RESUMEN
STUDY DESIGN: Herniation of a calcified C3-C4 disc into the left foramen transversarium in a child is reported. OBJECTIVE: To discuss the natural history and management of a calcified disc herniation into the foramen transversarium. SUMMARY OF BACKGROUND DATA: Cervical disc calcification in children usually follows a benign course. Herniation of the calcified disc into the spinal canal has already been described. However, herniation into the foramen transversarium has never been reported. METHODS: An 8-year-old girl presented with progressive neck pain and torticollis. Her neurologic examination was normal. She was treated using a head halter traction, analgesics, and muscle relaxants for 3 days, followed by the use of a soft cervical collar for 2 weeks. RESULTS: Computed tomography scan showed a calcified C3-C4 disc with herniation into the C3 left foramen transversarium. Her symptoms subsided and she rapidly regained full range of motion of her neck after 3 days of conservative treatment. Magnetic resonance angiography done after 2 months did not show any residual compression of the left vertebral artery. After 3 months, the herniation had completely disappeared, whereas only a small central calcification remained in the C3-C4 disc space. CONCLUSION: The natural history of cervical disc calcification is usually benign. A computed tomography scan can be performed for patients in whom a calcified disc herniation is suspected on the plain films. In this case of herniation into the foramen transversarium, magnetic resonance angiography was useful to evaluate the integrity of the vertebral arteries. Spontaneous resolution of the herniated disc and return to normal function can be expected with conservative treatment.
Asunto(s)
Calcinosis/complicaciones , Vértebras Cervicales , Desplazamiento del Disco Intervertebral/complicaciones , Enfermedades de la Columna Vertebral/complicaciones , Niño , Femenino , HumanosRESUMEN
The charts and radiographs of 79 patients with osteogenesis imperfecta (OI) actively followed at the authors' institution were reviewed to determine the incidence of acetabular protrusion (AP) in OI and to evaluate the clinical consequences of this pelvic deformity. All 79 patients had iliac crest bone biopsy and pelvic radiographs. They were subdivided into OI type 1, 3, and 4, according to the Sillence classification, and type 5, according to Glorieux. AP was measured on pelvic radiographs, using the center-edge angle of Wiberg and the acetabular ilioischial line. Twenty-six patients (33%) had radiologic evidence of AP, with the highest incidence in OI type 3 (69%) and OI type 5 (54%). Only 3 of these 24 patients (13%) had medical problems that could be related to AP: severe constipation and hip ankylosis. The authors conclude that in this series of 79 patients with OI, AP is not uncommon and in rare cases may lead to severe medical complications.
Asunto(s)
Acetábulo/patología , Osteogénesis Imperfecta/patología , Acetábulo/diagnóstico por imagen , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Osteogénesis Imperfecta/complicaciones , Osteogénesis Imperfecta/diagnóstico por imagen , RadiografíaRESUMEN
OBJECTIVE: This study was undertaken to demonstrate that the ankle frontal muscle power absorption and generation at push-off are related to the foot's initial position at heel-strike with respect to the body center of mass. DESIGN: Nineteen able-bodied male subjects participated in this study and were divided into two groups according to ankle frontal plane power generation or absorption at push-off. RESULTS: At heel-strike, the group that absorbed had a center of pressure that was located on average 25% more anteriorly and 36% more laterally to the body center of mass. Moreover, at push-off, the center of pressure was closer (26%) to the center of mass than in the generating group. The absorbing group compensated by increasing their sagittal plane hip energy by 30% to pull the lower limb forward and their knee power absorption by 47% to slow down the leg before the subsequent heel-strike. CONCLUSIONS: The foot's initial position at heel-strike explains in part the ankle frontal power generation or absorption at push-off. Increasing hip and knee sagittal joint powers and mechanical energies were the main contributors in compensating and providing a broader base of support and frontal plane ankle power absorption.