Validation of a translated version of the modified Japanese orthopaedic association score to assess outcomes in cervical spondylotic myelopathy: an approach to globalize outcomes assessment tools.

Background: Although the Japanese Orthopaedic Association (JOA) originally developed in Japan, the modified English version (mJOA) has become widely used and is arguably now the accepted standard.

Objective: In order to apply the mJOA successfully at an international level, we have translated it with a validated approach into Dutch to pave the way for other translated versions.

Methods: After a thorough forward and backward translation procedure, a final Dutch version of the mJOA was developed.

Thoracolumbar junction injuries after rollover crashes: difference between belted and unbelted front seat occupants.

Motor vehicle collision (MVC) is one of the most common causes of thoracolumbar junction (TLJ) injury. Although it is of no doubt that the use of seatbelt reduces the incidence and severity of MVC-induced TLJ injury, how it is protective for front-seat occupants of an automobile after rollover crashes is unclear. Among 200 consecutive patients with a major TLJ (Th11-L2) injury due to high-energy trauma admitted from 2000 to 2004, 22 patients were identified as front-seat occupants of a four-wheel vehicle when a rollover crash occurred.

An alternative source of autograft bone for spinal fusion: the femur: technical case report.

Objective: Autograft bone obtained from the iliac crest remains the "gold standard" for spinal fusion. For various reasons, including previous harvesting or pelvic dysmorphism, the iliac crest bone graft may not be available to the spinal surgeon. We present a novel use of a common orthopedic procedure, intramedullary reaming, for obtaining autograft for revision spinal fusion.

Posterior instrumentation surgery for thoracolumbar junction injury causing neurologic deficit.

Thoracolumbar junction (TLJ) injury is one of the most common spine injuries. TLJ injury manifesting as neurologic deficit usually requires surgery because of the underlying spinal instability and/or neural compression. The objectives of surgical treatment are to restore biomechanical stability of the spine and/or to achieve neural decompression.

Flexion-distraction injury of the L1 vertebra treated with short-segment posterior fixation and Optimesh.

We report a patient with a flexion-distraction injury of the L1 vertebra treated with a combination of short-segment posterior fixation and Optimesh (Spineology Inc., St. Paul, MN, USA), a flexible balloon-shaped mesh that is deployed into the fractured vertebra together with allograft.

In vitro biomechanical comparison of an anterior and anterolateral lumbar plate with posterior fixation following single-level anterior lumbar interbody fusion.

Object: Anterior lumbar interbody fusion (ALIF) is often supplemented with instrumentation to increase stability in the spine. If anterior plate fixation provided the same stability as posterior pedicle screw fixation (PSF), then a second approach and its associated morbidity could be avoided.

Methods: Seven human cadaveric L4-5 spinal segments were tested under three conditions: ALIF with an anterior plate, ALIF with an anterolateral plate, and ALIF supplemented by PSF.

Thoracolumbar junction injuries after motor vehicle collision: are there differences in restrained and nonrestrained front seat occupants?

Object: Motor vehicle collision (MVC) is one of the most common causes of thoracolumbar junction (TLJ) injury. Although there is little doubt that the use of seat belts reduces the incidence and severity of TLJ injury after MVC, the mechanism by which this is protective against TLJ injury for drivers and passengers is relatively unknown.

Methods: Thirty-nine patients with TLJ (T11-L2) injury who were front seat occupants of a four-wheeled vehicle at the time of MVC (frontal crash) were admitted between 2000 and 2004.

Augmentation of an anterior lumbar interbody fusion with an anterior plate or pedicle screw fixation: a comparative biomechanical in vitro study.

Object: Posterior pedicle screw (PS) instrumentation is often used to augment anterior lumbar interbody fusion (ALIF) but at the cost of an increase in the morbidity rate due to the second approach and screw placement. If anterior plates were found to be biomechanically equivalent to PS fixation (PSF) after ALIF, then this second approach could be avoided without decreasing vertebral stability.

Methods: Eight cadaveric L5-S1 spinal segments were tested under four conditions: intact, following anterior discectomy and interbody spacer placement, after placement of an anterior plate, and following PSF.

Transoral vertebroplasty for renal cell metastasis involving the axis: case report.

Study Design: Case report.

Objective: This is one of the first reported cases of transoral vertebroplasty for a solid metastatic tumor at C2 body.

Summary Of Background Data: Percutaneous vertebroplasty has gained popularity as a treatment option for painful neoplastic lesions of the spine.

Intracranial hypotension with spinal pathology.

Background Context: Intracranial hypotension (IH) is a syndrome in which volume depletion of the cerebrospinal fluid (CSF) results in various neurological symptoms. Most commonly, a small tear or defect in the spinal dural sac is the underlying lesion that results in a CSF leakage and IH. Causes of IH can be classified as 1) spontaneous (primary), and 2) secondary.

A review of factors predictive of surgical outcome for ossification of the ligamentum flavum of the thoracic spine.

Object: Ossification of the ligamentum flavum (OLF) is a pathological condition that affects the ligament and causes slowly progressive myeloradiculopathy in adults. Although OLF has been regarded as endemic to East Asian countries, studies from outside these areas have increasingly been reported. Because of long-standing compression of the spinal cord by OLF, a patient's functional prognosis may not always be favorable, and attempts have been made in recent studies to identify clinical factors that are predictive of the surgical outcome of patients with thoracic OLF.

Vertebral hemangioma symptomatic during pregnancy treated by posterior decompression, intraoperative vertebroplasty, and segmental fixation.

Hemangioma is one of the most common benign tumors of the spine, and it remains silent in the vast majority of the subjects afflicted. Pregnancy is a known risk factor for symptomatic conversion of the previously dormant vertebral hemangiomas. However, the occurrence is rare with only 24 cases reported in the literature.

Ossification of the posterior longitudinal ligament: an update on its biology, epidemiology, and natural history.

Significant progress has been achieved in basic research during the past decade on the pathogenesis of ossification of the posterior longitudinal ligament (OPLL), a multifactorial disease in which complex genetic and environmental factors interact. A review of the literature was conducted to update recent findings on the biology, epidemiology, natural history, and related diseases of OPLL. Gene analysis studies found specific polymorphisms that may be associated with OPLL in several collagen genes, which encode for extracellular matrix proteins.

Vertebral artery injury after blunt cervical trauma: an update.

Background: Vertebral artery injury (VAI) after blunt cervical trauma has been considered to be rare. The incidence of VAI has increased dramatically within the last decade after a heightened awareness of this entity on the part of spine surgeons. Diagnostic or therapeutic guidelines for VAI have not been established fully, however.

Iatrogenic carotid artery injury in neurosurgery.

Iatrogenic carotid artery injury (CAI) results from various neurosurgical procedures. A review of the literature was conducted to provide an update on the management of this potentially devastating complication. Iatrogenic CAIs are categorized according to each diagnostic or therapeutic procedure responsible for the injury, i.

Bone grafting.

In recent years our understanding of spinal fusion biology has improved. This includes the continued elucidation of the step-by-step cellular and molecular events involved in the prototypic bone induction cascade, as well as the identification and characterization of the various critical growth factors governing the process of bone formation and bone graft incorporation. Based on these fundamental principles, growth factor technology has been exploited in an attempt to improve rates of spinal fusion, and promising results have been realized in preclinical animal studies and initial clinical human studies.

Vertebroplasty for osteoporotic compression fractures: current practice and evolving techniques.

Perutaneous vertebroplasty was developed in France by Deramond et al., who provided initial reports of the procedure in 1987. This minimally invasive procedure uses a large-bore bone-cutting needle to percutaneously access a vertebral body, inject bone cement, and thereby stabilize and reinforce the remaining bone structure.

A minimally invasive technique for decompression of the lumbar spine.

Study Design: The technical feasibility of percutaneous microendoscopic bilateral decompression of lumbar stenosis via a unilateral approach was evaluated in a human cadaver model.

Objectives: The purpose of this study was to determine the feasibility of using a microendoscopic laminotomy technique to treat spinal stenosis.

Summary And Background Data: Minimally invasive surgery is an important means of reducing tissue trauma and patient morbidity.