Spine
-
Comparative Study
Comparison of bone grafts for posterior spinal fusion in adolescent idiopathic scoliosis.
A retrospective comparison of three different types of bone grafts for posterior spinal fusion in adolescent idiopathic scoliosis. ⋯ Fusion rates were comparable for GroupA (ICBG) and Group C (composite graft of autologous bone marrow and demineralized bone matrix). The composite graft is our preferred graft for fusions in adolescent idiopathic scoliosis.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Prospective randomized clinical trial comparing patient-controlled intravenous analgesia with patient-controlled epidural analgesia after lumbar spinal fusion.
A prospective, randomized, double-blind clinical trial was conducted. ⋯ Both postoperative analgesic regimens provided good overall patient satisfaction. The only clinical advantage of PCEA over PCA for spine fusion patients was the lower amount of opioid consumed, although the PCEA group experienced significantly more side effects than the PCA group. There were no other significant differences. Therefore, patient or physician preference could select either postoperative pain management delivery system.
-
A new surgical technique for en bloc resection of posterior mediastinum tumors invading the spine is described. ⋯ Even though a learning curve is necessary to achieve this extreme type of surgery, selective preoperative screening of patients is mandatory. Interesting results today confirm the feasibility of possible treatment of tumors still considered unresectable.
-
Case Reports
Cauda equina compression after trauma: an unusual presentation of spinal epidural lipoma.
A case report is presented. ⋯ Previously asymptomatic epidural masses such as lipomas can present with neurologic deficit after trauma. Appropriate imaging can help in the diagnosis and management of such cases.
-
Comparative Study
Pedicle morphology of the lower thoracic, lumbar, and S1 vertebrae: an Indian perspective.
Analysis of morphometric data obtained from computed tomography scans in relation to the lower thoracic, lumbar, and S1 pedicle in patients from the Indian subcontinent. ⋯ Significant differences exist between the pedicles of Indian and white populations. It is suggested that preoperative computed tomography scans of the patients must be evaluated to choose the appropriately sized implant and avoid inadvertent complications. Preparation of the pedicle intraoperatively should take into account the orientation of the transverse pedicle angle.