11/16. Complications of posterior arthrodesis of the cervical spine in patients who have down syndrome.Ten patients who had down syndrome and had had a posterior arthrodesis of the upper cervical spine were studied. The mean age at the time of the operation was 8.9 years, and the patients had been followed for three days to forty-nine months. Complications related to the operation occurred in all patients. They included infection and dehiscence at the site of the wound, incomplete reduction of the atlanto-axial joint, instability of the adjacent motion segment, neurological sequelae, resorption of the autogenous bone graft, and death in the postoperative period. Resorption of the bone graft, which occurred in six of the patients, has not previously been reported in patients who have down syndrome, to our knowledge. Several theoretical mechanisms for this complication are proposed. We recommend non-operative management for patients who have down syndrome and atlanto-axial instability without neurological signs or symptoms. If the severity of symptoms necessitates a posterior arthrodesis, a high rate of complications must be anticipated.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
12/16. Evaluation of cervical spine inflammatory arthritis with somatosensory evoked potentials.Bilateral independent median nerve somatosensory evoked potentials (SEP) were obtained in 15 patients with inflammatory arthritis of the cervical spine. Limitation of neck motion, neck pain, abnormal neurologic findings, and atlantoaxial subluxation were evaluated. Ten of 15 patients had abnormal SEP associated with subluxation in 9. Neurological signs specifically localizable to the central nervous system (CNS) were present in only 2 of the 10 patients. SEP were normal in the remaining 5 patients despite the presence of nonspecific neurological signs including atrophy of the intrinsic muscles of the hands and atlantoaxial subluxation determined by radiographic evaluation in 3 of 5 patients. Our study demonstrates the value of SEP in the evaluation of CNS function when findings on examination and radiographs may not conclusively document spinal cord impairment.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
13/16. Cervical intervertebral disc calcification in children.intervertebral disc calcification in children is a rare occurrence. The clinical symptoms and signs are distinctively confined to the cervical area with pain, limitation of motion, and torticollis. Long tract signs or radicular involvement are extremely unusual. CT scan and cervical spinal X-ray films shown the calcification to be in the nucleus pulposus with anterior or posterior mild protrusion into the spinal canal. Recovery without neurological sequelae is the rule in most of the pediatric cases with conservative treatment. intervertebral disc calcification does not necessarily disappear with the onset of clinical symptoms. A case with persistent and even denser calcification at the same level of intervertebral disc space at the second episode of recurrence is illustrated.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
14/16. Biomechanical study of cervical spine stabilization with methylmethacrylate.Polymethylmethacrylate (PMMA) has been used to provide immediate fixation in the spine, especially in the cervical region. With its use spreading to nontumor cases and a younger patient population, its biomechanical contribution to the stability and strength of the injured spine becomes increasingly important. The present study is unique, as it provides, for the first time, results of a three-dimensional stability and flexion strength testing of a surgical specimen removed at autopsy after 7 years. Also tested, in the identical manner, is a normal specimen to provide control data. The PMMA specimen, as compared with the control, was generally found to have less motion. Its flexion strength was at par with that of the control, although it did not exhibit the initial low-stiffness region of the normal spine specimen.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
15/16. Vertebral pseudoarthrosis associated with diffuse idiopathic skeletal hyperostosis.Diffuse idiopathic skeletal hyperostosis is an ossifying diathesis that commonly affects the vertebral skeleton. Spinal ankylosis can occur, predisposing the spine to abnormal stresses and fracture. Fracture through an ankylosed segment with continued motion at the site of fracture can result in pseudoarthrosis. Pseudoarthrosis can also develop at the junction of the fused and mobile spine secondary to chronic abnormal stresses. This complication is manifest radiographically by single-level intervertebral disc space destruction, vertebral endplate erosions, marked vertebral sclerosis, and large osteophytes. The radiographic manifestations can mimic infective spondylitis or neuropathic changes.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
16/16. Anterior lumbar vertebral translation following translaminar screw fixation. A report of five cases.Translaminar screw fixation is a good procedure for posterolateral spinal fusion of one or two motion segments. Anterior translation of the upper fused vertebra occurred in 5 of our patients following this procedure. A further fusion with pedicle screw fixation was needed in 2 of them. This complication has been previously reported after decompression operations on the lumbar spine. Translaminar screwing produces slight posterior distraction which pushes forward the upper vertebra. This procedure should be avoided in cases with even minimal anterior translation before operation. Translaminar screw fixation is an ideal technique for fusion of a degenerated segment when the upper vertebra has slipped posteriorly.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
| <- Previous | |