IntroductionCombination between SCIWORA and Brown-Sequard syndrome in a patient is a rare condition. In SCIWORA, there is usually a delay in neurologic deficits which can potentially lead to misdiagnosis. Therefore, the clinician should have a good understanding of the course of the disease to make a good diagnosis and treatment.Case reportReporting a case of female 20 years old with chief complaint of severe neck pain and delayed limbs weakness. The mechanism of injury was fall with the head hit the ground in left lateral flexion position. The physical examination showed zero motor power of the right limbs and contralateral pain and temperature deficit 1 h after the injury. We diagnosed the patient with incomplete spinal cord injury at C4 level with associated Brown-Sequard syndrome. We gave soft collar neck for immobilization, medication with NSAID for analgetic and Methylprednisolon. We found dramatic improvement in 10 h after the injury with motor improvement from 0 to 5 and normal sensory function. The patient then was discharged with good functional outcome and with no sequelae.ConclusionIncomplete cervical spinal cord injury without radiological abnormality that manifested as Brown-Sequard syndrome is a rare case and potentially confusing condition. Better understanding of the course of the disease may help the clinician to make a right diagnosis and plan for management.
Objective
This research aimed to developing customized pedicle screw based on Indonesian vertebral anatomy and compare the insertion time, pull-out strength, and screw-media interface area of different screw design. We have developed 3 different types of pedicle screws (v-thread cylinder-core, square-thread cylinder-core and square-thread conical-core). The thread diameter was calculated from pedicle width of Indonesian population (6 mm). We used commercially available pedicle screw as control group (6.2 mm).
Result
The insertion time were significantly difference between v-thread cylinder-core pedicle screw (22.94 s) with commercially available pedicle screw (15.86 s) (p < 0.05). The pull-out strength was significantly difference between commercially available pedicle screw (408.60 N) with square-thread conical pedicle screw (836.60 N) (p < 0.05). The square-thread conical-core group have the highest interface area (1486.21 mm2). The data comparison showed that the square-thread conical-core customized pedicle screw group has comparable insertion time and has better pull-out strength than commercially available pedicle screw.
Objective: This research aimed to developing customized pedicle screw based on Indonesian vertebral anatomy and compare the insertion time, pull-out strength, and screw-media interface area of different screw design. We have developed 3 different types of pedicle screws (v-thread cylinder-core, square-thread cylinder-core and square-thread conical-core). The thread diameter was calculated from pedicle width of Indonesian population (6 mm). We used commercially available pedicle screw as control group (6.2 mm). Result: The insertion time were significantly difference between v-thread cylinder-core pedicle screw (22,94 s) with commercially available pedicle screw (15.86 s) (p<0.05). The pull-out strength was significantly difference between commercially available pedicle screw (408.60 N) with square-thread conical pedicle screw (836.60 N) (p<0.05). The square-thread conical-core group have the highest interface area (1486.21 mm2). The data comparison showed that the square-thread conical-core customized pedicle screw group has comparable insertion time and has better pull-out strength than commercially available pedicle screw.
Background: The changes of lifestyle and mobility during the Coronavirus Disease 2019 (COVID-19) pandemic may influence the epidemiology of traumatic fractures. This study aimed to investigate the epidemiology of traumatic fractures in Yogyakarta Special Region (Daerah Istimewa Yogyakarta/DIY) during the COVID-19 emergency response period and compare the data with the similar period in the previous year.Methods: This was a retrospective study involving five secondary referral hospitals and one tertiary referral hospital. We included all patients who presented to the emergency departments or orthopedic clinics who were then diagnosed with new onset fractures. We compared the data during the emergency response period (COVID group) with a similar period in 2019 (control group).Results: There were 1,249 patients with 1,428 fractures included in this study. There was almost half reduction of patients during the emergency response period. There was no significant difference in proportion of gender and mean of age between patients in the control group and the COVID group. During the emergency response period, there was significant increases in the proportions of patients experiencing low energy injuries (38.0% vs. 30.8%), injuries occurring at home (34.0% vs. 23.8%), and surgically treated closed fractures (51.8% vs. 45.3%), along with decrease of patients’ referrals (1.6% vs. 4.1%). The difference in proportions of fracture type, osteoporotic fractures, and multiple trauma was not significant across the groups. Conclusions: During the COVID-19 emergency response period in DIY, there were nearly half reduction (47.68%) of patients with fractures, increased proportion of patients injured at home, reduced proportion of patients referred to another hospital, and increased proportion of surgically treated closed fractures. The knowledge about this epidemiological trend may help in developing preventive programs and treatment policy for fractures and other injuries during the current pandemic.
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