Journal of spinal disorders最新文献

{"title":"Change of muscle motor-evoked potentials after motor cortex stimulation caused by acute spinal cord injury in cats.","authors":"S. Nakatoh, H. Kitagawa, Y. Kawaguchi, H. Nakamura, H. Takano","doi":"10.1097/00002517-200102000-00006","DOIUrl":"https://doi.org/10.1097/00002517-200102000-00006","url":null,"abstract":"The validity of the evoked compound muscle action potential (ECMAP) as an index of spinal cord injury has not been established in neurophysiologic monitoring of motor function, although evoked spinal cord potential (ESCP) has been. In the current study, nine cats were used. After craniotomy, electric stimuli were applied to the motor area. Four cats were given stimulation of various numbers and frequencies, and the other five cats underwent graded compression of the spinal cord, and then ECMAPs and ESCPs were recorded. Three cats were awakened and their motor functions were assessed 3 weeks later. The amplitude of the ESCP never decreased to 60% or less of the control value, even when ECMAPs disappeared. No motor dysfunction was present 3 weeks after the experiment. ECMAP is clinically useful, providing information on impairments of the spinal cord that otherwise would remain undetected.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 1 1","pages":"32-8"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200102000-00006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61369209","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":"Thoracic pedicle: surgical anatomic evaluation and relations.","authors":"H. Ugur, A. Attar, Aysun Uz, Ibrahim Tekdemir, N. Egemen, Yasemin Genç","doi":"10.1097/00002517-200102000-00007","DOIUrl":"https://doi.org/10.1097/00002517-200102000-00007","url":null,"abstract":"This anatomic study investigated the thoracic pedicle and its relations. The objective was to emphasize the importance of the thoracic pedicle for transpedicular screw fixation to avoid complications during surgery. Twenty cadavers were used to observe the cervical pedicle and its relations. The isthmus of the pedicle was exposed after removal of whole-posterior bony elements, including spinous processes, laminas, lateral masses, and the inferior and superior facets. The pedicle width and height, interpedicular distance, pedicle-inferior nerve root distance, pedicle-superior nerve root distance, pedicle-dural sac distance, root exit angle, and nerve root diameter were measured. There was no distance between the pedicle and dural sac in eight specimens. There was, however, a short distance in 12 remaining specimens in the upper and lower thoracic regions. The distances between the thoracic pedicle and the adjacent nerve roots ranged from 1.5 to 6.7 mm and 0.8 to 6.0 mm superiorly and inferiorly at all levels. The mean pedicle height and width at T1-T12 ranged from 2.9 to 11.4 mm and 6.2 to 21.3 mm, respectively. The interpedicular distance decreased gradually from T1 to T5 and then increased gradually to T12. The mean root exit angle decreased consistently from 104 degrees to 60 degrees. The nerve root diameter was between 2.3 and 2.5 mm at the T1-T5 level and then increased consistently from 2.5 to 3.7 mm. All significant differences were noted at p < 0.05 and p < 0.01. The following suggestions are made based on these results. 1) More care should be taken when a transpedicular screw is placed in the horizontal plane. 2) Improper medial placement of the pedicle screw, especially in the middle thoracic spine, should be avoided, and the anatomic variations between individuals should be considered. 3) Because of substantial variations in the size of thoracic pedicles, utmost attention should be given to the findings of a computed tomographic evaluation before thoracic transpedicular fixation is begun.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 1 1","pages":"39-45"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200102000-00007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61368767","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 thoracic kyphosis using the Debrunner kyphometer.","authors":"P. Korovessis, G. Petsinis, Z. Papazisis, A. Baikousis","doi":"10.1097/00002517-200102000-00010","DOIUrl":"https://doi.org/10.1097/00002517-200102000-00010","url":null,"abstract":"The Debrunner kyphometer is an accepted tool for detecting and evaluating thoracic kyphosis. This prospective study was conducted to create a mathematical formula that provides, with high approximation, the roentgenographic angle of thoracic kyphosis (T4-T12) using only the kyphometer. Several clinical (kyphometer value, age, and sex) and radiographic (Cobb angle [T4-T12]) parameters from 90 consecutively screened adolescents (44 male and 46 female) were correlated using simple and multiple linear regression analyses. The reliability of measurement using the Debrunner kyphometer was high. The kyphometer value was strongly correlated with the roentgenographically measured thoracic Cobb angle (simple linear regression analysis; probability range, 0.0026 to 0.0002). There was no correlation between age or sex and thoracic kyphosis. The predicted kyphosis angle using the kyphometer and the mathematic formula was 44.66 degrees +/- 2.68 degrees, (range 27 to 62 degrees), and the real roentgenographic kyphosis angle was 47.5 degrees +/- 3.53 degrees, (range, 24 to 70 degrees). The kyphometer and formula were more reliable and accurate when kyphosis less than 50 degrees was measured. In this study, the authors constructed a mathematical formula that accurately provides the roentgenographic T4-T12 kyphosis angle in adolescents using only the Debrunner kyphometer with a deviation of less than 3 degrees. The authors recommend that all physicians engaged in kyphosis screening programs use the kyphometer combined with the recently constructed simple mathematic formula. This method will reduce the cost of school screening programs, overdiagnoses, and unnecessary exposure of adolescents to irradiation.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 1 1","pages":"67-72"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200102000-00010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61369255","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":"Exuberant transverse ligament degeneration causing high cervical myelopathy.","authors":"C. Cai, C. Palmer, C. Paramore","doi":"10.1097/00002517-200102000-00014","DOIUrl":"https://doi.org/10.1097/00002517-200102000-00014","url":null,"abstract":"Two patients with cervical myelopathy and C1-C2 retro-odontoid masses were examined. Preoperative magnetic resonance imaging studies suggested soft tissue pannus, as might be seen in rheumatoid arthritis; however, the results of serologic testing for rheumatoid factor were negative in both patients. Intraoperative findings and pathologic examination revealed degenerative fibrocartilage without inflammation or neoplasia. Similar lesions reported in the literature have been described as retro-odontoid disk hernia, damaged transverse ligaments, transverse ligament degeneration, synovial cysts, ganglion cysts, and degenerative articular cysts. These lesions may share a common pathophysiologic origin and represent a single disease process, namely exuberant degeneration of the transverse ligament.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 1 1","pages":"84-8"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200102000-00014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61369327","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":"Surgical treatment of adolescent idiopathic scoliosis: a comparative study of two segmental instrumentation systems.","authors":"F. Girardi, O. Boachie-Adjei, S. Burke, B. Rawlins","doi":"10.1097/00002517-200102000-00008","DOIUrl":"https://doi.org/10.1097/00002517-200102000-00008","url":null,"abstract":"This study compares two different surgical techniques and instrumentation types in the treatment of adolescent idiopathic scoliosis. The charts and radiographs of 116 patients with adolescent idiopathic scoliosis treated by posterior spine fusion with Isola or Cotrel-Dubousset instrumentation were reviewed. Patients were separated into two equivalent groups matched for age, sex, curve type, and curve magnitude. All patients had a minimum of 2 years follow-up. The instrumentation in group 1 consisted of hooks, wires, and pedicle screws. That used in group 2 was limited to hooks and rods. The Mann-Whitney, Wilcoxin, and the paired Student t tests for matched pairs were used for statistical analysis. Patients in group 1 had increased curve correction (66% vs. 52%), apical vertebral translation (63% vs. 30%), and correction of the end vertebral tilt angle (11 degrees vs. 3 degrees) (p < 0.001). The percentage of coronal curve correction in curves larger than 65 degrees also was greater in group 1 (59% vs. 40%). Physiologic sagittal alignment was obtained in 80% of the patients in group 1 and 25% in group 2. No major complication or pseudoarthrosis occurred in either group. This study supports improved correction of curve magnitude, apical translation, and end vertebral tilt angle with the use of multiple anchor types compared with the correction achieved with standard hook-and-rod constructs.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 1 1","pages":"46-53"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200102000-00008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61368825","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 cervical instrumentation enhances fusion rates in multilevel reconstruction in smokers.","authors":"B. Bose","doi":"10.1097/00002517-200102000-00002","DOIUrl":"https://doi.org/10.1097/00002517-200102000-00002","url":null,"abstract":"This retrospective consecutive case study evaluated the effect of anterior plating on multilevel anterior cervical decompressions and fusions in smokers and non-smokers. Multilevel anterior cervical decompression and fusion surgery in smokers provides an important challenge. Higher nonfusion rates in smokers have been reported. Cigarette smoking has been shown to interfere with bone metabolism and revascularization and to suppress bone formation. One hundred six patients underwent anterior cervical decompression and fusion using autografts or allografts and anterior plating. The minimum follow-up was 12 months. The mean age was 50.12 years (+/- 11.72; range, 27 to 80 years). Autografts were used in 90 patients and allograft in 16. The mean level fused was 2.74 (+/- 0.61). Forty-six (45.5%) patients were smokers. Successful fusion was achieved in all but three patients (97.17%). C5 root weakness was seen in four patients (3.8%); two patients experienced acute airway obstruction, of which one required tracheotomy. Temporary recurrent laryngeal nerve palsy developed in three (2.8%) patients. A fusion rate of 97% was achieved in multilevel anterior cervical decompression and fusions using anterior plating. No difference in fusion rates between smokers and nonsmokers was seen. Anterior cervical plating markedly improved the fusion rate in smokers.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"42 1","pages":"3-9"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200102000-00002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61369119","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 spondylosis: the role of anterior instrumentation after decompression and fusion.","authors":"G. Zaveri, M. Ford","doi":"10.1097/00002517-200102000-00003","DOIUrl":"https://doi.org/10.1097/00002517-200102000-00003","url":null,"abstract":"The role of plate stabilization after anterior decompression and fusion of the cervical spine for cervical spondylosis remains controversial. This study aimed to justify the use of instrumentation to stabilize anterior cervical fusion for cervical spondylosis through a risk-benefit analysis and comparison of the results with those reported in the literature on the outcome of fusion without instrumentation. The authors retrospectively reviewed the charts and radiographs of 47 patients with symptoms secondary to cervical spondylosis who underwent anterior cervical decompression and instrumented fusion. After operation, patients were mobilized early, and neither neurologic injury nor infection developed in any patient. At an average 3.4 years after surgery, the rate of graft complications, including nonunion (4.26%), was low, whereas the rate of hardware-related morbidity was minimal (6%). An average 0.4 degrees loss of the intraoperative correction of cervical lordosis was observed at the last follow-up examination. Accelerated degenerative changes at levels adjacent to the fusion were seen in 17% of patients, but only two patients required repeat operation for persistent symptoms. The use of instrumentation to stabilize the cervical spine in patients with cervical spondylosis after anterior decompression and fusion is relatively safe. It permits early pain-free mobilization, successfully maintains sagittal cervical spine alignment, and promotes consistent and reliable spinal fusion.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 1 1","pages":"10-6"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200102000-00003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61369135","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":"Sterile, benign radiculitis associated with lumbosacral lateral recess spinal canal stenosis: evaluation with enhanced magnetic resonance imaging.","authors":"L. Xiong, J. Jinkins","doi":"10.1097/00002517-200102000-00011","DOIUrl":"https://doi.org/10.1097/00002517-200102000-00011","url":null,"abstract":"Two cases of symptomatic lumbar lateral recess stenosis are described in which the compressed nerve root became focally enhanced on magnetic resonance imaging (MRI) studies performed with gadolinium DTPA. Two men with low back pain and lumbar radiculopathy were examined with contrast-enhanced MRI studies, which showed intradural enhancement of the symptomatic nerve roots. In selected cases of lateral recess stenosis, focal radicular injury may be visualized on enhanced MRI as a result of a breakdown of the blood-brain barrier.","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"14 1 1","pages":"73-5"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200102000-00011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61369265","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":"Radiographic assessment of anterior titanium mesh cages.","authors":"K R Eck,&nbsp;L G Lenke,&nbsp;K H Bridwell,&nbsp;L A Gilula,&nbsp;C J Lashgari,&nbsp;K D Riew","doi":"10.1097/00002517-200012000-00006","DOIUrl":"https://doi.org/10.1097/00002517-200012000-00006","url":null,"abstract":"<p><p>Carbon fiber and titanium cage implantation for anterior column support during spinal fusions is an alternative to the use of more traditional structural allografts and autografts. The authors report instrumentation and cage failure for patients who underwent spinal fusion with structural titanium mesh cages implanted into the anterior column a minimum of 2 years after surgery. They wanted to determine whether plain radiographic techniques can be used to critically assess disk space and corpectomy fusions after implantation of these radioopaque cages. Fifty patients having undergone spinal fusions using structural titanium mesh cages in the anterior column had 99 anterior levels fused with at least 1 (maximum of 2) titanium mesh cage, resulting in a total of 131 cages used. The cages were examined for evidence of settling, migration, or failure. The anterior and posterior instrumentation was assessed for evidence of failure, and the spine was examined for evidence of successful fusion. Radiographic cage settling (>2 mm) into the vertebral body end plates was observed, but cage migration or failure were not. An average lordotic correction of 10 degrees was observed, with loss of correction into kyphosis from immediately after operation to final follow-up averaging 2 degrees. As an average of all reviewers, using a strict radiographic fusion assessment, definite or probable anterior fusion was graded at 81% of the levels, probably not or no at 5% of the levels, and could not be assessed at 14% of the levels. Definite or probable posterior fusion as an average of all reviewers was graded at 44% of the posterior fusion levels, questionable at 4%, no at 5%, and could not be assessed at 47%. The use of anterior-only, posterior-only, or anterior and posterior instrumentation with structural titanium mesh cages in the anterior spine along with proper autogenous bone grafting techniques provided anterior column support with a low rate of radiographic complications. Acceptable anterior spinal fusion rates, as assessed by a consensus agreement of reviewers, were observed primarily by evaluation of the fusion mass around the cages (extracage fusion), because intracage fusion was difficult to assess.</p>","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"13 6","pages":"501-9; discussion 510"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200012000-00006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21954073","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":"Anderson type II fracture of the odontoid process: results of anterior screw fixation.","authors":"H ElSaghir,&nbsp;H Böhm","doi":"10.1097/00002517-200012000-00011","DOIUrl":"https://doi.org/10.1097/00002517-200012000-00011","url":null,"abstract":"<p><p>Controversy exists in the literature regarding the adequacy of one or two screws for direct fixation of the odontoid process. Proponents of the two-screw technique believe that a single screw is not adequate to stabilize the fracture. Conversely, the insertion of two 3.5-mm screws in the medullary cavity of the odontoid process is technically difficult and can jeopardize the surface area left for fracture healing. The authors conducted a prospective study of 30 cases with Anderson type II fracture of the odontoid process treated by direct anterior fixation using the two-screw technique. The screws used were 2.7-mm cortical screws manufactured from titanium. Two C-arms were used to control reduction of the displaced fracture and for its direct anterior stabilization. The operation was performed with the patients under general anesthesia. The anterolateral incision was made at the level of C4 to facilitate exposure of the C2-C3 disk and for fracture fixation. No evidence of nonunion was encountered. Spontaneous fusion of the C2-C3 segment was found in one case. Limitation of rotation of the cervical spine was a subjective description in a single case. No major complications were attributed to the surgical technique. The two 2.7-mm self-tapping titanium cortical screws provided adequate stability for fixation of type II odontoid fractures.</p>","PeriodicalId":77226,"journal":{"name":"Journal of spinal disorders","volume":"13 6","pages":"527-30; discussion 531"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00002517-200012000-00011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21954077","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}