Late vertebral body fracture after lumbar transpedicular fixation

2005 ◽  
Vol 3 (1) ◽  
pp. 57-60 ◽  
Author(s):  
Paolo Missori ◽  
Alessandro Ramieri ◽  
Giuseppe Costanzo ◽  
Simone Peschillo ◽  
Sergio Paolini ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Late Onset ◽  
Traumatic Injury ◽  
Spinal Instrumentation ◽  
Lumbar Pain ◽  
Content Type ◽  
Transpedicular Fixation ◽  
Body Fracture ◽  
Sharing Function ◽  
Fine Print

✓ Late-onset vertebral body (VB) fracture after lumbar transpedicular fixation has not been previously described in the literature. The authors present three cases in which VB fracture occurred several months after posterolateral fixation in patients with degenerative disease or traumatic injury. The authors suggest that postoperative osteopenia, modified load-sharing function, and intravertebral clefts were responsible for the fractures. Two women and one man were evaluated at a mean follow-up interval of 3 months. Two patients suffered recurrent lumbar pain. Radiography and magnetic resonance imaging revealed fracture of some of the instrumentation-treated VBs. These two patients underwent surgical superior or inferior extension of instrumentation. The third, an asymptomatic patient, received conservative management. The two patients who underwent reoperation made complete recoveries, and there was no evidence of further bone collapse in any case. The authors speculate that alterations in the VBs may occur following application of spinal instrumentation. In rare cases, the device can fracture and consequently lead to recurrent lumbar back pain. Recovery can be achieved by extending the instrumentation in the appropriate direction.

Aspergillus infection complicating transsphenoidal yttrium-90 pituitary implant

1977 ◽  
Vol 46 (4) ◽  
pp. 530-532 ◽  
Author(s):  
Michael Feely ◽  
Marta Steinberg
Keyword(s):  
Cerebrospinal Fluid ◽  
Late Onset ◽  
Content Type ◽  
Aspergillus Infection ◽  
Yttrium 90 ◽  
Fine Print

✓ Diagnosis proved difficult in two cases of Aspergillus infection complicating yttrium-90 ablation of the pituitary. This serious complication occurs rarely. Whatever the initial organism obtained from cases with meningitis of late onset, Aspergillus infection should be considered and cerebrospinal fluid should be cultured for fungi.

Ultrastructural scoring of graded acute spinal cord injury in the rat

2002 ◽  
Vol 97 (1) ◽  
pp. 49-56 ◽  
Author(s):  
Erkan Kaptanoglu ◽  
Selcuk Palaoglu ◽  
H. Selcuk Surucu ◽  
Mutlu Hayran ◽  
Etem Beskonakli
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Behavioral Assessment ◽  
Traumatic Injury ◽  
Significant Negative Correlation ◽  
Content Type ◽  
Cord Injury ◽  
Contusion Injury ◽  
Weight Drop ◽  
Fine Print

Object. There is a need for an accurate quantitative histological technique that also provides information on neurons, axons, vascular endothelium, and subcellular organelles after spinal cord injury (SCI). In this paper the authors describe an objective, quantifiable technique for determining the severity of SCI. The usefulness of ultrastructural scoring of acute SCI was assessed in a rat model of contusion injury. Methods. Spinal cords underwent acute contusion injury by using varying weights to produce graded SCI. Adult Wistar rats were divided into five groups. In the first group control animals underwent laminectomy only, after which nontraumatized spinal cord samples were obtained 8 hours postsurgery. The weight-drop technique was used to produce 10-, 25-, 50-, and 100-g/cm injuries. Spinal cord samples were also obtained in the different trauma groups 8 hours after injury. Behavioral assessment and ultrastructural evaluation were performed in all groups. When the intensity of the traumatic injury was increased, behavioral responses showed a decreasing trend. A similar significant negative correlation was observed between trauma-related intensity and ultrastructural scores. Conclusions. In the present study the authors characterize quantitative ultrastructural scoring of SCI in the acute, early postinjury period. Analysis of these results suggests that this method is useful in evaluating the degree of trauma and the effectiveness of pharmacotherapy in neuroprotection studies.

Prophylactic phenytoin in severe head injuries

1979 ◽  
Vol 51 (4) ◽  
pp. 507-509 ◽  
Author(s):  
Richard N. W. Wohns ◽  
Allen R. Wyler
Keyword(s):  
Retrospective Study ◽  
Head Injury ◽  
High Probability ◽  
Late Onset ◽  
Head Injuries ◽  
Content Type ◽  
Posttraumatic Epilepsy ◽  
Fine Print

✓ We are reporting a retrospective study of 62 patients whose head injury was sufficiently severe to cause a high probability of posttraumatic epilepsy. Of 50 patients treated with phenytoin, 10% developed epilepsy of late onset. Twelve patients not treated with phenytoin but who had head injuries of equal magnitude had a 50% incidence of epilepsy. These data from a highly selected group of patients with severe head injuries confirm the bias that treatment with phenytoin decreases the incidence of posttraumatic epilepsy.

Spontaneous spinal subdural hematoma associated with low-molecular-weight heparin

2005 ◽  
Vol 2 (5) ◽  
pp. 612-613 ◽  
Author(s):  
Yoon-Hee Cha ◽  
John H. Chi ◽  
Nicholas M. Barbaro
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Spinal Instrumentation ◽  
Cord Compression ◽  
Low Molecular Weight ◽  
Content Type ◽  
First Case ◽  
Spinal Subdural Hematoma ◽  
History Of ◽  
Fine Print

✓ Spinal subdural hematomas (SDHs) are a rare cause of cord compression and typically occur in the setting of spinal instrumentation or coagulopathy. The authors report the first case of a spontaneous spinal SDH occurring in conjunction with low-molecular-weight heparin use in a patient with a history of spinal radiotherapy.

The use of visible light-curing resin for vertebral body replacement

1991 ◽  
Vol 75 (1) ◽  
pp. 91-96 ◽  
Author(s):  
Ricardo Segal ◽  
Moufid Alsawaf ◽  
Ali Tabatabai ◽  
Reisuke Saito ◽  
Eduardo D. Segal ◽  
...  
Keyword(s):  
Visible Light ◽  
Methyl Methacrylate ◽  
Vertebral Body ◽  
Vertebral Body Replacement ◽  
Halogen Lamp ◽  
Content Type ◽  
Spinal Implant ◽  
Light Curing ◽  
Visible Light Curing ◽  
Fine Print

✓ The technology of visible light-curing resin has recently been developed for use in removable prosthodontics. A quartz halogen lamp producing a 400- to 500-nanometer wave-length spectrum of visible light is used to polymerize high-molecular-weight acrylic resin monomers. While several in vitro and in vivo studies of visible light-curing resin are found in the dental literature, no studies have yet been performed to evaluate it as an intracorporeal implant in surgery. The authors have designed a rat model of microcervical corpectomy to assess vertebral body replacement with visible light-curing resin in comparison to conventional autopolymerizing methyl methacrylate. Spinal cord function tests, spinal-implant stability assessments, and histological evaluations were made in a total of 41 rats at 2, 4, or 6 months postimplant. No animal developed a neurological deficit or radiographic instability, and at sacrifice there was no evidence of implant fracture-extrusion. In addition, there were no signs of adverse reaction in the surrounding tissues. Morphological investigation of the resin/bone interface at 6 months revealed very good implant anchorage. Visible light-curing resin was found to be far superior to methyl methacrylate for construction of spinal implants. Its waxy consistency makes it easy to handle. It remains pliable until light is applied, allowing adjustments in shape for a well-fitted implant without time constraints. Applied in layers, adjustments can be made even after polymerization of a previous layer. This new implantable resin will allow safer, immediate stabilization in patients with neoplastic destruction of the spine, and may also be advantageous for other neurosurgical applications, such as cranioplasty.

Fracture dislocation of the cervical spine with gross displacement

1975 ◽  
Vol 42 (2) ◽  
pp. 209-211 ◽  
Author(s):  
Ian C. Bailey
Keyword(s):  
Cervical Spine ◽  
Vertebral Body ◽  
Cervical Spine Injury ◽  
Fracture Dislocation ◽  
Spine Injury ◽  
Content Type ◽  
Fine Print

✓ A case of cervical spine injury is presented in which complete displacement of one vertebral body was accompanied by only mild quadriparesis.

Activation of the complement cascade and increase of clusterin in the brain following a cortical contusion in the adult rat

1996 ◽  
Vol 85 (3) ◽  
pp. 468-475 ◽  
Author(s):  
Bo-Michael Bellander ◽  
Hans von Holst ◽  
Pam Fredman ◽  
Mikael Svensson
Keyword(s):  
Traumatic Injury ◽  
Complement Cascade ◽  
Complement Factor ◽  
Survival Times ◽  
Adult Rats ◽  
Content Type ◽  
Junction Protein ◽  
Cortical Contusion ◽  
The Brain ◽  
Fine Print

✓ The aim of the present study was to examine the glial cell response and the possible involvement of the complement cascade following a cerebral cortical contusion. The lesion was produced using a standardized weight-drop technique in adult rats. The blood-brain barrier was damaged, as demonstrated by a decrease of immunoreactivity for a tight junction protein normally expressed by endothelial cells of small vessels in the central nervous system. Increased immunoreactivity for microglial (OX42) and astroglial cells (glial fibrillary acidic protein), as well as macrophages expressing ED1-immunoreactivity (IR) were found in the vicinity of the lesion at all postoperative survival times (2–14 days). In the present study complement factor C3d- and C9-IR was found around the lesion, indicating that activation of the complement cascade had taken place. Furthermore, immunoreactivity for the putative complement inhibitor clusterin (sulfated glycoprotein-2) was found in some of the injured neurons. The contralateral hemisphere showed no evidence of the reaction found in the ipsilateral hemisphere. The balance between complement activation and complement inhibitors may have an impact on the degenerative components in the brain following traumatic injury and in particular on the events leading to nerve cell death.

Crossed-screw fixation of the unstable thoracic and lumbar spine

1995 ◽  
Vol 82 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Edward C. Benzel ◽  
Nevan G. Baldwin
Keyword(s):  
Vertebral Body ◽  
Screw Fixation ◽  
Three Dimensional ◽  
Deformity Correction ◽  
Pedicle Screws ◽  
Short Segment ◽  
Content Type ◽  
Thoracic And Lumbar Spine ◽  
Spinal Segments ◽  
Fine Print

✓ An ideal spinal construct should immobilize only the unstable spinal segments, and thus only the segments fused. Pedicle fixation techniques have provided operative stabilization with the instrumentation of a minimal number of spinal segments; however, some failures have been observed with pedicle instrumentation. These failures are primarily related to excessive preload forces and limitations caused by the size and orientation of the pedicles. To circumvent these problems, a new technique, the crossed-screw fixation method, was developed and is described in this report. This technique facilitates short-segment spinal fixation and uses a lateral extracavitary approach, which provides generous exposure for spinal decompression and interbody fusion. The technique employs two large transverse vertebral body screws (6.5 to 8.5 mm in diameter) to bear axial loads, and two unilateral pedicle screws (placed on the side of the exposure) to restrict flexion and extension deformation around the transverse screws and to provide three-dimensional deformity correction. The horizontal vertebral body and the pedicle screws are connected to rods and then to each other via rigid crosslinking. The transverse vertebral body screws are unloaded during insertion by placing the construct in a compression mode after the interbody bone graft is placed, thus optimizing the advantage gained by the significant “toe-in” configuration provided and further decreasing the chance for instrumentation failure. The initial results of this technique are reported in a series of 10 consecutively treated patients, in whom correction of the deformity was facilitated. Follow-up examination (average 10.1 months after surgery) demonstrated negligible angulation. Chronic pain was minimal. The crossed-screw fixation technique is biomechanically sound and offers a rapid and safe form of short-segment three-dimensional deformity correction and solid fixation when utilized in conjunction with the lateral extracavitary approach to the unstable thoracic and lumbar spine. This approach also facilitates the secure placement of an interbody bone graft.

Relief of spinal block during embolization of a vertebral body hemangioma

1976 ◽  
Vol 45 (3) ◽  
pp. 327-330 ◽  
Author(s):  
Cordell E. Gross ◽  
Charles J. Hodge ◽  
Eugene F. Binet ◽  
Irvin I. Kricheff
Keyword(s):  
Vertebral Body ◽  
Spinal Block ◽  
Vertebral Hemangioma ◽  
Percutaneous Embolization ◽  
Content Type ◽  
Subarachnoid Block ◽  
Fine Print

✓ The authors describe a case in which a subarachnoid block caused by a thoracic vertebral hemangioma was relieved during percutaneous embolization of the tumor.

Thoracic idiopathic spinal cord herniation at the vertebral body level: a subgroup with a poor prognosis?

2002 ◽  
Vol 97 (3) ◽  
pp. 369-374 ◽  
Author(s):  
Giuseppe M. V. Barbagallo ◽  
Laurence A. G. Marshman ◽  
Carl Hardwidge ◽  
Richard W. Gullan
Keyword(s):  
Spinal Cord ◽  
Vertebral Body ◽  
Prosthetic Material ◽  
Dural Defect ◽  
Content Type ◽  
Distinct Subgroup ◽  
Surgical Reduction ◽  
Spinal Cord Herniation ◽  
Idiopathic Spinal Cord Herniation ◽  
Fine Print

✓ The authors present two cases of thoracic idiopathic spinal cord herniation (TISCH) occurring at the vertebral body (VB) level in whom adequate surgical reduction failed to reverse symptoms. In the second case, in which TISCH occurred into a VB cavity, presentation was atypical (subacute spinal cord syndrome) and there was persistent postoperative deterioration. In both cases, adequate surgical reduction was achieved via a posterior midthoracic laminectomy, and reduction was maintained by closure of the anterior dural defect by using prosthetic material. Thoracic idiopathic spinal cord herniation occurring at a VB level may be technically well treated by surgical reduction, but the outcome appears less predictable. Herniation that occurs directly into a VB cavity may form a distinct subgroup in which the presentation is atypical and the prognosis worse.

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