Curtis A Dickman

STUDY DESIGN: A multicenter, retrospective study using computed tomographic and magnetic resonance imaging data to establish quantitative, reliable criteria of canal compromise and cord compression in patients with cervical spinal cord injury.

OBJECTIVES: To develop and validate a radiologic assessment tool of spinal canal compromise and cord compression in cervical spinal cord injury for use in clinical trials.

SUMMARY OF BACKGROUND DATA: There are few quantitative, reliable criteria ...

STUDY DESIGN: Human lumbosacral cadaveric specimens were tested in an in vitro biomechanical flexibility experiment using physiologic loads in 5 sequential conditions.

OBJECTIVE: To determine the biomechanical differences between anterior lumbar interbody fusion (ALIF) using cylindrical threaded cages alone or supplemented with an anterior screw-plate or posterior pedicle screws-rods.

SUMMARY OF BACKGROUND DATA: Clinically and biomechanically, stand-alone ALIF performs modestly in ...

Thirty patients were treated surgically for spinal epidural hematoma (SEH). Twelve of these cases resulted from spinal surgery, seven from epidural catheters, four from vascular lesions, three from anticoagulation medications, two from trauma, and two from spontaneous causes. Pain was the predominant initial symptom, and all patients developed neurological deficits. Eight patients had complete motor and sensory loss (Frankel Grade A); six had complete motor loss but some sensation ...

OBJECT: The authors sought to determine the biomechanical effectiveness of threaded interbody cages or dowels compared with that achieved using pedicle screw instrumentation in resisting Grade I lumbar spine degenerative spondylolisthesis.

METHODS: Thirty-three levels obtained from seven cadaveric lumbar spines were instrumented with cages or dowels, pedicle screw/rod instrumentation, or both. Entire specimens were loaded with nonconstraining torques. Each level was loaded with ...

STUDY DESIGN: A repeated measures in vitro flexibility experiment was performed in calf spines.

OBJECTIVES: To determine the biomechanical differences among three techniques for augmenting stability of an anterolateral lumbar threaded interbody cage.

BACKGROUND: Stand-alone interbody cages are known to inadequately stabilize the spine. Surgeons often add supplementary instrumentation for a more stable construct.

METHODS: Six L2-L5 calf spines (L3-L4 level instrumented) were tested: 1) ...

STUDY DESIGN: Retrospective review of acute axis fractures treated at a tertiary referral center.

OBJECTIVE: To determine the optimal treatment of axis fractures based on 340 cases from a single institution.

SUMMARY OF BACKGROUND DATA: Axis fractures account for almost 20% of acute cervical spine fractures. However, their management and the clinical criteria predictive of nonoperative failure remain unclear.

METHODS: Admission imaging studies and clinical variables were obtained for 340 ...

STUDY DESIGN: In a clinical retrospective study, the authors review long-term results of occipitocervical fusion using a wide diameter, contoured, threaded Steinmann pin.

OBJECTIVES: To evaluate the clinical and radiographic results of occipitocervical fusion using this technique in a variety of abnormalities including rheumatoid arthritis. SUMMARY OF BACKGROUND DATA. The various surgical techniques and hardware developed for occipitocervical fusion have been associated with mixed ...

Cannulated screw systems use thin Kirschner wires (K-wires) that have been drilled into the bone to direct screw trajectories accurately into small bone fragments. Use of the K-wires avoids overdrilling the pilot holes and allows fixation of adjacent bone fragments during screw insertion. Hollow tools and hollow screws are inserted into the bone over the K-wires. Cannulated screw fixation is useful in the cervical spine to stabilize odontoid fractures and to treat atlantoaxial ...

OBJECT: The authors compare clinical outcomes demonstrated in patients with traumatic central cord syndrome (CCS) who underwent early (< or = 24 hours after injury) or late (> 24 hours after injury) surgery.

METHODS: The clinical characteristics, radiographic findings, surgery-related results, length of hospital stay (LOS), and clinical outcomes obtained in 50 patients with surgically treated traumatic CCS were reviewed retrospectively. Shorter intensive care unit (ICU) stay and LOS were ...

BACKGROUND CONTEXT: Locking posterior instrumentation in the cervical spine can be attached using 1) pedicle screws, 2) lateral mass screws, or 3) laminar hooks. This order of options is in order of decreasing technical difficulty and decreasing depth of fixation, and is thought to be in order of decreasing stability.

PURPOSE: We sought to determine whether substantially different biomechanical stability can be achieved in a two-level construct using pedicle screws, lateral mass screws, ...

Twenty normal human subjects and 14 patients with upper cervical spine pathology were studied with axial high-field magnetic resonance (MR) imaging to examine the transverse atlantal ligament. Gradient-echo MR imaging pulse sequences provided reliable visualization of the transverse ligament, which exhibited low signal intensity and extended behind the dens between the medial portions of the lateral masses of C-1. The MR imaging characteristics of the transverse ligament were verified in ...

Twenty-seven cases of craniovertebral junction compression treated with transoral surgery were reviewed to assess the influences of pathological processes and surgical interventions on spinal stability. All patients presented with signs and symptoms of spinal-cord or brain-stem dysfunction. Pathology included rheumatoid arthritis in 11 patients, congenital osseous malformations in 11, spinal fractures in two, plasmacytoma in one, osteomyelitis in one, and a gunshot injury in one. ...

STUDY DESIGN: Human cadaveric cervical spines were subjected to nondestructive repeated-measures flexibility tests before, during, and after unilateral facet dislocation.

OBJECTIVES: To assess the relative stability and kinematics of the spine in the normal condition, after unilateral facet lock without bony injury and after reducing (unlocking) the facet dislocation.

SUMMARY OF BACKGROUND DATA: Experimental unilateral facet dislocation has been studied only when associated with ...

Comprehensive anatomic and clinical analyses of 39 patients with injuries involving the transverse atlantal ligament or its osseous insertions were performed to assess the morphology of the injured ligaments and the patients' capacity to heal. Injuries of the upper cervical spine were screened with plain radiographs, thin-section computed tomography, and magnetic resonance imaging studies. The injuries were classified as disruptions of the substance of the ligament (Type I injuries, n = ...

STUDY DESIGN: Seven cadaveric cervical spines were implanted with a porous tantalum spacer and a titanium alloy spacer, and their radiographic and imaging characteristics were evaluated.

OBJECTIVE: To determine the radiographic characteristics of porous tantalum and titanium implants used as spacers in the cervical spine.

SUMMARY OF BACKGROUND DATA: Anterior decompressive surgery of the disc space or the vertebral body creates a defect that frequently is repaired with autologous bone ...