Spine
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Comparative Study
Comparison of standing sagittal spinal alignment in asymptomatic adolescents and adults.
A retrospective examination of the spine radiographs of 88 asymptomatic adolescents was performed to analyze the indices of regional and segmental sagittal spinal alignment in relation to the sagittal vertical axis as determined by the C7 plumb line. ⋯ Asymptomatic adolescents tend to stand in greater negative sagittal spinal balance than asymptomatic adults, despite similar regional and segmental alignments in the thoracic and lumbar spine. The role of hip extension, spinopelvic axis rotation, and other sagittal alignment parameters in determining the sagittal vertical axis in adolescents warrants further study.
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A retrospective study evaluating the complications in 43 consecutive patients treated with posterior lateral mass plate fixation of the subaxial cervical spine. ⋯ With the authors' surgical technique, lateral mass plate fixation is safe and effective. There were no nerve root or vertebral artery injuries.
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Clinical Trial
Magnetic resonance imaging analysis of lumbar disc changes below scoliosis fusions. A prospective study.
The authors of this prospective study examined the preoperative and 3-year postoperative magnetic resonance images of 14 patients undergoing anterior and posterior fusion and/or posterior fusion only for scoliosis. All magnetic resonance images were ready by two independent neuroradiologists, who were blinded to the purposes of the study, for the presence of disc narrowing, signal decrease on T2, or herniated nucleus pulposus before and after surgery. Particular attention was paid to the disc changes at the level directly below the end vertebral level of the fusion and two levels below the fusion in the lumbosacral spine existing before surgical intervention. ⋯ If these results are corroborated in a larger sample size, surgeons who manage deformity may have to consider altering fusion levels at the time of fusion based on magnetic resonance imaging predictors. The present data may help to inform patients about the risk of developing junctional degenerative changes and potential symptoms from these changes below scoliosis fusions.
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A retrospective study of 44 museum cases of spinal osteoid osteoma or osteoblastoma and a meta-analysis using 421 additional cases from a review of the literature. ⋯ The findings support the concept that scoliosis is secondary to asymmetric muscle spasm in patients with spinal osteoid osteoma or osteoblastoma.
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Pain outcome and functional outcome after primary lumbar fusion surgery were determined by a self-assessment questionnaire. The responses were correlated with various clinical parameters. ⋯ The outcome of primary lumbar fusion surgery was decreased pain and increased function for the majority of patients in all five diagnostic categories. The amount of improvement varied by diagnostic group. Patients with developmental conditions showed greater improvement than patients with degenerative conditions.