STUDY DESIGN: The study retrospectively investigated 15 cases with multilevel noncontiguous spinal fractures (MNSF). PURPOSE: To clarify the evaluation of true diagnosis and to plane the surgical treatment. OVERVIEW OF LITERATURE: MNSF are defined as fractures of the vertebral column at more than one level. High-energy injuries caused MNSF, with an incidence ranging from 1.6% to 16.7%. MNSF may be misdiagnosed due to lack of detailed neurological and radiological examinations. METHODS: Patients with metabolic, rheumatologic diseases and neoplasms were excluded. Despite the presence of a spinal fracture associated clearly with the clinical picture, all patients were scanned within spinal column by direct X-rays, computed tomography and magnetic resonance imaging. When there were > or =5 intact vertebrae between two fractured vertebral segments, each fracture region was managed with a separated stabilization. In cases with < or =4 intact segments between two fractured levels, both fractures were fixed with the same rod and screw system. RESULTS: There were 32 vertebra fractures in 15 patients. Eleven (73.3%) patients were male and age ranged from 20 to 64 years (35.9+/-13.7 years). Eleven cases were the American Spinal Injury Association (ASIA) E, 3 were ASIA A, and one was ASIA D. Ten of the 15 (66.7%) patients returned to previous social status without additional deficit or morbidity. The remaining 5 (33.3%) patients had mild or moderate improvement after surgery. CONCLUSIONS: The spinal column should always be scanned to rule out a secondary or tertiary vertebra fracture in vertebral fractures associated with high-energy trauma. In MNSF, each fracture should be separately evaluated for decision of surgery and planned approach needs particular care. In MNSF with < or =4 intact vertebra in between, stabilization of one segment should prompt the involvement of the secondary fracture into the system.
Asia ; Diagnosis ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Spinal Fractures* ; Spinal Injuries ; Spine

PURPOSE: The purposes of this study were to evaluate the staining resistance of CAD/CAM resin-ceramics polished with different techniques and to determine the effectiveness of the polishing techniques on resin-ceramics, comparing it with that of a glazed glass-ceramic. MATERIALS AND METHODS: Four different CAD/CAM ceramics (feldspathic ceramic: C-CEREC Blocs, (SIRONA) and three resin-ceramics: L-Lava Ultimate, (3M ESPE), E-Enamic, (VITA) and CS-CeraSmart, (GC)) and one light cure composite resin: ME-Clearfil Majesty Esthetic (Kuraray) were used. Only C samples were glazed (gl). Other restorations were divided into four groups according to the polishing technique: nonpolished control group (c), a group polished with light cure liquid polish (Biscover LV BISCO) (bb), a group polished with ceramic polishing kit (Diapol, EVE) (cd), and a group polished with composite polishing kit (Clearfil Twist Dia, Kuraray) (kc). Glazed C samples and the polished samples were further divided into four subgroups and immersed into different solutions: distilled water, tea, coffee, and fermented black carrot juice. Eight samples (8 × 8 × 1 mm) were prepared for each subgroup. According to CIELab system, four color measurements were made: before immersion, immersion after 1 day, after 1 week, and after 1 month. Data were analyzed with repeated measures of ANOVA (α=.05). RESULTS: The highest staining resistance was found in gl samples. There was no difference among gl, kc and cd (P>.05). Staining resistance of gl was significantly higher than that of bb (P<.05). Staining resistances of E and CS were significantly higher than those of L and ME (P<.05). CONCLUSION: Ceramic and composite polishing kits can be used for resin ceramics as a counterpart of glazing procedure used for full ceramic materials. Liquid polish has limited indications for resin ceramics.
Ceramics ; Coffee ; Daucus carota ; Immersion ; Tea ; Water