CLINICAL TECHNOLOGIES
Barth A. Green, MD • Allan D.O. Levi, MD • Robert M. Quencer, MD

Radiologists and surgeons strive to develop and apply new techniques and technologies to improve current clinical practice. Common neurosurgical techniques to treat cervical bilateral facet fracture dislocations have included prolonged cervical traction, halo-thoracic bracing, posterior wiring, and anterior plates using Casper plates. Casper plating involves placing two screws in the vertebrae to be fused. Neurosurgeons, Drs. Barth Green, Allan Levi, and their colleagues report their experience with anterior fixation with unicortical locking plates in cervical spine fracture dislocations. An advantage of this plating system is the use of only one screw in each vertebral body. In their retrospective study, they found that this procedure is effective in achieving spinal stability and offers an excellent surgical alternative in managing these types of injuries.

While continuing to improve the initial surgical treatment in spinal cord injury, the Miami Project is also interested in developing better diagnostic capabilities. When spinal paralysis results from non-traumatic events such as transverse myelitis or spinal cord stroke, definitive radiologic diagnosis can be difficult. Magnetic Resonance Imaging (MRI) using a technology known as diffusion-weighted imaging (DWI) may provide a more definitive diagnosis. DWI has already been proven helpful in accurately diagnosing brain abnormalities. Dr. Quencer suggests, in this paper, that DWI may be useful in providing definitive diagnoses in certain spinal cord disorders and reviews the technical problems that need to be overcome in order to make use of DWI technology in the spinal cord.