The effect of surgically implanted metallic bullet fragments on the intervertebral disc using a canine model☆.

Purpose: To characterize the gross, histologic, and systemic changes caused by implantation of metal fragments commonly used in commercial bullets into the intervertebral disc.

Background Context: Long-term complications of retained bullet fragments in the spine have been documented in the literature; however, the impact of different metal projectiles on the intervertebral disc has not been described. This study was performed to assess the local effects of the metallic bullet fragments on the intervertebral disc and their systemic effects regarding metal ion concentrations in serum and solid organs.

Postoperative spinal wound infections and postprocedural diskitis.

Background/objective: Postprocedural infections are a significant cause of morbidity after spinal interventions.

Methods: Literature review. An extensive literature review was conducted on postprocedural spinal infections.

Use of stand-up magnetic resonance imaging for evaluation of a cervicothoracic injury in a patient with ankylosing spondylitis.

Background Context: Injuries at the cervicothoracic junction are common in patients with ankylosing spondylitis. These injuries present challenges for both initial and follow-up imagings.

Purpose: To describe a case of a patient with ankylosing spondylitis who was treated with laminectomy and a cervicothoracic orthosis for a spinal epidural hematoma after a nondisplaced fracture at the cervicothoracic junction and to discuss the merits of stand-up magnetic resonance imaging (MRI) for follow-up evaluation of this type of injury.

Surgical issues in the injured worker with lower back pain.

Although most workers who sustain lower back can be managed without surgery, a carefully selected subset of patients benefit from operative intervention. When evaluating these patients, care must be taken to identify surgical emergencies, including patients with cauda equina syndrome and progressive neurologic deficits and patients with cauda equina syndrome and progressive neurologic deficits and patients with certain historical red flags that should prompt further evaluation. Conditions that may benefit from surgery include lumbar disc herniations, discogenic back pain, spinal stenosis, and spondylolisthesis.

Methemoglobinemia after fiberoptic intubation in a patient with an unstable cervical fracture: a case report.

Methemoglobinemia, a condition associated with cyanosis and diminished pulse oximetry values, has been reported after use of local anesthetics to facilitate fiberoptic intubation. The majority of reports in the literature detail this development during diagnostic procedures such as endoscopy and bronchoscopy. A case of methemoglobinemia in a multiple-injury patient with an unstable compressive-flexion injury of the cervical spine undergoing fiberoptic intubation is presented.

Timing of surgery following spinal cord injury.

Background: The optimal timing for surgical intervention after traumatic spinal injuries with spinal cord injury remains unclear.

Design: Literature review.

Findings: Multiple laboratory investigations (in animal models) and many clinical studies suggest better neurological outcomes with early surgical intervention.

Biomechanical effects of unipedicular vertebroplasty on intact vertebrae.

Study Design: To assess the biomechanical effects of unipedicular vertebroplasty on nonfractured vertebrae.

Objectives: To evaluate the potential benefits of vertebroplasty as a preventative treatment. To evaluate the effects of cement volume and bone mineral density on the mechanics of augmented intact vertebral bodies.