Complete remodelling of a displaced odontoid synchondrosis fracture managed conservatively: a case report

In this report, we present the long-term functional and radiological outcomes following nonoperative treatment of such a fracture in a 5-year-old female. The patient was referred to our tertiary centre with radiological progression of angulation from 10° to 35° within 5 weeks of the injury, despite wearing a rigid collar. She had no neurological compromise. Although we examined the fracture under general anaesthetic, and subsequently applied halo traction, there was no effect on alignment. The halo device was removed after 11 days and a rigid collar was fitted again. The patient had no pain or neurological symptoms out of the collar at 12 weeks after injury (6 weeks after removal of halo), and a computed tomography scan at 15 weeks confirmed that the fracture had united in malalignment. However, serial radiographs and MRI subsequently have shown that the axis has remodelled completely. At 7 years follow-up, there has been no impact on the patient’s functional range of movement or quality of life. This case highlights the preservation of the motion segment and the remarkable remodelling potential of the paediatric cervical spine.
Source: Journal of Pediatric Orthopaedics B - Category: Orthopaedics Tags: SPINE Source Type: research

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If you ask health care providers about the most challenging condition to treat, chronic pain is mentioned frequently. By its nature, chronic pain is a complex and multidimensional experience. Pain perception is affected by our unique biology, our mood, our social environment, and past experiences. If you or a loved one is suffering from chronic pain, you already know the heavy burden. People are looking for novel, nonaddictive ways to treat pain Given the ongoing challenges of chronic pain management coupled with the consequences of the opioid epidemic, pain management practitioners and their patients are searching for eff...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Back Pain Marijuana Pain Management Source Type: blogs
Conclusions: Irrespective of the BMI, all patients exhibited similar satisfactory outcomes following ACDF. The results support surgery in all subgroups of patients with symptomatic nerve compression in the cervical spine. PMID: 32951406 [PubMed - as supplied by publisher]
Source: Asian Spine Journal - Category: Orthopaedics Tags: Asian Spine J Source Type: research
Authors: Yong LN, Ahmedy F, Yin KN, Engkasan JP Abstract Spinal tuberculosis often leads to neurological deficit and subsequent deterioration in functional outcomes. This review assesses the recent evidence on functional outcomes in spinal tuberculosis, highlighting functional recovery, assessment tools for functional measures, and associative factors for functional recovery. Using PubMed, a literature search was done using the terms "spinal tuberculosis," "tuberculous spondylitis," "tuberculous spondylodiscitis," and "functional outcome" for original articles published betwe...
Source: Asian Spine Journal - Category: Orthopaedics Tags: Asian Spine J Source Type: research
Authors: Inoue D, Shigematsu H, Nakagawa Y, Takeshima T, Tanaka Y Abstract Study Design: Prospective clinical study. Purpose: To determine the optimal posture for instability evaluation using flexion-extension X-ray imaging in patients with lumbar spondylolisthesis. Overview of Literature: Currently, flexion-extension X-ray imaging is the most practical approach for the evaluation of lumbar instability. In flexion-extension X-ray imaging, achievement of the greatest segmental motion with flexion-extension movement is necessary. However, to our knowledge, currently, there is no standardized posture for deter...
Source: Asian Spine Journal - Category: Orthopaedics Tags: Asian Spine J Source Type: research
Source: Journal of Pain Research - Category: Anesthesiology Tags: Journal of Pain Research Source Type: research
In this study, we parcellated the nuclear masses and the principal fiber pathways that were visible in a high-resolution T2-weighted MRI dataset of 50-micron isotropic voxels of a postmortem human brainstem. Based on this analysis, we generated a detailed map of the human brainstem. To assess the validity of our maps, we compared our observations with histological maps of traditional human brainstem atlases. Given the unique capability of MRI-based morphometric analysis in generating and preserving the morphology of 3D objects from individual 2D sections, we reconstructed the motor, sensory and integrative neural systems o...
Source: Frontiers in Neuroanatomy - Category: Neurology Source Type: research
ConclusionsWhile the SOLAS intervention and trial procedures were acceptable to participants and PTs, the recruitment of enough participants is the biggest obstacle to a definitive trial.Trial registrationISRCTNISRCTN49875385. Registered on 26 March 2014.
Source: Trials - Category: Research Source Type: clinical trials
AbstractThe antiallodynic effect of PhAR ‐DBH‐Me was evaluated on two models of neuropathic pain, and the potential roles of CB1, CB2, and TRPV1 receptors as molecular targets of PhAR‐DBH‐Me were studied. Female Wistar rats were submitted to L5/L6 spinal nerve ligation (SNL) or repeated doses of cisplatin (0.1 mg/kg, i.p.) to indu ce experimental neuropathy. Then, tactile allodynia was determined, and animals were treated with logarithmic doses of PhAR‐DBH‐Me (3.2‐100 mg/kg, i.p.). To evaluate the mechanism of action of PhAR‐DBH‐Me, in silico studies using crystallized structures of CB1, CB2, an...
Source: Pharmacology Research and Perspectives - Category: Drugs & Pharmacology Authors: Tags: ORIGINAL ARTICLE Source Type: research
Case submitted by Dan Singer MD and Ryan Barnicle MD, Written by Pendell MeyersA woman in her 60s with history of smoking presented to the ED with left sided chest pain radiating to the left arm and back, starting at about 1330. She described the pain as a " heaviness, " without exacerbating or alleviating factors. Her pain at the time of arrival was 10/10.Here is her triage ECG (no prior for comparison):What do you think?Findings: - Sinus rhythm at around 100 bpm - Grossly normal QRS complex - 1.0 mm STE in lead III, and just a hint of STE in aVF (both of which have to be measured just after signi...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
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Source: International Journal of Neuroscience - Category: Neuroscience Authors: Source Type: research
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