwent lumber surgery after cardiac surgery. After decompression, the patient improved and was discharged with no symptoms.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 1 1","pages":"76-8"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200102000-00012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61369274","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":"Transclavicular approach for a large dumbbell tumor in the cervicothoracic junction.","authors":"T. Kubo, H. Nakamura, Y. Yamano","doi":"10.1097/00002517-200102000-00013","DOIUrl":"https://doi.org/10.1097/00002517-200102000-00013","url":null,"abstract":"Neurogenic dumbbell tumors occur more frequently in the cervical than in the thoracic or lumbar spine. Cervical paravertebral masses usually do not become exceptionally large because they are superficial and are palpated easily. Thoracic tumors can become large before they are detected. The authors describe a large intrathoracic dumbbell tumor arising from the C8 nerve root. The intraspinal tumor was resected through a posterior approach. In the second stage, dividing the clavicle, the intrathoracic component was resected by separating it from the lung. Two years after treatment, the preoperative neurologic deficit had improved except for weakness of muscles innervated by the C8 nerve root. Radiographs showed no residual or recurrent mass at the apex of the lung. Sometimes a retroclavicular location may conceal a large paravertebral mass, such as Pancoast tumors. As described here, the transclavicular approach gave adequate access to the cervicothoracic junction.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"10 1","pages":"79-83"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200102000-00013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61369287","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}