Harrington Instrumentation to treat the unstable fracture (including the fracture dislocation) of the thraco-lumbar spine with neurologic deficits is a very effective method. This method provides rigid fixation and stability for thoracolumbar fracture, also offers the optimum condition for recovery of nerve roots, and decompresses the spinal canal with anatomical reduction. The principal advantage for this method of treatment is the early mobilization of the patient and enhanced rehabilitation. Authors, performed Harrington Instrumentation with a laminectomy experienced 20 cases of unstable thoraco-lumbar spine fracture(including the fracture-dislocation) with neurologic deficit from Aug. 1980 to Oct. 1984. The following results were obtained : 1) Of twenty patients, the patients at the age 20 to 49 were commonly injured and predominant cause of spinal injury was falling accident. 2) The thoraco-lumber fracure(including fracture-dislocation) were thoracolumbar junction, the commonest site among them was the lst lumber vertebra, and the commonest mechanism of spinal injury way flexon injury. 3) Most commonly, paraplegia was with twelve thoracic vertebra injury, and paraparesis was with lst lumbar vertebra. 4) Correction of the kyphotic deformity was 8 degree on the average, and the range of the correction was between 0 degree and 19 degree. 5) Neurological recoveries were gained from 14 patients(70%), and the 10 patients(50%) among them were completely recovered. 6) Average hospital periods were 78 days and after an average 21 postoperative days, ambulation was started. 7) In complication, three hook dislocations were occured. 8) Early operation (laminectomy for posterior decompression and Harrington Instrumentation for anterior decompression) was very effective in spinal cord injury.
Congenital Abnormalities ; Decompression ; Dislocations ; Early Ambulation ; Humans ; Laminectomy ; Neurologic Manifestations ; Paraparesis ; Paraplegia ; Rehabilitation ; Spinal Canal ; Spinal Cord Injuries ; Spinal Injuries ; Spine ; Walking

PURPOSE: This study investigated the incidence of adverse events (AEs) and risk factors associated with sedation using chloral hydrate (CH) for brain magnetic resonance imaging (MRI) in the neonatal intensive care unit (NICU). METHODS: This was a retrospective study of infants who received CH for brain MRI in the NICU. Among the enrolled infants (n=143), 12.6% (n=18) were included in the AE group and 87.4% (n=125) were in the non-adverse event group (NAE). RESULTS: Gestational age (GA) at birth and corrected GA at sedation were 35+0±7+2 and 39+5±3+1 respectively. The rate of AEs was 12.6%, included oxygen desaturation (5.6%), aspiration (4.9%), paradoxical agitation (0.7%), tachycardia or bradycardia (0.7%), and arrest (0.7%). In univariate analysis, the AE group was younger in corrected GA at sedation than the NAE group (37+2 [range, 36+0 to 40+0] vs. 40+1 [range, 38+2 to 41+4], P=0.015). There was no significant difference in CH dosage (50.0 [range, 50.0 to 50.0] vs. 50.0 [range, 50.0 to 50.0], P=0.092), cardiopulmonary (33.3% [n=6] vs. 17.6% [n= 22], P=0.209) and central nervous system (61.1% [n=11] vs. 65.6% [n=82], P=0.054) morbidity. In multivariate analysis, CH dosage was the only significant risk factor for AEs associated with sedation (odds ratio, 1.04; 95% confidence interval, 1.01 to 1.07; P=0.0186). CONCLUSION: AEs associated with sedation using CH are not uncommon and should be considered when using high dose CH for diagnostic testing in the NICU.
Bradycardia ; Brain ; Central Nervous System ; Chloral Hydrate ; Diagnostic Tests, Routine ; Dihydroergotamine ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Magnetic Resonance Imaging ; Multivariate Analysis ; Oxygen ; Parturition ; Retrospective Studies ; Risk Factors ; Tachycardia