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"Normal" Cervical Spine Radiographs and Computed Tomography Scans in the Emergency Department: Beware of Posttraumatic Instability of the Mobile Segment of the Lower Cervical Spine.
World Neurosurg
December 2024
Neurosurgery Department, Sainte-Anne Military Teaching Hospital, Toulon, France.
The NEXUS criteria have been introduced in the 1990s to assist emergency department physicians to decide whether to perform radiographic work-up following cervical whiplash injury. Four criteria have been described on these profile radiographs of the cervical spine including angulation between cervical endplates, 3-mm listhesis, posterior facet joints overlap, and widened interspinous space. Although these criteria could help to detect patients suffering from unstable trauma of the mobile segment if the lower cervical spine, the radiographic signs may be so subtle that even specifically trained physicians like spine surgeons and neuroradiologists may miss them, especially during after-hour shifts.
View Article and Find Full Text PDFPatient-reported symptomatology and its course in spontaneous intracranial hypotension - Beware of a chameleon.
Clin Neurol Neurosurg
January 2024
Department of Neurosurgery, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
Objective: Although orthostatic headache is the hallmark symptom of spontaneous intracranial hypotension (SIH), patients can present with a wide range of different complaints and thereby pose a diagnostic challenge for clinicians. Our aim was to describe and group the different symptoms associated with SIH and their course over time.
Methods: We retrospectively surveyed consecutive patients diagnosed and treated for SIH at our institution from January 2013 to May 2020 with a specifically designed questionnaire to find out about their symptomatology and its course.
Complications of Anterior Cervical Discectomy and Fusion.
Acta Neurochir Suppl
August 2023
University of South Florida, Tampa, FL, USA.
Anterior cervical discectomy and fusion (ACDF) is the most common surgery performed on the cervical spine, and the number of its cases has tripled over the last two decades. Although this intervention is typically safe and effective, it carries an inherent complication risk, which should not be underestimated. Improvements in surgical techniques and advances in interbody fusion devices and plating systems have certainly reduced the rate of postoperative morbidity, but despite such progress, surgeons need to beware consistently of the potential complications, inform the patient of their possibility, and have a management strategy as they develop.
View Article and Find Full Text PDFVariations in lower limb alignments indicate pelvic tilt after total hip arthroplasty.
BMC Musculoskelet Disord
December 2022
Department of Orthopaedics, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of medicine, No.1665 Kongjiang Road, Yangpu District, 200092, Shanghai, People's Republic of China.
Objective: We sought to correlate various spinopelvic and lower limb alignments, and to examine the current spinopelvic theories on a Chinese cohort.
Methods: We retrospectively reviewed 166 patients undergoing THA. Among them, 138 patients with unilateral THA met the inclusion criteria.
Beware of open triradiate cartilage: 1 in 4 patients will lose > 10° of correction following posterior only fusion.
Spine Deform
January 2023
Division of Orthopedics and Sports Medicine, Seattle Children's Hospital, M/S OA.9.120, 4800 Sandpoint Way NE, Seattle, WA, 98105, USA.
Purpose: As 2-year follow-up may not be sufficient to assess the risk of curve progression following fusion in immature patients with adolescent idiopathic scoliosis (AIS), this study reports on 5-year outcomes of AIS patients, factoring in maturity and surgical approach, to determine whether immature patients are at risk of continued curve progression beyond 2 years.
Methods: A multicenter database was reviewed for AIS patients who underwent spinal fusion with pedicle screw fixation and who had both 2 and 5-year follow-up. Radiographic and SRS-22 scores were compared between three groups: open triradiate cartilage-posterior fusion (OTRC-P), OTRC-combined anterior/posterior fusion (OTRC-APSF), and closed TRC (CTRC, matched to OTRC-P group).
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