Spine
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A retrospective study was done in 12 teenagers with severe L5-S1 spondylolisthesis surgically treated with a single-stage posterior procedure for reduction, posterior interbody fusion, and segmental instrumentation. ⋯ Intraoperative distraction appears to be truly effective in reducing severe lumbosacral olyshtesis in children. Posterior interbody fusion (and eventual sacral dome osteotomy) successfully combines the goals of solid fusion with the requirements of root decompression. No neurologic problems were seen as a consequence of distraction. The solidity of the posterior segmental pedicle instrumentation combined with the anterior strut graft eliminate the need for postoperative casting.
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This anatomic study tested placement of C2 pedicle screws using cadaver specimens. ⋯ The present anatomic study suggests that transpedicular screw fixation may be performed safely in the C2 pedicle by using the second technique. Using the first technique is not safe.
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This retrospective study analyzed the clinical and radiologic results of two groups of patients with unstable burst fractures of the thoracolumbar spine treated with anterior decompression, reduction of the kyphotic deformity, and stabilization by grafting and instrumentation. ⋯ The double rod instrumentation performs significantly better regarding loss of correction compared with the single rod instrumentation.
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A retrospective review of all cases of bacterial meningitis after spinal surgery. ⋯ This is a rare complication from which a good outcome is possible with early diagnosis and prompt management.
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This study analyzed anteroposterior, lateral, inlet, and outlet radiographic representations of different iliosacral screw orientations and evaluated anatomic features of the superior aspects of the sacral alae. ⋯ The inlet view shows the orientation of screws relative to the coronal plane and extraosseus screws extending anterior to the ala, whereas the outlet view elucidates the placement of screws relative to the transverse plane and extraosseus screw tips extending into the sacral foramina or superior to the ala. Evaluation of preoperative pelvic computed tomography scans may be helpful in understanding the unique morphology of each individual patient and enhancing the safety of iliosacral screw placement.