Effect of O-arm for spinal injury

Purpose : To compare the effectiveness of O-arm navigation with that of conventional fluoroscopic guidance in corrective posterior fixation for cervical spinal injury. Methods : This retrospective comparative study involved 11 consecutive patients who underwent corrective posterior fixation using O-arm navigation or conventional fluoroscopy for cervical spinal injury between February 2016 and May 2021. Patient-specific characteristics (age and sex), number of screws, number of pedicle screws, accuracy of pedicle screw insertion, number of vertebral bodies fixed, operating time, and length of hospital stay were analyzed using the t-test. A P-value 0.05). Conclusion : O-arm navigation can improve the accuracy of cervical pedicle screw insertion. Its introduction could expand the indications for use of pedicle screws in posterior fixation of cervical spinal injury beyond those that are possible using conventional fluoroscopy

Salmonella osteomyelitis of the distal radius in a healthy young adult patient : Report of a rare case and literature review

Salmonella osteomyelitis of the radius in a healthy individual is very rare. We present such a case involving the distal radius of a healthy 23-year-old man without underlying disease or possible episode. He had right wrist pain for approximately 3 years, and osteolytic lesion was seen in the right distal radius. He underwent surgical treatment, and salmonella was isolated from pus in the lesion. Postoperative antibiotics successfully treated his infection. He had no sign of recurrence, but the point of entry for infection remains unknown

Double Smiley Face Rod Method

We report a case of double-level lumbar spondylolysis at L4 and L5 that was successfully treated with the double “smiley face” rod method. A healthy 29-year-old man who presented with a 6-year history of chronic low back pain was referred to us for surgical treatment. Plain radiographs and computed tomography of the lumbar spine revealed bilateral pars defects at L4 and L5 without slip or scoliosis. The patient underwent direct repair of the pars defects using the double smiley face rod method at L4 and L5. There were no intraoperative or postoperative complications, and the patient had improved clinically by 1 year after surgery. The low back pain was completely disappeared and visual analog scale was 0. He restarted tennis again as the recreational level. While several techniques for direct repair of lumbar spondylolysis have been described, this is the first report of the double smiley face rod method being used to repair the consecutive double-level lumbar spondylolysis

Open dislocation of the proximal interphalangeal joint of the little finger subsequent to chronic radial collateral ligament injury : a case report of primary ligament reconstruction with a half-slip of the flexor digitorum superficialis : Case Report

Open dislocation of the proximal interphalangeal (PIP) joint is relatively rare. We report a case of a 32-year-old man who had open dislocation of the PIP joint of the little finger while playing American football. He had a history of chronic radial collateral ligament injury. We reconstructed the radial collateral ligament with a half-slip of the flexor digitorum superficialis tendon

Natural history of extruded lumbar intervertebral disc herniation

We studied the natural history of extruded lumbar intervertebral discs using MRI. Forty-nine patients with lumbar disc herniation were included in this study. Ages ranged from 19 to 57. On the T2-weighted sagittal MR image, the signal intensity in the herniated mass was measured and the ratio to that in the original nucleus (i.e, nucleus pulposus from which they extruded) was calculated (signal intensity ratio ; SIR). The relationship with SIR and duration of illness was evaluated. In ten patients who were re-examined by MRI after conservative treatment, the size of the herniation measured by T1-weighted axial MR image was compared before and after treatment. The signal intensity of HNP became higher than that of the original nucleus immediately following herniation and thereafter decreased with time, suggesting that initial hydration of the HNP occurred shortly after herniation followed by dehydration of the HNP. The size of the HNP with a SIR value of 1.2 and higher on T2-weighted MR images decrease with time, however, the HNP with a SIR below 1.2 did not show any size reduction. The SIR of 1.2 and higher is a good indicator predicting spontaneous reduction of the HNP. Dehydration in the HNP may play an important role in the reduction of the lumbar disc herniation

カノウセイ セキツイエン ニタイスル キョウシカ ツイカンバン ヘルニア テキシュツジュツ PED ノ ジュツゴ セイセキ

The number of pyogenic spinal infections has been increasing in the past few decades. The main reason for increasing of cases is increasing of immunosuppressed patients, such as diabetes mellitus, neoplasmic disease, collagen disease or chronic renal failure. Some immunosuppressed patients with pyogenic spinal infection were resistant to an antibiotic treatment and they were not able to undergo major spinal surgery due to their poor general conditions. Percutaneous endoscopic lumbar discectomy（PED）is performed under local anesthesia and requires an８mm skin incision. PED is the least invasive disc surgery procedure, especially for poor general condition patients with pyogenic lumbar spondylitis. The purpose of this study is to evaluate effect of PED procedure for pyogenic spondylitis. Four male and one female pyogenic spondylitis underwent PED surgery under local anesthesia. The mean age was６７．０±12.9（４７－７７）. The number of complications for ４ patients is as follows；２malignant tumor,３hypertension,１diabetes mellitus,１liver cirrhosis and １ Parkinson disease. Causative bacteria were identified in the blood or the biopsy specimens. We performed the debridement of the infected disc and of the partial endplate in the lumbar spine. Approximately３０００－ ５０００milliliter saline was used for irrigation. The mean day from diagnosis to surgery was １２．６ days（１１－１５ days）. Post operative courses of all patients were successful. The mean day to turn CRP negative after surgery is５２．２ days（３８－１１０ days）. There was no complication and no additional surgery after debridement using PED procedure. The PED procedure is superior to other treatments in terms of directly debridement and lavage the infected sites. The most advantage of PED procedure is able to directly observe on clear vision under endoscope. Moreover, PED surgery can be safely performed under local anesthesia and requires the least invasion. This procedure can be applied to the poor general condition’s patients

Osteomyelitis Caused by Candida glabrata in the Distal Phalanx

Osteomyelitis caused by Candida glabrata is rare and its optimal treatment is unknown. Here we report a case of osteomyelitis caused by C. glabrata in the distal phalanx in a 54-year-old woman. Despite partial resection of the nail and administering a 1-month course of antibiotics for paronychia, the local swelling remained and an osteolytic lesion was found. C. glabrata osteomyelitis of the distal phalanx was later diagnosed after curettage. Thereafter, the patient was treated with antifungal agents for 3 months. The infection eventually resolved, and radiological healing of the osteolytic lesion was achieved. Antifungal susceptibility testing should be performed in the case of osteomyelitis caused by nonalbicans Candida species, due to their resistance to fluconazole