The impact of stenosis and translation on spinal cord injuries in traumatic cervical facet dislocations.

BACKGROUND CONTEXT: Although facet dislocations account for only 6% of cervical trauma, the consequences are often devastating. Cervical facet dislocations are associated with a disproportionate amount of spinal cord injuries; however, neurologic examination of patients is often difficult, as patients commonly present with reduced levels of consciousness. There are limited studies that have investigated the impact of spinal canal diameter and translation on neurologic injury following facet dislocations. PURPOSE: Review a consecutive series of patients with facet dislocations to assess the impact of sagittal diameter and translation on Spinal Cord Injury (SCI). STUDY DESIGN: Retrospective review at a level I trauma center identified 97 patients with facet dislocations. METHODS: Between 2004 and 2014, a retrospective review at a level I trauma center identified patients with traumatic facet dislocation. Demographic data, neurologic exams, and radiographic findings were reviewed. We assessed sagittal diameter at the injury level, as well as above and below, and translation. This study has no funding source and its authors have no potential conflicts of interest-associated biases. RESULTS: Ninety-seven patients presented with facet dislocations. Fifty-nine (61%) presented with a SCI. Those with ASIA A averaged 8.0 mm of injury level canal diameter, and ASIA E averaged 12.6 mm (p < .001). Additionally, those with ASIA A averaged 8.0 mm of translation, and ASIA E averaged 4.2 mm (p < 0.001). Two groups were created based on their general motor function. Those with ASIA A-C averaged 8.4 mm of injury level canal diameter, and ASIA D-E averaged 12.3 mm (p < .001). Those with ASIA A-C averaged 7.8 mm of translation, and ASIA D-E averaged 4.4 mm (p < .001). Receiver operating characteristic (ROC) curves demonstrated that translation was a good predictor of ASIA A-C and canal diameter was an almost perfect predictor of ASIA D-E. CONCLUSIONS: Our data indicate that patients with greater translation and/or a smaller canal diameter at the injury level have a higher rate of SCI. Adjacent canal diameter did not correlate with neurologic injury.

Simple steps to minimize spine infections in adolescent idiopathic scoliosis.

BACKGROUND: To examine the surgical site infection (SSI) rates in patients undergoing posterior spinal fusion surgery for adolescent idiopathic scoliosis (AIS) after implementation of a change in antibiotic prophylaxis and intraoperative irrigation. METHODS: A retrospective review of all consecutive spinal fusions for AIS from 1996 to 2008 was performed. In 2003, 2 changes in our protocol were implemented: (1) routine antibiotic prophylaxis was changed from cefazolin alone to vancomycin and ceftazidime; (2) intraoperative irrigation technique was changed from bulb syringe to pulse lavage irrigation. We compared the rates of deep SSI requiring irrigation and debridement before institution of these changes (1996 to 2002) to the rates after these changes (2003 to 2008). RESULTS: Before the change in the antibiotic and lavage regimen, 261 spinal fusions were performed. Of these, 28/261 (11%) patients underwent irrigation and debridement for SSI. The most common infecting pathogen was coagulase-negative Staphylococcus aureus (47%). Between the years 2003 and 2008, 263 spinal fusions were performed. Only 2/263 (0.7%) patients underwent irrigation and debridement for SSI. This decrease in infection rate is highly significant (P<0.001). CONCLUSIONS: Routine use of vancomycin and ceftazidime and pulsatile lavage for posterior spinal fusion in AIS patients decreased the rates of postoperative infection by 10 fold. As 2 variables were changed, it is impossible to know the relative effect of each. However, as spine infections can be so devastating, and the potential risks of these changes are small, we recommend both the new antibiotic and irrigation protocol. LEVEL OF EVIDENCE: Level III.

Formula-fed and breast-fed baboons: Weight growth from birth to adulthood.

The objective of this study was to compare the immediate and long-term effects of type of infant diet (formula-fed vs. breast-fed) on the weight growth of baboons. Longitudinal (serial) weight data were collected from 44 savannah baboons (Papio cynocephalus anubis) for the total preadult period of growth from birth to approximately 8 years of age. Fifty percent of the sample (11 females and 11 males) were fed a standard infant formula by a nursery care technician for the first 18 weeks of postnatal life. The remaining 11 females and 11 males were breast-fed by their mothers for an equivalent period of time. After 18 weeks of age the animals were removed from their infant environments (either nursery or mother-reared) and assigned to one of four age-cohort social groups. Each age-cohort group was balanced for infant treatment and gender. The animals remained in these social groups for the duration of the project and were provided nutritionally identical postweaning diets. No significant weight differences were found between the two rearing conditions for either gender during the initial 15 weeks of growth. Following this period, however, females of breast-fed environments averaged greater weight at all ages than their bottle-fed peers. The intensity of the adolescent growth spurt was also slightly greater among the female breast-fed group. No postinfant average weight-per-age disparity was observed between the male treatment groups.

Comparative radiographic study of human and animal long bone patterns / Estudo comparativo do padrão radiográfico de ossos longos humanos e animais

The objective of this study was to test the hypothesis that certain radiographic features can be found to distinguish between human and animal long bone fragments, and therefore would be useful as an adjunct in forensic science identification. Using proposed radiographic criteria, 13 archeologists and 12 dentists were asked to identify 20 radiographic samples as representing human or animal bone. Results showed that archeologists correctly identified 86.8 percent of the samples, and dentists correctly identified 81.9//. Based on the results of this study, it was conclueded that radiographic interpretation of long bone fragments may be a useful aid in a forensic science investigation of human and animal remains

Positional and activity behavior in a captive slow loris: A quantitative assessment.

This study examines the positional and activity behavior of a captive slow loris, Nycticebus coucang. The male individual was housed in a primate facility providing a seminatural environment and was subjected to a series of videotape recordings from which 1,878 point observations were taken. The enclosure was designed to allow maximum flexibility of substrate use. Quantitative information detailing activity, positional mode, and substrate geometry was collected using a checklist of 15 variables. Data were tabulated and compared as frequency distributions to describe activity budgets, the use of locomotor and postural modes, and the relation of posture to activity behavior and substrate geometry. The results indicated that almost 90% of the active day may be devoted to behaviors directly or indirectly related to dietary functions. For locomotor behavior, both climbing and walking were associated with the use of diagonal couplets. The loris devoted 52% of its positional behavior to postural modes, favoring the quadrupedal stand, triplets, and sitting. Suspension was found to be used more often in posture than locomotion. Overall, the loris's repertory of positional modes accommodated a wide range of substrate geometries.

Growth and development in the saddle-back tamarin: The sequence and timing of dental eruption and epiphyseal union.

A cross-sectional sample of 121 colony-born saddle-back tamarins, Saguinus fuscicollis, was examined to identify the sequence and timing of dental eruption and epiphyseal union. The state of dental development of the deciduous and permanent dentitions was recorded as erupted or non-erupted on the basis of gingival penetration. Eighteen areas of union of long bone epiphyseal and other secondary centers, the union of the primary elements of the innominate, and the spheno-occipital synchondrosis were examined. The state of union at the areas was recorded on a three-point scale of not united, uniting, and united. The data indicated that deciduous incisors and canines were present at birth and that all deciduous teeth were erupted by 12 weeks. The first permanent tooth, M(1), erupted between weeks 16 and 23; the permanent dentition was fully erupted by 45 weeks. Union of the long bone epiphyses began in the third month at the distal humerus and continued until the first quarter of the second year. The secondary centers at the ischial tuberosity and iliac crest were united slightly later than four and six years of age, respectively. Regression analysis of the data indicate their potential use as parameters for predicting age in feral specimens.