Spinal Instability

As defined by White and Panjabi, clinical instability "is the loss of the ability of the spine under physiological loads to maintain its pattern of displacement so that there is no initial or additional neurological deficit, no major deformity, and no incapacitating pain" [26]. For clinical purposes, this definition has rather limited utility. The work of Holdsworth, in which fracture patterns were radiographically identified and stability definition was attempted, based on a two-column stability pattern, was the first attempt at classifying stability in such a way that was accessible to clinicians to determine appropriate treatments [27]. Denis modified this model to include a third column and this is the pattern currently used by many physicians (Fig. 22.6) [28]. As defined, the anterior column is made up of the anterior half of the vertebral body, anterior half of the annulus fibrosus and the anterior longitudinal ligament. The middle column consists of the posterior half of the vertebral body, the posterior half of the annulus fibrosus and the posterior longitudinal ligament. The posterior column comprises the supra- and infraspinous ligaments, the ligamentum flavum, articular processes and joint capsules, the laminae and the spinous processes. This three-column model states that instability results when an injury affects two or more columns.

Cure Your Yeast Infection For Good

Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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