EDS analysis detected trace amounts of primer or gunpowder signature elements characteristic of gunshot residue on the cranial bone fragments but not on the vertebral
spinous process (Figure 5).
A rod was introduced on the left side, bilateral facet fusion with local bones obtained from the lower one-third of the L1
spinous process was performed, and the wound was closed.
Once all the screws are placed in position we open the facet joint, thoroughly decorticate the articulate surfaces and pack small pieces of bone chips retrieved from the excised
spinous process. Finally we tighten the rods in neutral position maintaining the reduction.
* Bases 1 and 2, and height: Acromio-glenoidal length; Distance between inferior surface of anterior acromial tip and
spinous process; Length of
spinous process.
For example, with a right C2 transverse process sensitivity, the block would be placed under a prone patient on the left side between the ASIS and greater trochanter, and the right side of the L4
spinous process would be contacted, on the right side, with pressure directed from right to left.
Spinous processes of C7 and T7 were palpated and 2 adhesive markers were attached over the midpoint of the most prominent parts of C7 and T7.
At operation fracture of
spinous process of L4-5, bilateral fracture-dislocation of L5 inferior facets, disruption of interspinal ligaments and flaval ligaments of L5-S1, disruption of annular fibrosus of L5 intervertebral disc were confirmed.
The accessory motion of the cervical and thoracic spine was tested with segmental mobility and posterior to anterior spring testing of C2-T9 over the
spinous processes with the patient in the prone position (Fig.
The lumbar region segment was defined by a vector from a reflective marker on the second sacral
spinous process (origin marker on the pelvic triad) to a marker on the first lumbar
spinous process (Figure 2).
One was described by lines between the markers on dorsal side of distal forearm (wrist marker), elbow joint (humerus marker) and acromion process of the throwing shoulder (shoulder marker), and the other was described by lines between markers on the humerus marker, the shoulder marker, and the
spinous process of the 8th thoracic vertebrae (Th 8 marker) (Figure 1a).