Double Dome Laminoplasty: A Novel Technique for C2 Decompression

Objective: To introduce a new surgical technique - double dome laminoplasty for decompression of the entire C2 lamina and preservation of an extensor muscle insertion.Methods: Eleven consecutive cervical myelopathy patients due to ossification of the posterior longitudinal ligament involving the Axis (C2) area were contained at this study. Direct decompression was evaluated as an increasing rate in space available cord (%) and posterior cord shift (mm) at C2 level. The Japanese Orthopaedic Association (JOA) score, visual analogue scale, and C2–7 Cobb angle in a neutral lateral x-ray were analyzed.Results: The mean increase in space available for spinal cord at the C2 level, average posterior cord shift, and JOA recovery rate were 69.7%, 5.3 ± 0.15 mm, and 58.0%, respectively. Cervical lordotic angle was maintained in all patients. One patient reported neck pain (visual analogue scale 6) postoperatively. No specific complications such as C2 laminar fracture or insufficient decompression were observed.Conclusion: We recommend double dome laminoplasty for treating patients with cervical myelopathy involving the C2 area to avoid C2 laminectomy, reduce postoperative neck pain, and maintain lordotic cervical spine alignment.

Correlation of the CT Scan Findings and Neurologic Impairment in Thoracolumbar Burst Fractures

Background: Spinal injury is the most common injury which may lead to devastating disability. Such fractures are relatively rare but frequently result in neurologic damage due in part to retro- pulsed fragments that narrow the spinal canal. Hereby we would like to correlate the CT scan findings and neurologic impairment in thoracolumbar burst fractures at our center. Materials and Methods: This prospective observational study was conducted at B&C teaching hospital, Birtamode, Nepal. Patients were evaluated by CT scan between July 2016 to December 2018 referred from the emergency department with a history of trauma and suspected thoracolumbar vertebral fractures with or without neurological deficit were included in the study. The different demographic variables like gender, age were included and injury at the level of the spine and neurological deficit was studied. Thus, obtained data were processed in statistical software and expressed in percentage and frequency. Results: The total number of patients was 34 (male: 19, female: 15). The age ranged from 16 years to 77 years with a mean age of 39.1 years. The neurologic deficit was detected in 10 cases (29.4%), out of which complete deficit in 6 (60%) and incomplete deficit in 4 (40%). The neurologic deficit was absent in 24 cases (70.6%). An associated laminar fracture was detected in 17 patients (50%). Laminar fracture associated with the neurologic deficit was found in 10 patients. Conclusion: CT scan is an excellent imaging modality for the evaluation of thoracolumbar fractures. Measurement of central canal ratio and assessment of associated laminar fracture can be useful information to predict the neurologic deficit and plan for further management.

A Numerical Assessment on the Influences of Material Toughness on the Crashworthiness of a Composite Fuselage Barrel

In the present work, a numerical study on the dynamic response of a composite fuselage barrel, in relation to crashworthiness, has been investigated. The aim of this work is to investigate the influence of the material fracture toughness on the capability of a composite fuselage barrel to tolerate an impact on a rigid surface. Three different material configurations with different intra-laminar fracture energy values were considered to take into account variations in material toughness. Indeed, the dynamic behaviour of the analysed fuselage barrel has been numerically simulated by means of the FE (Finite Element) code Abaqus/Explicit. The effects of intralaminar fracture energy variations on the impact deformation of the barrel has been evaluated comparing the numerical results in terms of displacements and damage evolution for the three analysed material configurations.