Spine
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A retrospective review of all patients surgically treated by a single surgeon with a three-level anterior cervical discectomy and fusion with and without anterior plate fixation. ⋯ The addition of plate fixation for three-level anterior cervical discectomy and fusion is a safe procedure and does not result in higher complication rates. In this study, the pseudarthrosis rate was lower for patients with a cervical plate. However, this difference was not statistically significant. Patients treated with cervical plating had overall better results when compared with those of patients treated without cervical plates. Although the use of cervical plates decreased the pseudarthrosis rate, a three-level procedure is still associated with a high nonunion rate, and other strategies to increase fusion rates should be explored.
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A study of five patients whose dumbbell or paraspinal tumors of the thoracic spine were managed by using thoracoscopic surgery is reported. ⋯ Combined laminectomy and thoracoscopic surgery may be a good alternative method for managing thoracic dumbbell tumors.
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A retrospective analysis of the long-term outcomes of standard discectomy for lumbar disc herniation. ⋯ The long-term outcome of standard discectomy in this series was favorable. Although patients with preserved disc height generally had favorable results, the risk of recurrent disc herniation was high in this population.
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A case report of anterior en bloc resected cervical intradural disc herniation and a review of the literature. ⋯ Cervical intradural disc herniation is an extremely rare condition. The pathogenesis remains obscure. Only 16 cases have been reported in the literature, and there has been little discussion concerning the local pathology of the herniated portion. The pathogenesis of the disease in the patient reported here was considered to be the adhesion and fragility of dura mater and posterior longitudinal ligament. This was caused by hypertrophy, with chronic inflammation and ossification of the posterior longitudinal ligament sustaining chronic mechanical irritation to the dura mater, leading to perforation of the herniated disc by an accidental force.
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Comparative Study
Facet tropism: a comparison between far lateral and posterolateral lumbar disc herniations.
An assessment of the difference in the degree of facet tropism and disc degeneration between far lateral and posterolateral lumbar disc herniations. ⋯ This results suggest that the differences in the degree of facet tropism and disc degeneration might be considered a key factor in distinguishing the development of far lateral lumbar disc herniation from that of posterolateral lumbar disc herniation.