Simple and Economical Method to Create Thoracolumbar Burst Fracture in a Calf Spine Model

STUDY DESIGN: Calf spine model study. PURPOSE: To describe a technique of creating thoracolumbar burst fractures in calf spine model by low weight drop weight. OVERVIEW OF LITERATURE: Burst fractures are one of the commonest types of thoracolumbar fractures and their treatment is controversial. Biomechanical studies aid in the decision of treatment of these fractures. A simple method of creation of burst fractures would help these biomechanical studies. METHODS: Ten specimens of thoracolumbar spines harvested from 6-8 week old calves were weakened at the target vertebra by standardized osteotomy cuts. Burst fractures were created by dropping a 5-kg of weight from a height of 1.2 m using an in-house device. An accelerometer attached to the weight measured the acceleration at the point of impact. RESULTS: Average weight and bone mineral density of the specimens was 390 g and 0.67 g/cm2, respectively. Computed tomography scan analysis of the fractures revealed McCormack grade 2 and grade 3 fractures in 5 and 3 specimens, respectively, Dennis type 2B in 4, type 2A burst fractures in 5 specimens and fracture dislocation in 1 specimen, AO type A3.1.1 in 4 specimens, type A3.2.2 in 4 and type A3.3.3 in 2 specimens. Vertical laminar split fracture was seen in 6 specimens. Average acceleration and energy at impact was 9.04 m/sec and 54.24 Nm, respectively. CONCLUSIONS: We describe a technique to create thoracolumbar burst fractures in calf spine by a drop weight method using a device that is simple to operate and easy to construct. The method is consistent and produces fractures similar to those occurring naturally, and can be considered as an alternative method for creating burst fractures in biomechanical studies.

Lumbosacral Transition Vertebra: Prevalence and Its Significance

STUDY DESIGN: Retrospective analysis of radiological images. PURPOSE: To determine the prevalence of lumbosacral transition vertebra (LSTV) and to study its significance with respect to clinically significant spinal symptoms, disc degeneration and herniation. OVERVIEW OF LITERATURE: LSTV is the most common congenital anomaly of the lumbosacral spine. The prevalence has been debated to vary between 7% and 30%, and its relationship to back pain, disc degeneration and herniation has also not been established. METHODS: The study involved examining the radiological images of 3 groups of patients. Group A consisted of kidney urinary bladder (KUB) X-rays of patients attending urology outpatient clinic. Group B consisted of X-rays with or without magnetic resonance images (MRIs) of patients at-tending a spine outpatient clinic, and group C consisted of X-rays and MRI of patients who had undergone surgery for lumbar disc herniation. One thousand patients meeting the inclusion criteria were selected to be in each group. LSTV was classified by Castellvi's classification and disc degeneration was assessed by Pfirrmann's grading on MRI scans. RESULTS: The prevalence of LSTV among urology outpatients, spine outpatients and discectomy patients was 8.1%, 14%, and 16.9% respectively. LSTV patients showed a higher Pfirrmann's grade of degeneration of the last mobile disc. Results were found to be significant statistically. CONCLUSIONS: The prevalence of LSTV in spinal outpatients and discectomy patients was significantly higher as compared to those attending the urology outpatient clinic. There was a definite causal relationship between the transitional vertebra and the degeneration of the disc immediately cephalad to it.

Symptomatic Solitary Osteochondroma of the Subaxial Cervical Spine in a 52-Year-Old Patient

Osteochondromas are the most common benign tumors of the bone. They mostly arise from the appendicular skeleton and present clinically in the second or third decade of life. Ostechondromas arising from the subaxial cervical spine and presenting after the 5th decade of life are extremely rare. We report a 52-year-old male patient who presented with numbness and subjective weakness of left upper and lower limbs and neck pain, and had lobulated bony hard fixed swelling in the right lower cervical paraspinal region. Radiological images revealed a bony swelling arising from C4 and C5 lamina with a cartilaginous cap and intraspinal extension. Excision biopsy with stabilisation of the spine was performed. Histopathalogical examination of the specimen confirmed the diagnosis of osteochondroma. We conclude surgical excision of such rare tumors, including the cartilaginous cap as well as the intraspinal component can reliably produce a good clinical outcome.

Gorham's Disease of Spine

Gorham's disease is a rare disorder characterized by clinical and radiological disappearance of bone by proliferation of non-neoplastic vascular tissue. The disease was first reported by Jackson in 1838 in a boneless arm. The disease was then described in detail in 1955 by Gorham and Stout. Since then, about 200 cases have been reported in the literature, with only about 28 cases involving the spine. We report 2 cases of Gorham's disease involving the spine and review related literature to gain more understanding about this rare disease.