A review of the value of MRI signs in low back pain.

Low back pain is a common symptom that can lead to disability and major socio-professional repercussions. Despite advances in imaging, the etiology of the pain often remains unknown. Morphological changes related to normal ageing of the disc appear on MR imaging without any symptoms. The potential impact of changes seen on imaging, especially MRI, also warrants discussion. The purpose of this work is to review the state-of-the-art of this subject, underlining relevant key features for routine radiological practice. We will first discuss anterior and posterior segments of the spine with a focus on anatomical, physiopathological and semiological findings. Secondly we will discuss the diagnostic value of each sign.

Anterior screw fixation of type IIB odontoid fractures in octogenarians.

PURPOSE: Type IIB odontoid fractures (OF) in elderly patients are life-threatening conditions. Optimal treatment of these fractures is still controversial. The aim of this study was to assess the clinical and radiological outcome of surgically treated type IIB OF by anterior screw fixation in octogenarians. METHODS: Eleven octogenarians with type IIB OF were operated using anterior screw fixation. Follow-up assessment included operative mortality and morbidity rates, long-term functional outcome and fracture union and stability. RESULTS: There was neither operative mortality nor morbidity. Five patients had excellent clinical outcome, two good outcome, one fair and three poor. Two patients died of unrelated causes 2 months after surgery. Radiographs showed stable bone union in four patients and stable fibrous union in five patients. CONCLUSIONS: Given the results in this short series, we suggest that anterior screw fixation of Type IIB OF may be offered as primary treatment in octogenarians.

Interest of complementary inferior glenohumeral ligament fixation in capsulo-labral repair for shoulder instability: A biomechanical study.

Arthroscopic repair of Bankart lesions is part of the arsenal available to the shoulder surgeon to manage chronic anterior instability of the shoulder. Despite improvements in technique, rates of recurrence remain high. Some factors relate to the patients and their lesions, others to technique.The hypothesis that insufficient repair may be the cause of failure in Bankart arthroscopy was investigated in an anatomic and biomechanical study. Bankart lesions were made on 12 cadaver shoulders and repaired using two suture techniques. The aim was to investigate whether there was any biomechanical interest in reinforcing the labrum and capsule suture by a complementary inferior gleno-humeral ligament (IGHL) suture to double the labral repair. No significant difference in overall resistance was found between the two techniques. Failure generally started from the superior suture, and the present findings suggest that special attention should be paid to superior reinsertion. In the present model, complementary IGHL fixation did not alter the biomechanics of repair. Failure of repair can be traced to the superior suture.