Spine
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Thirty-two patients with failed back syndrome received a trial of spinal cord stimulation. Stimulators were internalized in 26; long-term follow-up was available for 23 of these patients. ⋯ The most common complication was electrode migration. Spinal cord stimulation should be considered as an important therapeutic modality in carefully selected patients with failed back syndrome.
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Fifteen cervical spines from cadavers were used to compare the rotational and translational stability of the Brooks fusion, a fusion construct using Halifax interlaminar clamps, and the Gallie fusion. The Brooks and Halifax clamp constructs exhibited significantly greater rotational and translational stiffness than the Gallie construct (P < 0.001). ⋯ The Brooks and Halifax fixation constructs provided superior fixation but presented technical challenges. The Gallie construct is less technically demanding but provides less stable fixation.
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Preoperative and postoperative pulmonary function and body temperature were measured prospectively in 15 patients undergoing either microlumbar discectomy or standard lumbar laminectomy and discectomy for herniated nucleus pulposus. In these otherwise comparable groups patients undergoing standard lumbar laminectomy and discectomy had significant depression in pulmonary function in the first 20 hours postsurgery and febrile temperatures for as long as 48 hours postsurgery. No alteration in pulmonary function or body temperature was observed in those operated on by the microlumbar discectomy technique. We conclude that patients undergoing microlumbar discectomy for lumbar disc herniation have less postsurgical pulmonary morbidity and temperature elevation than those treated by lumbar laminectomy and discectomy.