Spine
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Rigid post-traumatic kyphosis after fracture of the thoracolumbar and lumbar spine represents a failure of initial management of the injury. Kyphosis moves the center of gravity anterior. The kyphosis and instability may result in pain, deformity, and increased neurologic deficits. Management for symptomatic post-traumatic kyphosis always has presented a challenge to orthopedic surgeons. ⋯ This method provides single-stage posterior decompression, correction, and stabilization on as definitive management for post traumatic kyphosis of the thoracolumbar and lumbar spine.
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A report of a patient with cervical intramedullary cysticercosis is presented. ⋯ A preoperative diagnostic suspicion of cysticercosis is important in patients with intramedullary cystic lesions because specific drug treatment is available. Treatment with anthelmintics, particularly albendazole, should be considered in patients with intramedullary cysticercosis before surgery. Corticosteroids may be added to the therapeutic regimen because this may reduce the perilesional edema and prevent neurologic deterioration during the course of anthelmintic treatment.
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A cadaveric study was performed to analyze the changes of foraminal dimensions of the lumbar spine and also to estimate the amount of foraminal distraction, achieved with pedicle screw instrumentation, that will create the greatest improvement in foraminal dimensions. ⋯ Posterior distraction using pedicle screws increased foraminal dimensions. The ideal amount of distraction on the rod, or the minimal amount of distraction necessary for improving foraminal dimensions, may be 6 mm using pedicle screw instrumentation.
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A prospective study was done to assess the diagnostic value of radionuclide imaging (bone scan) in the evaluation of sacroiliac joint syndrome ⋯ The results demonstrated very low sensitivity and high specificity of nuclear imaging in the evaluation of sacroiliac joint syndrome. The authors do not recommend bone scan in the diagnostic algorithm for sacroiliac joint syndrome.
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This case report illustrates the development of a cerebrospinal fluid fistula and pseudomeningocele in a patient after lumbar discectomy and fusion with instrumentation. ⋯ Postoperative pseudomeningocele and cerebrospinal fluid fistula in patients with spinal instrumentation can be treated successfully with epidural blood patch and a brief course (4 days) of spinal drainage. This combined treatment protocol may have some advantages to treatment with 7 days of cerebrospinal fluid diversion or to percutaneous epidural blood patch alone.