[Do severe sprains of the spino-occipital joint occur?].
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Biomedical subjects
Publications and source records attributed to G Saillant.
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The authors think that the prognosis in fractures of the odontoid process could be based on an evaluation of the stability and on the direction of the fracture line. The stability depends on the integrity of the common posterior spinal ligament. When it is disrupted, the spine should be surgically fixed. When it is intact, conservative treatment is indicated. The stability should be appreciated on dynamic X rays 15 days after the trauma. The fracture lines oblique anteriorly are more stable than the fracture lines oblique posteriorly. The comminuted type, like "English policeman's hat" are very unstable.
Although severe ocular complications after spinal surgery are rarely reported in the orthopaedic literature, they are not uncommon. We studied 10 cases observed in 4 orthopaedic units to determine the types of complications and their mechanisms. It appears that the classic head-rest used to stabilise the position of the head and protection of the ocular globes during the operation have not fulfilled their functions correctly. An original head-rest is proposed together with preventive pre- and intraoperative measures which should be used in all procedures involving spinal surgery.
Spine surgery exposes to neurological complications. There were 170 immediate complications of spine surgery at Pitiè-Salpétrière Hospital out of 2,855 reviewed (5.95%) during 9 years. The nature of the complication (radicular or medullar), severity and evolution were quite different but less than 2.76% where permanent. Among them, 1.43% were major neurological complications. The "high risk" etiologies were cervical stenosis and primitive malignant tumors. The major cause for these complications was due to surgical procedure in 60% of the cases.