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L1-L2 vertebral cord injury

Jae-Kwang Kim, Bong Ju Moon, Sang-Deok Kim, Jung-Kil Lee
RATIONALE: In the treatment of noncontiguous lumbar burst fractures, there still remains controversy over proper surgical procedures. PATIENT CONCERNS: A 19-year-old female patient visited our hospital after fall down from 3 m high. DIAGNOSES: Initial neurologic examination revealed an incomplete spinal cord injury characterized by hypoesthesia and motor grade of 2 below the L2 segment. Lumbar computed tomography and magnetic resonance imaging demonstrated L2 and L5 burst fractures severely obliterating the spinal canal...
March 2018: Medicine (Baltimore)
Hsin-Yao Chen, Chiu-Liang Chen, Wei-Liang Chen
BACKGROUND: Pedicle screw instrumentation for treating spinal disorder is becoming increasingly widespread. Many studies have advocated its use to facilitate rigid fixation for spine; however, adjacent segmental disease is a known complication. Instrumented fusion for osteoporotic spines remains a significant challenge for spine surgeons. Prophylactic vertebroplasty for adjacent vertebra has been reported to reduce the complications of junctional compression fractures but has raised a new problem of vertebral subluxation...
2016: Therapeutics and Clinical Risk Management
Yang Yang, Bin Liu, Limin Rong, Ruiqiang Chen, Jianwen Dong, Peigen Xie, Liangming Zhang, Bu Yang, Tao Shu, Mao Pang
OBJECTIVE: To evaluate the effectiveness of modified "eggshell" osteotomy for the treatment of thoracolumbar kyphoscoliosis. METHODS Between April 2009 and June 2014, 19 patients with spinal deformity underwent modified "eggshell" osteotomy consisting of preserving posterior bony structures initially and enlarging surgical field for cancellous bone removal. There were 14 males and 5 females with an average age of 37.8 years (range, 18-76 years) and with a median disease duration of 7 years (range, 1-40 years)...
January 2016: Chinese Journal of Reparative and Reconstructive Surgery
Ashraf Youssef Nasr
Anatomical orientation of the caudal space and termination level of conus medullaris (CMT) and dural sac (DST) has great significance for anesthetists and neurosurgeons. This study aimed to explore the anatomical landmarks important to perform save spinal anaesthesia, lumber puncture and caudal analgesia through the correlation between the vertebral level of CMT, DST and sacral hiatus apex (SHA) in human cadavers and by using MR images. 60 adult cadavers (40 male and 20 females) and 200 (100 female & 100 male) MR lumbosacral images of 16 to 69 years-old persons were used in this study...
January 25, 2016: Folia Morphologica (Warsz)
Dan W Parrish, Amanda Barnhorst, Katarzyna Trebska-McGowan, Michael Amendola, Jeffrey H Haynes
"Seat belt syndrome" was first described by Garret and Braunstein in 1962. The syndrome involves skin and abdominal wall ecchymosis (seat belt sign) intra-abdominal solid organ and visceral injuries, as well as Chance fractures (compression and/or wedging deformity of the anterior portion of the vertebral body with disruption or fracture of the posterior elements, generally at L1-L3). We present a case of a 12-year-old male involved in a high-speed motor vehicle collision wearing only a lap belt resulting in seat belt syndrome, with disruption of the abdominal wall, mesenteric avulsion with multiple intestinal perforations, abdominal aortic dissection, and an L2 Chance fracture with cord transection...
August 2015: Annals of Vascular Surgery
Xioangyu Meng, Kaibin Zeng, Turghunjan-Abdurxit, Jiang Xie, Huizhong Tian, Yuan Ma
OBJECTIVE: To explore the effectiveness of pedicle screw fixation combined with non-fusion technology for the treatment of thoracolumbar fracture (AO type A) through Wiltse paraspinal approach. METHODS: Between March 2011 and December 2012, 35 cases of thoracolumbar fractures were treated with pedicle screw fixation combined with non- fusion technology by Wiltse paraspinal approach. There were 27 males and 8 females, aged from 19 to 51 years (mean, 39.7 years). The time from injury to operation varied from 3 to 15 days (mean, 5...
September 2014: Chinese Journal of Reparative and Reconstructive Surgery
Takashi Moriwaki, Koichi Iwatsuki, Noriko Mochizuki-Oda, Yu-ichiro Ohnishi, Masahiro Ishihara, Masao Umegaki, Koshi Ninomiya, Toshiki Yoshimine
STUDY DESIGN: Using biotinylated dextran amine (BDA) and wheat germ agglutinin (WGA) tracers, we measured the effectiveness of olfactory mucosa (OM) transplantation as a scaffold in a rat model of chronic spinal cord injury (SCI). OBJECTIVE: We examined whether OM transplantation for chronic SCI in rats results in reconstruction of neuronal pathways by both regeneration of the remaining axons and supply of OM-derived trans-synaptic neurons. SUMMARY OF BACKGROUND DATA: OM is one of the ideal scaffolds for axonal regeneration after chronic SCI...
July 15, 2014: Spine
Zuozhong Liu, Zhenyong Ke, Liang Chen, Zhengjian Yan, Fu Chen, Zhongliang Deng
OBJECTIVE: To discuss the effectiveness of anterolateral decompression and three column reconstruction through posterior approach for the treatment of unstable thoracolumbar fracture. METHODS: Between March 2009 and October 2011, 39 patients with unstable burst thoracolumbar fracture were treated. Of them, there were 32 males and 7 females, with an average age of 43.8 years (range, 25-68 years). The injury causes included falling from height in 17 cases, bruise in 10 cases, traffic accident in 4 cases, and other in 8 cases...
July 2013: Chinese Journal of Reparative and Reconstructive Surgery
Shao-Qi He, Ming-Hai Dai, Yi-Jiang Huang, Xiao-Jun Tang, Mao-Xiu Peng, Li-Xing Lin, Cheng-Xuan Tang
OBJECTIVE: To investigate the feasibility and safety of the treatment for thoracolumbar fractures with pedicle screw at the fracture level and vertebroplasty via paraspinal approach. METHODS: From August 2007 to August 2010, 22 old patients with thoracolumbar fractures were treated with pedicle screw at the fracture level and vertebroplasty via paraspinal approach. There were 14 males and 8 females, ranging in age from 60 to 71 years (mean, 64.6 years). The time from injury to surgery varied from 1 to 4 d (mean,2...
December 2012: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Fu-Jin Cai, Yu-Chun Luo, Jian-Ping Zhu, Xiao-Hua Yu, Xiao-Hui Liu, Hong Li, Xu-Dong Chu, Yi-Ping Hu
OBJECTIVE: To investigate clinical effects and advantages of Wiltse paraspinal approach to thoracolumbar burst fractures. METHODS: From June 2008 to June 2010, the data of 53 patients with thoracolumbar burst fractures with no obviously nerve injury were retrospectively analyzed, including 43 males and 10 females with an average age of 41 years ( ranged, 19 to 62 years). For segmental distribution, 6 cases were T11, 11 cases were T12, 22 cases were L1 and 14 cases were L2...
December 2012: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Li Fan, Bo Yang, Qiao Shi, Yong Xu, Liao Chen, Jialu Chen, Wanggou Zheng
OBJECTIVE: To investigate the effectiveness of debridement and single-incision vertebral screw-rod fixation combined with pedicle screw-rod fixation and autograft bone fusion in treatment of thoracolumbar tuberculosis. METHODS: Between January 2008 and October 2010, 22 patients with thoracolumbar tuberculosis were treated by debridement and single-incision vertebral screw-rod fixation combined with pedicle screw-rod fixation and autograft bone fusion, and were given anti-tuberculosis therapy after operation...
September 2012: Chinese Journal of Reparative and Reconstructive Surgery
Jaimie B Dougherty, James M Goodman, Eric B Knudsen, Karen A Moxon
Epidural electrical stimulation (EES) has often been used to restore stereotypic locomotor movements after spinal cord injury (SCI). However, restoring freeform movement requires specific force generation and independently controlled limbs for changing environments. Therefore, a second stimulus location would be advantageous, controlling force separately from locomotor movements. In normal and transected rats treated with mineral oil or saline, EES was performed at L1-L6 vertebral levels, caudal to spinal segments typical for locomotion, identifying secondary sites capable of activating hindlimb musculature, producing unilateral force at the paw...
July 2012: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Qing Wang, Gaoju Wang, Dejun Zhong, Peng Xiu, Sen Li, Song Wang
OBJECTIVE: To evaluate the surgical management of rigid post-traumatic thoracolumbar kyphosis (RPTK) by simultaneous posterior-anterior circumferential releasing, correction and anterior corpectomy with preserved posterior vertebral wall. METHODS: Twenty patients with RPTK were treated between October 2004 and October 2010 by posterior releasing, anterior subtotal corpectomy with preserved posterior vertebral wall, correction, strut graft, and short segmental fixation...
March 2012: Chinese Journal of Reparative and Reconstructive Surgery
Sung-Lang Chen, Yu-Hui Huang, Tsung-Yu Wei, Kang-Ming Huang, Sin-Haw Ho, Liu-Ing Bih
OBJECTIVE: To present the motor deficits and type of neurogenic bladder dysfunction (NBD) in patients with vertebral fractures at thoracolumbar junction. METHODS: Fifty-two patients with single level vertebra fracture over T11-L2 with onset duration of longer than 3 years were enrolled. All participants provided basic demographic data, ambulatory status and received neurologic examination and urodynamic studies. The differences in distribution of NBD types, neurologic injury sites and functional walkers in patients with different levels of vertebral injury were analyzed...
May 2012: European Spine Journal
Qinliang Li, Yi Liu, Zhaoming Chu, Jinchuan Chen, Ming Chen
OBJECTIVE: To study the effectiveness of transpedicular intervertebral bone graft and pedicle screws fixation in injured vertebrae for the treatment of thoracolumbar fractures. METHODS: Between February 2007 and January 2009, 25 patients with thoracolumbar fractures were treated by posterior short-segment fixation combined with transpedicular intervertebral bone graft and pedicle screw fixation in injured vertebrae. There were 18 males and 7 females with a mean age of 46 years (range, 28-63 years)...
August 2011: Chinese Journal of Reparative and Reconstructive Surgery
Wan-xiang Deng, Hu-rui Zhao, Hua Liu, Hui Dong, Si-bo Ye, Hu Sun
OBJECTIVE: To investigate the clinical results of pedicle-screw placement and reduction on the level of injured vertebrae in treating thoracolumbar fractures. METHODS: From March 2006 to May 2009, 27 patients with thoracolumbar fractures were treated with short-segment fixation system and pedicle-screw placement on injured vertebrae through posterior approach. There were 19 males and 8 females with an average age of 36 years old ranging from 24 to 68 years. Eleven patients were injuried by traffic accident, 9 patients were injuried by falling from high, 5 patients were injuried by crush from weighty object, 2 patients were others injuries...
July 2011: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Di Zhang, Ryohei Nishimura, Shotaro Nagahama, Toshie Iseri, Manabu Mochizuki, Takayuki Nakagawa, Nobuo Sasaki
To compare the technical difficulty and safety of epidural catheterization between cranial and caudal lumbar region, thirteen dogs were randomly assigned to a cranial lumbar group (group CraL, n=6) or a caudal lumbar group (group CauL, n=6) depending on different epidural sites, and one dog was used as a negative control without catheterization. After general anesthesia, an epidural catheter was advanced 10 cm cranially from the interspace of L1-L2 in group CraL or from lumbosacral space in group CauL. Dogs were euthanized and catheter position and tip location were confirmed by laminectomy...
December 2011: Journal of Veterinary Medical Science
Mehmet Arslan, Ayhan Comert, Halil Ibrahim Acar, Mevci Ozdemir, Alaittin Elhan, Ibrahim Tekdemir, R Shane Tubbs, Hasan Caglar Ugur
BACKGROUND: Although injury to the lumbar arteries during anterior spinal approaches is often encountered, there are few published articles regarding the relationship between the lumbar arteries and spinal cord ischemia. OBJECTIVE: To examine the morphology of the lumbar arteries and to emphasize their clinical importance. METHODS: With the aid of a surgical microscope, 80 lumbar arteries in 10 formalin-fixed male cadavers were studied. Measurements of these structures were made and relationships observed...
March 2011: Neurosurgery
Yun Zeng, Min Xiong, Hualong Yu, Ning He, Zhiyong Wang, Zhigang Liu, Heng Han, Sen Chen
OBJECTIVE: To investigate the effect of methylprednisolone sodium succinate (MP) and mouse nerve growth factor (mNGF) for injection in treating acute spinal cord injury (ASCI) and cauda equina injury. METHODS: Between December 2004 and December 2007, 43 patients with ASCI and cauda equina injury were treated, including 33 males and 10 females with an average age of 43 years (range, 32-66 years). Injured vertebral columns were C2 in 1 case, C4 in 5 cases, C5 in 7 cases, C6 in 3 cases, T8 in 1 case, T10 in 1 case, T11 in 2 cases, T12 in 3 cases, L1 in 9 cases, L2 in 5 cases, L3 in 3 cases, L4 in 1 case, and L5 in 2 cases...
October 2010: Chinese Journal of Reparative and Reconstructive Surgery
D H Heo, Y J Cho, S H Sheen, M S Hong, S M Cho, S H Park
BACKGROUND AND PURPOSE: Injury to spinal segmental arteries may potentially occur during spinal surgery, particularly during anterior or minimally invasive approaches. Use of a noninvasive radiologic tool to evaluate these arteries before surgery may reduce this risk. MATERIAL AND METHODS: We performed spinal CT angiography and reconstructed 3D images of segmental arteries in 41 patients. We classified the pathways and locations of the segmental arteries into 4 zones (A, B, C, and D) according to pedicle and vertebral endplates...
October 2010: AJNR. American Journal of Neuroradiology
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