STUDY DESIGN: Retrospective cohort.PURPOSE: To evaluate clinical outcomes, including pain and neurologic status, and to evaluate radiographic outcomes of patients treated with extended posterior decompression, posterior fixation, and fusion in different vertebral segments.OVERVIEW OF LITERATURE: The standard surgical treatment of spinal tuberculosis is radical debridement via anterior approach. However, this approach may lead to several serious complications. Meanwhile, extended posterior approach, the posterior surgical approach, involving the removal of posterior elements, ribs, and pedicles, is an alternative option that can achieve the aims of treatment in this disease and may reduce the serious complications from anterior approach.METHODS: The medical records and imaging of 50 patients admitted with spinal tuberculosis from January 2010 to June 2016 were reviewed. The Visual Analog Scale (VAS), Frankel grading scale, and kyphotic Cobb angle between the pre- and postoperative periods were used to evaluate the patients.RESULTS: The patients had significant improvement of VAS score in all the groups. The T/T–L, L, and L–S group scores improved from 7.2±1.5 to 1.7±1.2 (p<0.01), from 8.1±1.8 to 1.7±1.4 (p<0.01), and from 7.9±2.2 to 1.7±0.8 (p<0.01), respectively, and overall, the patient scores (n=50) improved from 7.8±1.4 to 1.7±1.3 (p<0.01). Ten patients (20%) had Frankel grade E preoperatively, which was improved to 38 patients (76%) postoperatively. A significant improvement of the kyphotic Cobb angle was observed when compared at the preoperative, early postoperative, and final follow-up period in the T/T–L, L, and L–S groups. The loss of correction angle in the LS group was 7.7°±4.3° at the final follow-up compared with the early postoperative correction angle at 9.1°±5.8°, with no statistically significant difference.CONCLUSIONS: Extended posterior decompression, posterior instrumentation, and fusion are effective methods of surgery for treatment of spinal tuberculosis involved in the thoracic, thoracolumbar, lumbar, and lumbosacral regions.
Cohort Studies ; Debridement ; Decompression ; Follow-Up Studies ; Humans ; Lumbosacral Region ; Medical Records ; Postoperative Period ; Retrospective Studies ; Ribs ; Tuberculosis, Spinal ; Visual Analog Scale

STUDY DESIGN: Cross-sectional study.PURPOSE: This was carried out to evaluate the benefit of a ‘fulcrum bending position’ compared with the standing position for evaluation of sagittal translation and sagittal rotation in symptomatic patients with spondylolisthesis.OVERVIEW OF LITERATURE: In lumbar X-ray, the standing position is the most common position used in determining abnormalities in lumbar movement. Lack of standardized method is one of the pitfalls in this technique. We hypothesized that the new technique, that is, fulcrum bending position, may reveal a higher translation and rotation in spondylolisthesis patients.METHODS: The extension lumbar radiographs of 36 patients with low-grade spondylolisthesis were included in the analysis and measurement. Sagittal translation and sagittal rotation were measured in both the routine standing position and in our new technique, the fulcrum bending position, which involves taking lateral cross-table images in the supine position wherein the patient lies on a cylindrical pipe to achieve maximum passive back extension by the fulcrum principle.RESULTS: Results of the measurement of sagittal translation in both positions revealed that compared with the extension standing position, the fulcrum bending position achieved a statistically significant increase of 1.57 mm in translation of the vertebra position (95% confidence interval [CI], 0.52–2.61; p=0.004). The measurement of sagittal rotation in both positions revealed that when compared with the extension standing position, the fulcrum bending position achieved a statistically significant increase of 3.47° in the rotation of the vertebra (95% CI, 1.64–5.30; p<0.001).CONCLUSIONS: For evaluation of both sagittal translation and sagittal rotation in symptomatic patients with spondylolisthesis, compared with the extension standing position, the fulcrum bending position can achieve an increased change in magnitude. Our technique, that is, the fulcrum bending position, may offer an alternative method in the detection or exclusion of pathological mobility in patients with spondylolisthesis.
Cross-Sectional Studies ; Humans ; Methods ; Posture ; Spine ; Spondylolisthesis ; Supine Position

Background: Road traffic incidents, particularly those involving motorcycles, pose a significant public health concern, especially in low-income countries. This study aims to investigate the incidence and patterns of head and neck injuries, as well as to analyze factors contributing to these injuries. Methods: A retrospective analysis was undertaken utilizing the medical records of motorcycle incident patients derived from the provincial injury surveillance data collected between January 1, 2021, and December 31, 2021, at a single center. The study encompasses data on age, sex, rider classification, types and quantities of alcohol ingested, helmet employment, Glasgow Coma Score, Injury Severity Score, and classifications of head and neck injuries. The incidence rate of head and neck injuries correlated with motorcycle incidents will be delineated. Subsequently, a logistic regression analysis was conducted to discern the factors associated with head injury severity. Results: The study examined motorcycle incident trauma in 1,413 patients. The incidence of head and neck injuries was 20%. Multivariable logistic regression analysis identified the age of more than 60 years, non-helmeted riding, and alcohol consumption as significant factors for head injuries, with odds ratios of 1.86, 1.76, and 4.17, respectively. Conclusion This study emphasizes the protective role of helmets in reducing head injuries and highlights potential associations between alcohol consumption and the severity of head injuries. These findings may be utilized to advocate for improvements in road safety policies and reduce healthcare costs related to motorcycle accidents.

Background: Road traffic incidents, particularly those involving motorcycles, pose a significant public health concern, especially in low-income countries. This study aims to investigate the incidence and patterns of head and neck injuries, as well as to analyze factors contributing to these injuries. Methods: A retrospective analysis was undertaken utilizing the medical records of motorcycle incident patients derived from the provincial injury surveillance data collected between January 1, 2021, and December 31, 2021, at a single center. The study encompasses data on age, sex, rider classification, types and quantities of alcohol ingested, helmet employment, Glasgow Coma Score, Injury Severity Score, and classifications of head and neck injuries. The incidence rate of head and neck injuries correlated with motorcycle incidents will be delineated. Subsequently, a logistic regression analysis was conducted to discern the factors associated with head injury severity. Results: The study examined motorcycle incident trauma in 1,413 patients. The incidence of head and neck injuries was 20%. Multivariable logistic regression analysis identified the age of more than 60 years, non-helmeted riding, and alcohol consumption as significant factors for head injuries, with odds ratios of 1.86, 1.76, and 4.17, respectively. Conclusion This study emphasizes the protective role of helmets in reducing head injuries and highlights potential associations between alcohol consumption and the severity of head injuries. These findings may be utilized to advocate for improvements in road safety policies and reduce healthcare costs related to motorcycle accidents.

Background: Road traffic incidents, particularly those involving motorcycles, pose a significant public health concern, especially in low-income countries. This study aims to investigate the incidence and patterns of head and neck injuries, as well as to analyze factors contributing to these injuries. Methods: A retrospective analysis was undertaken utilizing the medical records of motorcycle incident patients derived from the provincial injury surveillance data collected between January 1, 2021, and December 31, 2021, at a single center. The study encompasses data on age, sex, rider classification, types and quantities of alcohol ingested, helmet employment, Glasgow Coma Score, Injury Severity Score, and classifications of head and neck injuries. The incidence rate of head and neck injuries correlated with motorcycle incidents will be delineated. Subsequently, a logistic regression analysis was conducted to discern the factors associated with head injury severity. Results: The study examined motorcycle incident trauma in 1,413 patients. The incidence of head and neck injuries was 20%. Multivariable logistic regression analysis identified the age of more than 60 years, non-helmeted riding, and alcohol consumption as significant factors for head injuries, with odds ratios of 1.86, 1.76, and 4.17, respectively. Conclusion This study emphasizes the protective role of helmets in reducing head injuries and highlights potential associations between alcohol consumption and the severity of head injuries. These findings may be utilized to advocate for improvements in road safety policies and reduce healthcare costs related to motorcycle accidents.