Spine
-
Meta Analysis
Meta-analysis of surgical outcome in adolescent idiopathic scoliosis. A 35-year English literature review of 11,000 patients.
Meta-analysis of the English literature on the surgical treatment of adolescent idiopathic scoliosis. ⋯ Patients appear to be more satisfied by the magnitude of curve correction rather than the percent of curve correction. The degree of curvature before surgery did not predict patient satisfaction. Pearsons r' = 0.045. Satisfaction appears to be best predicted by the degree of correction only and not by the percent curve correction, the curve magnitude before surgery, nor the Group type (King, unspecified). Patient satisfaction is subjective. It does not reflect the benefits of surgery with respect to the future preservation of pulmonary function in thoracic curves nor the prevention of osteoarthritis in lumbar curves.
-
This study described and compared retroperitoneal and transperitoneal laparoscopic approaches to the lumbar vertebrae in pigs. Technical and perioperative complications were evaluated for each approach. ⋯ The retroperitoneal approach was difficult because of the degree of muscle dissection required for exposure of the lumbar vertebrae. Complications associated with the retroperitoneal approach included loss of pneumoretroperitoneum because of entry into the peritoneal cavity, hemorrhage, and limited exposure of the lumbar vertebrae. The transperitoneal approach was easier technically, allowing identification and access to lumbar vertebral bodies and intervertebral discs from L1-L6/L7. Operative complications associated with the transperitoneal laparoscopic approach were minimal.
-
Comparative Study
The morbidity of heparin therapy after development of pulmonary embolus in patients undergoing thoracolumbar or lumbar spinal fusion.
The postoperative course of patients who developed a pulmonary embolus after thoracolumbar or lumbar spinal fusion treated with heparin was studied to quantify the morbidity risk of anticoagulation. ⋯ Heparinization after the development of pulmonary embolus in patients recently undergoing spinal fusion is associated with a high complication rate. The morbidity of vena cava filter placement is low and should be considered a treatment alternative in the treatment of patients who experience pulmonary embolus after surgery.
-
Two separate experiments (A and B), each involving six human cadaveric torsos with intact rib cages and sternums, were done to determine the effect of two different sequences of surgical releases (at T8-T9) on thoracic spinal motion. ⋯ These experiments indicate that the combination of rib head resection and radical discectomy may be the optimal thoracic spinal release.
-
Biography Historical Article
Description of variations of the sciatica stretch phenomenon.