Scoliosis after thoracoplasty. A study of thirty patients.
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Biomedical subjects
Publications and source records attributed to E S Stauffer.
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Two patients with Down's syndrome and associated atlantoaxial instability with a chronically narrow spinal canal at C1-2 underwent surgical procedures in which the lesion was manipulated and posterior wiring and fusion were done. Both patients developed quadriplegia from the surgery. The authors recommend preoperative traction to reduce the deformity, then surgery with the traction maintained as a method to avoid this complication. Further, if reduction does not occur with traction, onlay grafting is recommended, avoiding any sublaminar wiring.
From this literature, we have made the following conclusions: (1) Complete cord lesions do not recover cord functional motor control. (2) Complete lesions recover one nerve root level of function at the fracture site. (3) Partial lesions recover partially. (4) The less the injury, the greater the recovery. (5) Brown-Sequard lesions recover more than central cord syndromes, which recover more than anterior cord syndromes. (6) Reduction of dislocated facets facilitates nerve root recovery. (7) Better documentation of specific pathology and recovery rates are necessary to determine the surgical benefits in complete lesions, incomplete lesions, and nerve root recovery.
The structure and anatomical relationships of cartilage canals in the developing vertebral endplates of rabbits and humans are described in this study. In newborn rabbits, we observed a similar morphology and topologic arrangement to that in human fetal spines. Each vascular organ consisted of an arteriole, a glomerular tuft of sinusoidal capillaries, recurrent venules, and supporting loose connective tissue. Because the canals terminate adjacent to the intervertebral discs, they may provide an important source of nutrition to the disc during development when it is sandwiched between two layers of thick hyaline cartilage and contains no intrinsic vascular supply.
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