Spine
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Review Case Reports
Unilateral calf hypertrophy seen in lumbosacral stenosis: case report and review of the literature.
A case report of a patient with neurogenic unilateral calf hypertrophy and review of the literature are reported. ⋯ Although the patient had bilateral L5 radiculopathies, he only had hypertrophy in the distribution of his right S1 radiculopathy. This supports the hypothesis that dysfunction of the S1 nerve root or its distribution is a predisposing factor to develop neurogenic muscle hypertrophy. Furthermore, patients presenting with unilateral calf hypertrophy need a careful diagnostic evaluation for S1 radiculopathy as well as to exclude asymmetric presentation of systemic neuromuscular conditions.
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This report details the sudden catastrophic neurologic deterioration concerning a patient with an acute fracture of T5 associated with osteoporosis. ⋯ With increasing awareness of the morbidity attached to the osteoporotic spine, investigation and pharmacologic treatment are warranted and may reduce the possibility of catastrophic neurologic impairment as occurred in this case.
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Retrospective clinical, radiographic, and patient outcome review of surgically treated adolescent idiopathic scoliosis. ⋯ The clavicle angle, not T1 tilt, upright proximal thoracic, or side-bending proximal thoracic Cobb, provided the best preoperative radiographic prediction of postoperative shoulder balance. In each of the four groups, postoperative shoulder balance and clinical appearance also improved and correlated with patient postoperative assessments.
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This is a clinical study that examines the results of partial reduction and fibular dowel graft placement for high-grade isthmic spondylolisthesis. ⋯ Fibular strut grafting is a useful surgical adjunct in high-grade spondylolisthesis that is partially reduced. Clinical and radiographic outcomes were satisfactory. Our experience shows that there is no significant difference between allograft and autograft. All struts healed and remodeled by the ultimate follow-up, and there was only one instance of fibula fracture.
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Multicenter Study Comparative Study
Pelvic or lumbar fixation for the surgical management of scoliosis in duchenne muscular dystrophy.
This retrospective study evaluates two groups of patients with scoliosis and Duchenne muscular dystrophy, treated with two different surgical stabilization methods. ⋯ Lumbar fixation to L5 is adequate if the surgery is performed early, soon after becoming wheelchair bound, and with smaller curves and minimal pelvic obliquity. Use of pedicle screws in lumbar spine provides a solid foundation to maintain the correction over the period of relatively short life expectancy of these children. Pelvic fixation may be necessary in older children, who have larger curves and established pelvic obliquity. In the presence of deteriorating lung function, this is associated with a greater morbidity and higher complication rate.