Spine
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This study retrospectively, reviewed the effects of pedicle screw fixation on lumbosacral fusion for degenerative conditions. The records and radiographs of a group of patients treated by wide decompression and fusion of the lumbosacral spine and by one surgeon were studied. Two treatment groups were identified by fusion technique; one group received autologous bone graft only, and second group was treated by autologous bone grafting supplemented with pedicle screw fixation. ⋯ Use of pedicle screw and rod fixation with the Edwards system led to significantly improved results in lumbosacral fusions over autogenous bone graft alone, with a lower complication rate. The use of spinal is a valuable adjunct to achieve lumbosacral fusion in patients who have undergone decompressive surgery for the spine.
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Comparative Study
Assessing health-related quality of life in patients with sciatica.
This study analyzed health-related quality-of-life measures and other clinical and questionnaire data obtained from the Maine Lumbar Spine Study, a prospective cohort study of persons with low back problems. ⋯ These measures performed well in measuring the health-related quality-of-life of patients with sciatica. The modified Roland and the physical dimension of the SF-36 were the measures most responsive to change over time, suggesting their use in prospective evaluation. Disability day measures, although valuable for assessing the societal impact of dysfunction, were less responsive to changes over this short-term follow-up of 3 months.
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This is a retrospective single-patient case report with a literature review. ⋯ Traumatic bilateral atlantoaxial rotatory subluxation is uncommon in adults. This probably is due to the unique biomechanical features of the atlantoaxial articulation and the probable lethality of injury to the adjacent medulla or vertebral arteries before presentation at the trauma center.
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Thirty-nine adults and five children with active spinal tuberculosis and resulting kyphosis of the dorsal and lumbar spine who had combined posterior instrumentation and anterior interbody fusion were observed to determine whether the corrected spinal deformity could be maintained until solid fusion. ⋯ Posterior instrumental stabilization and anterior interbody fusion were found helpful in arresting the disease early, providing early fusion, preventing progression of kyphosis, and correcting the kyphosis.
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Lower extremity polysynaptic reflexes and descending neurogenic motor and ascending somatosensory activity were recorded. ⋯ Intraoperative lower extremity reflex changes are more sensitive to spinal cord compromise than are changes in long tract function. Lower extremity polysynaptic reflexes monitor the integrated activity of the spinal cord that is responsible for the control of complex motor behavior.