Introduction and Importance: The use of halo-femoral traction to ease correction in patients with scoliosis with multiple intraspinal pathologies is an evolving technique that is not yet fully understood. This report ...Introduction and Importance: The use of halo-femoral traction to ease correction in patients with scoliosis with multiple intraspinal pathologies is an evolving technique that is not yet fully understood. This report aimed to demonstrate the efficiency of using this technique to achieve maximum deformity correction along with decreasing complication rates. Case Presentation: Congenital scoliosis with two intraspinal pathologies was corrected in a 17-year-old male with severe truncal shift, who was easily fatigued due to respiratory symptoms, utilizing the traction method with no neurosurgical intervention. The patient had consulted many hospitals locally and internationally, and was told that surgery poses a great risk of neurological deficit. He needed neurosurgical release of the cord prior to any deformity correction. Management and Outcome: The patient did not undergo any neurosurgical intervention, but rather posterior spinal correction and instrumented fusion preceded by halo-femoral traction. He was followed up for 5 years and showed complete recovery without any short-term or long-term complications. The patient was able to return to full activity and resolution of respiratory symptoms, and a good alignment on follow-up radiography was observed. Discussion: Not all patients with scoliosis associated with intraspinal pathology need treatment before spinal correction. Perioperative halo-femoral traction seems to be safe and effective in maximizing deformity correction and decreasing the risk of complications.展开更多
Precise assessment of spinal cord cystic lesions is crucial to formulate effective therapeutic strategies,yet histological assessment of the lesion remains the primary method despite numerous studies showing inconsist...Precise assessment of spinal cord cystic lesions is crucial to formulate effective therapeutic strategies,yet histological assessment of the lesion remains the primary method despite numerous studies showing inconsistent results regarding estimation of lesion size via histology.On the other hand,despite numerous advances in micro-computed tomography(micro-CT)imaging and analysis that have allowed precise measurements of lesion size,there is not enough published data on its application to estimate intraspinal lesion size in laboratory animal models.This work attempts to show that micro-CT can be valuable for spinal cord injury research by demonstrating accurate estimation of syrinx size and compares between micro-CT and traditional histological analysis.We used a post-traumatic syringomyelia rat model to compare micro-CT analysis to conventional histological analysis.The study showed that micro-CT can detect lesions within the spinal cord very similar to histology.Importantly,micro-CT appears to provide more accurate estimates of the lesions with more measures(e.g.,surface area),can detect compounds within the cord,and can be done with the tissue of interest(spinal cord)intact.In summary,the experimental work presented here provides one of the first investigations of the use of micro-CT for estimating the size of intraparenchymal cysts and detecting materials within the spinal cord.All animal procedures were approved by the University of Akron Institutional Animal Care and Use Committee(IACUC)(protocol#LRE 16-05-09 approved on May 14,2016).展开更多
文摘Introduction and Importance: The use of halo-femoral traction to ease correction in patients with scoliosis with multiple intraspinal pathologies is an evolving technique that is not yet fully understood. This report aimed to demonstrate the efficiency of using this technique to achieve maximum deformity correction along with decreasing complication rates. Case Presentation: Congenital scoliosis with two intraspinal pathologies was corrected in a 17-year-old male with severe truncal shift, who was easily fatigued due to respiratory symptoms, utilizing the traction method with no neurosurgical intervention. The patient had consulted many hospitals locally and internationally, and was told that surgery poses a great risk of neurological deficit. He needed neurosurgical release of the cord prior to any deformity correction. Management and Outcome: The patient did not undergo any neurosurgical intervention, but rather posterior spinal correction and instrumented fusion preceded by halo-femoral traction. He was followed up for 5 years and showed complete recovery without any short-term or long-term complications. The patient was able to return to full activity and resolution of respiratory symptoms, and a good alignment on follow-up radiography was observed. Discussion: Not all patients with scoliosis associated with intraspinal pathology need treatment before spinal correction. Perioperative halo-femoral traction seems to be safe and effective in maximizing deformity correction and decreasing the risk of complications.
基金This study was financially supported by Conquer Chiari.
文摘Precise assessment of spinal cord cystic lesions is crucial to formulate effective therapeutic strategies,yet histological assessment of the lesion remains the primary method despite numerous studies showing inconsistent results regarding estimation of lesion size via histology.On the other hand,despite numerous advances in micro-computed tomography(micro-CT)imaging and analysis that have allowed precise measurements of lesion size,there is not enough published data on its application to estimate intraspinal lesion size in laboratory animal models.This work attempts to show that micro-CT can be valuable for spinal cord injury research by demonstrating accurate estimation of syrinx size and compares between micro-CT and traditional histological analysis.We used a post-traumatic syringomyelia rat model to compare micro-CT analysis to conventional histological analysis.The study showed that micro-CT can detect lesions within the spinal cord very similar to histology.Importantly,micro-CT appears to provide more accurate estimates of the lesions with more measures(e.g.,surface area),can detect compounds within the cord,and can be done with the tissue of interest(spinal cord)intact.In summary,the experimental work presented here provides one of the first investigations of the use of micro-CT for estimating the size of intraparenchymal cysts and detecting materials within the spinal cord.All animal procedures were approved by the University of Akron Institutional Animal Care and Use Committee(IACUC)(protocol#LRE 16-05-09 approved on May 14,2016).
