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At least 163 records · Page 9Linked to original sources
PubMed1986

[Stabilization of thoraco-lumbar spinal fractures using Harrington's equipment. Study of the evolution of spinal curvatures].

The radiographic results of treatment of unstable thoracolumbar spinal injuries by Harrington rods are reviewed. The loss of initial correction of kyphosis is 8 degrees on average. Correlation between good anatomical reduction and lapse of time before operation, level of instrumentation and solid spinal fusion exists. But, in burst fracture with deficient anterior pilar, the incidence of loss of reduction is important. The influence of Harrington rods on the spine is significant.

Adult↗
PubMed1996

Timing of surgical decompression and fixation of acute spinal fractures.

A retrospective evaluation of 138 patients requiring operative decompression, reduction and fixation of spinal injuries between January 1986 and April 1989 was conducted. The variables of timing and method of operative intervention, level and classification of fracture, associated injuries, injury severity score (ISS), associated neurologic deficits, length of intensive care unit and hospital stays, and projected costs were analyzed for correlation with postoperative complications (pulmonary, skin, urinary, other). Four subgroups were identified: group IA patients underwent surgery within 72 h of injury and had an ISS of < 18; group IB patients underwent surgery after 72 h and had an ISS of < 18; group IIA patients underwent surgery within 72 h and had an ISS of > or = 18; and group IIB underwent surgery after 72 h and had an ISS of > or = 18. There was no statistically significant difference in the incidence of medical complications in patients comparing groups IA and IB. Group IIB patients had a statistically significant higher rate of morbidity than did group IIA. A separate group of patients with cervical spine injuries with neurologic deficit was analyzed by the same statistical analysis. Irrespective of associated injuries, all had fewer complications if they underwent surgery within 72 h. Morbidity was higher in patients with a neurological deficit compared with neurologically intact patients. Surgical decompression, reduction, and/or fixation of spinal fractures within the first 72 h is indicated in patients with multiple trauma (ISS > or = 18) and cervical injuries with a neurological deficit.

Adolescent↗
PubMed1991

Post-traumatic syringomyelia following uncomplicated spinal fracture.

Two cases of post-traumatic syringomyelia presenting 10 and 41 years after spinal injuries that had caused lumbar vertebral fractures but no lasting neurological deficits are reported. In both patients the caudal end of the syrinx cavities, as shown by MRI, corresponded to the level of the previous vertebral fractures. Patients presenting with post-traumatic syringomyelia after uncomplicated spinal fracture are very rare, and the significance of the past history of spinal trauma may be overlooked.

Drainage↗
PubMed1991

Experimental evaluation of seven different spinal fracture internal fixation devices using nonfailure stability testing. The load-sharing and unstable-mechanism concepts.

Fracture site immobilization capabilities of seven internal spine fixation systems were experimentally evaluated: Harrington double distraction (plain, supplemented with Edwards sleeves, supplemented with sublaminar wires), Luque rectangle, Kaneda device, transfixed Kaneda device, and Steffee plates. Stability evaluation involved comparing the three-dimensional motion that occurred across an experimentally created L1 slice fracture, and the load resistance of the implants when subjected to axial, flexion, extension, lateral bending, and torsional loads. Each implant was tested on 15 different vertebral segments from 200-250-lb calves. All implants load-shared with the fractured vertebral column to varying degrees. All except the Steffee plate system showed an obvious biomechanical weakness in one or more load modes. The unstable 4R-4bar mechanism configuration of bilevel spinal implants was identified. Mechanism configurations allow free movement with little or no resistance to the applied load until load sharing by the spinal column stops the collapse and resists the applied load.

Animals↗
PubMed2000

Teaching model for intraoperative spinal sonography in spinal fractures. An experimental study.

To improve the technique of intraoperative sonography of the spinal canal, a teaching model of the thoracolumbar spine was developed. It allows to simulate the typical spinal stenosis of a vertebral fracture and the sonographic procedure to detect and measure such a lesion. Moreover, partial laminectomy and modification of a fixateur interne set-up, which are preconditions for successful sonography, can be simulated. Independent of the surgical qualification, a high precision in sonographic localisation and measurement of the spinal canal stenosis was achieved by the training. The results could be validated in the cadaveric model. Thus, sonographic expertise acquired with the teaching model proved to be reliable in the clinical situation.

Cadaver↗
PubMed1989

Cotrel-Dubousset rods in spinal fractures.

Cotrel-Dubousset instrumentation (CDI) has been gaining popularity in scoliosis surgery because of their improved rigidity which can obviate the need for a brace in most cases. Early results of this new system in scoliosis surgery have demonstrated a low pseudarthrosis and hardware complication rate. Because of these advantages, CDI was used to stabilise thoracolumbar fractures at the Lucerne Spinal Center. The results of 23 patients were reviewed with respect to completion of healing, change in neurological status, hardware complications, and follow-up radiographic parameters. Nine patients were braced and 14 were not braced post-operatively. Two elderly patients expired at 1 and 6 months following their injury from medical complications. Of the remaining 21 patients, all were evaluated at follow-up ranging from 6 to 28 months, mean 12.7 months. The evaluation revealed that all patients showed complete healing without significant neurological or hardware complications.

Adolescent↗
PubMed1991

The use of the Hartshill system for the internal fixation of spinal fractures and tumors.

We present the use of our Hartshill system for the posterior fixation of fractures and tumors. We present our first 69 fractures with a minimum two year follow-up (11 cervical, 8 thoracic, 42 thoracolumbar, 8 lumbar). The Hartshill system is a simple and secure method for the fixation of the spine in such cases. Both in thoracolumbar fractures and in tumours the common problem is collapse of the anterior column so that the spine is in kyphosis. Biomechanically the solution for the reduction and internal fixation in such cases is to use a fixation system which reduces the kyphosis by creating a lordosis. This is simply achieved with the Hartshill system.

Biomechanical Phenomena↗
PubMed1996

Correlations of dual-energy X-ray absorptiometry, quantitative computed tomography, and single photon absorptiometry with spinal and non-spinal fractures.

Controversy continues as to which method of measuring bone mineral density (BMD) best detects osteoporosis and best correlates with fractures of the spine, hip and elsewhere. To answer these questions the prevalence of fractures was carefully determined among 90 subjects (70 with osteoporosis, 6 with mild primary hyperparathyroidism, 1 with osteomalacia and 13 normals) and simultaneous measurements were made using spinal computed tomography (QCT), spinal anteroposterior (AP) and supine lateral dual X-ray absorptiometry (DXA), femoral neck and total hip DXA, and distal third radial DXA and single photon absorptiometry (SPA). The DXA measurements which had the greatest sensitivity in detecting osteoporosis (defined as a BMD lower than -2.5 SD of peak bone mass at age 30 years) were the supine lateral spine DXA (84%) and femoral neck DXA (75%); less sensitive were the DXA measurements of the distal third of the radius (61%) and AP spine (51%). DXA measurements of the femoral neck and distal third of the radius were more useful than spinal measurements in detecting the osteopenia of mild primary hyperparathyroidism. Vertebral compression fractures (VCF) correlated well with spinal QCT (r = 0.38) and lateral spine DXA (r = -0.41), but poorly with AP spine DXA (r = -0.17) and distal third radial DXA (r = -0.02). Non-spinal fractures correlated best with the distal third radial DXA (r = -0.42). In conclusion, spinal QCT, supine lateral spine DXA and femoral neck DXA are the best BMD methods to screen for osteoporosis, whereas AP spine DXA is a poor screening method in women over 60 years of age. Spinal QCT and lateral spine DXA correlate well with VCFs, whereas correlations of VCFs with AP spine DXA, femoral neck DXA and distal third radial DXA are poor.

Absorptiometry, Photon↗
PubMed1991

Primary stabilization of spinal fractures with and without neurologic deficit.

This paper reports the results of our methods, describes the different approaches and shows the different techniques of implantation. To obtain stable fixation of the fracture we use three different types of implants, depending on the localisation. From C1 to C3, we use the new type of the Dens fixation plate. From C3 to Th1, we use the so-called doublewhole plate. Both plate types are fixed with so-called TKFS-screws. In the thoracic and lumbar region we have used up to now the Zielke USIS-system. To obtain a primary stable three-dimensional construction a dorsoventral procedure in one session is necessary.

Bone Plates↗