Spine
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Frontal plane geometry of postoperative curves was analyzed using a geometric model to investigate the relationship between coronal decompensation and postoperative apical shifts from the center sacral line for various thoracic and lumbar Cobb angles. ⋯ Decompensation does not appear to be caused by the relative magnitudes of the postoperative thoracic and lumbar curves, but is a result of inadequate relative distance between the thoracic and lumbar apical vertebrae in the postoperative geometry.
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The authors sought to measure the stiffness at the lumbosacral junction when it has been immobilized by means of two different posterior fixation systems in conjunction with three different anterior interbody fixation techniques. The information obtained provides a foundation for determining how methods of lumbosacral spinal fixation can maximize rigidity and improve fusion rates at this clinically important anatomic site. ⋯ The authors' data demonstrate that the threaded interbody fusion device may be an effective system for immobilization of the L5-S1 disc space. Rigidity of fixation at the lumbosacral junction may be enhanced by use of appropriate anterior interbody fusion techniques.
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Multicenter Study Clinical Trial Controlled Clinical Trial
Predictors of bad and good outcome of lumbar spine surgery. A prospective clinical study with 2 years' follow up.
Based on prospective assessment, patients with lumbar disc surgery were examined to determine reliable predictors for clinical outcome. ⋯ Patients with a high risk of a bad operation outcome after lumbar discectomy could be identified preoperatively. It is suggested that those patients take part in a pain management approach instead of or in addition to surgical intervention.
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Clinical Trial Controlled Clinical Trial
Increased limb lengths in patients with shortened spines due to tuberculosis in early childhood.
The spine and limb lengths of 26 patients who had a severe spinal deformity due to tuberculosis in childhood were measured and compared with similar data from 79 normal adult volunteers. ⋯ Patients whose spinal growth was stunted due to disease in childhood have longer legs and upper limbs than healthy people. A compensatory stimulatory growth mechanism may be responsible for this. This has implications for the whole gamut of childhood spinal disorders that result in stunted spinal growth.
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The case report presented herein shows tortuosity of the vertebral artery in a patient with cervical myelopathy. This case led the authors to evaluate 22 other patients who also had undergone anterior cervical fusion. They were studied before operation by either magnetic resonance imaging angiography or selective vertebral angiography. ⋯ This study suggests that vertebral artery loop formation is developed associated with cervical spondylotic changes. During the anterior decompression of cervical spondylotic myelopathy or radiculopathy, the looped vertebral artery could be injured by an excessive wide rejection of the bone or disc material. In the case of vertebral artery migration, the looped vertebral artery can even be injured by routine procedures.