Congenital stenosis and adjacent segment disease in the cervical spine.

Symptomatic adjacent segment disease (ASD) after anterior cervical fusion (ACF) is reported in 25% of patients at 10 years postoperatively. Debate continues as to whether this degeneration is due to the natural history of the disk or the changed biomechanics after ACF. This study explored whether congenital stenosis predisposes patients to an increased incidence of ASD after ACF.

Does smoking influence fusion rates in posterior cervical arthrodesis with lateral mass instrumentation?

Background: Smoking is associated with reduced fusion rates after anterior cervical decompression and arthrodesis procedures. Posterior cervical arthrodesis procedures are believed to have a higher fusion rate than anterior procedures.

Questions/purposes: We asked whether smoking (1) would reduce the fusion rate in posterior cervical procedures; and (2) be associated with increased pain, decreased activity level, and a decreased rate of return of work as compared with nonsmokers.

Antifibrinolytics in major orthopaedic surgery.

Total joint arthroplasty and deformity surgery of the spine can require complex reconstructive procedures accompanied by the potential for major blood loss. In an attempt to minimize the perioperative blood loss associated with these procedures, recent focus has concentrated on the efficacy of pharmacologic agents. Antifibrinolytics such as epsilon-aminocaproic acid, tranexamic acid, and aprotinin have been shown to reduce perioperative blood loss, autologous blood donation, transfusions, and associated costs in cardiac as well as major orthopaedic surgery.

Cervical radiculopathy: nonoperative management of neck pain and radicular symptoms.

Cervical radiculopathy is a disease process marked by nerve compression from herniated disk material or arthritic bone spurs. This impingement typically produces neck and radiating arm pain or numbness, sensory deficits, or motor dysfunction in the neck and upper extremities. Magnetic resonance imaging or computed tomographic myelography can confirm neurologic compression.

Anatomic variance of interfacet distance and its relationship to facet arthrosis and disk degeneration in the lumbar spine.

Inadequate separation of the L4-S1 facets predisposes individuals to spondylolytic defects. We proposed that decreased interfacet separation is a risk factor for increased lumbar degenerative disease. This study examined the correlation between interfacet distance and degenerative disease of the lumbar spine.

Prevalence of sacral spina bifida occulta and its relationship to age, sex, race, and the sacral table angle: an anatomic, osteologic study of three thousand one hundred specimens.

Study Design: An anatomic, osteologic study of spina bifida occulta (SBO).

Objective: To determine the prevalence and patterns of SBO in a large population and examine its relationship to age, sex, and race; then to evaluate SBOs relationship to the sacral table angle (STA) when compared with an age-matched control group.

Summary Of Background Data: SBO has a reported prevalence of 1.

Does lumbar facet arthrosis precede disc degeneration? A postmortem study.

It is believed lumbar degeneration begins in the disc, where desiccation and collapse lead to instability and compensatory facet arthrosis. We explored the contrary contention that facet degeneration precedes disc degeneration by examining 647 skeletal lumbar spines. Using facet osteophytosis as a measure of facet degeneration and vertebral rim osteophytosis as a measure of disc degeneration, we assumed bone degeneration in both locations equally reflected the progression of those in the soft tissues.

Prevalence of lumbar facet arthrosis and its relationship to age, sex, and race: an anatomic study of cadaveric specimens.

Study Design: An anatomic, epidemiologic study of facet arthrosis in cadaveric lumbar spines.

Objective: To define the prevalence of lumbar facet arthrosis in a large population sample and to examine its association with age, sex, and race.

Summary Of Background Data: Arthrosis of lumbar facet joints is a common radiographic finding and has been linked to low back pain.

Clearing the pediatric cervical spine following injury.

Injury to the pediatric cervical spine is uncommon; however, a missed or delayed diagnosis can lead to disastrous consequences. Thus, following trauma, clearance of the pediatric cervical spine is important. Problematic issues include child compliance with examination, the complex anatomy of the pediatric cervical spine, lack of agreement on definitive imaging modalities, and the coordination of multiple medical specialties.