Spine
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Case Reports
Polysegmental spondylodiscitis and concomitant aortic aneurysm rupture: case report with 3-year follow-up period.
A case report describing a patient with spondylodiscitis of the thoracic and lumbar spine complicated by rupture of an abdominal aortic aneurysm and aggravation of neurologic symptoms is presented. ⋯ In older patients, spondylodiscitis may be complicated by other underlying diseases. Pain and neurologic symptoms may occur secondarily to concomitant illnesses instead of being caused by the inflammation itself. Minimally invasive therapy is shown to be an effective alternative to surgery in older and multimorbid patients with spondylodiscitis and contained aortic aneurysm rupture.
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Review Case Reports
Paraplegia as a complication of percutaneous vertebroplasty with polymethylmethacrylate: a case report.
A case report and review of the literature are presented. ⋯ Percutaneous vertebroplasty with polymethylmethacrylate is not as simple and risk free as advocated in the literature. Careful safeguards and modifications are needed for the procedure, and new and physiologic material could be substituted for polymethylmethacrylate.
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Comparative Study Clinical Trial
An in vivo comparison of the potential for extravertebral cement leak after vertebroplasty and kyphoplasty.
A prospective in vivo study was conducted during the performance of kyphoplasty for the treatment of osteoporotic vertebral compression fractures, comparing extravertebral contrast extravasation with kyphoplasty and vertebroplasty. ⋯ The findings showed less vascular and transcortical extravasation of injected contrast with kyphoplasty than with vertebroplasty. Although leakage of contrast may not correlate precisely with polymethylmethacrylate leakage, the authors believe this study highlights the relative safety of these procedures.
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A 2-year follow-up study was conducted to investigate new patients who sought care for low back pain from all the caregivers in a specific region with a population of approximately 17,000 men and women ages 20 to 59 years. ⋯ In a general working population in Sweden ages 20-59 years, approximately 5% sought care because of a new low back pain episode during a 3-year period. Few of the care seekers became pain-free during the follow-up period. This study strengthens the hypothesis that low back pain often becomes chronic even when sick leave is rare.
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A retrospective radiographic study was conducted to analyze 50 consecutive adolescents with thoracolumbar-lumbar scoliosis treated with single solid-rod anterior instrumentation and either rib strut or morsellized interbody bone grafting technique. ⋯ Although the rib strut grafting technique improves the pseudarthrosis rate, as compared with morsellized graft, it did not affect the maintenance of correction or sagittal alignment. Adjunctive measures to provide truly structural interbody support (fusion cages, allograft rings, two-rod construct) appear to be required to address the shortcomings of anterior single-rod instrumentation.