Spine
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Comparative Study
Complications associated with lumbar laminectomy: a comparison of spinal versus general anesthesia.
A case-controlled, comparative study of 400 patients undergoing lumbar surgery, treated with either spinal or general anesthesia. An independent observer analyzed outcomes. ⋯ For patients undergoing decompressive lumbar surgery, spinal anesthesia is at least comparable to general anesthetic with respect to complications. Specific advantages to spinal anesthesia include decreased nausea and antiemetic requirements, reduced analgesic requirements, and reduced overall complication rate.
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This is a retrospective review on the application of the authors' technique of atlantoaxial lateral mass plate and screw fixation on a rare subset of patients having mobile and reducible atlantoaxial subluxation in the presence of occipitalized atlas. ⋯ Although lateral mass plate and screw fixation in the presence of occipitalized atlas is technically a relatively difficult and anatomically a precise surgical procedure, the firm and segmental stabilization that it provides offers an optimum situation for bony fusion.
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Comparative Study
Results of surgical treatment for degenerative cervical myelopathy: anterior cervical corpectomy and stabilization.
This retrospective study involves 26 patients with degenerative cervical myelopathy who were surgically treated by anterior corpectomy, titanium mesh cage (TMC) filled with autogenous bone, and anterior plate +/- posterolateral plate and fusion. ⋯ Anterior decompression provides good neurologic recovery in patients with degenerative cervical myelopathy. TMC provides good structural support, and solid fusion can be achieved with TMC and anterior plate (for < or =2-level corpectomy) and/or posterior plate (> or =3-level corpectomy). There is increased risk of C5 nerve root injury when first laminectomy and posterolateral plate stabilization are performed.
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Case Reports Comparative Study
New technique in congenital scoliosis involving fixation to the pelvis after hemivertebra excision.
The authors conducted a retrospective study involving description of a new surgical technique. ⋯ This prospective study demonstrates a successful surgical technique for spinal stabilization after congenital hemivertebra excision in infants and young children with relatively small and soft bones when standard constructs like pedicle screws may not be optimal devices. Coronal and sagittal balance (restoration with improvement of lordosis) was successfully achieved in all cases.
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Comparative Study
Occupational gonadal and embryo/fetal doses from fluoroscopically assisted surgical treatments of spinal disorders.
Simulation of lumbar spine fluoroscopy used during surgical treatments of spinal disorders on a humanoid phantom and monitoring of the scattered radiation levels. ⋯ Radiogenic genetic and embryo/fetal risks resulting from occupational exposure due to fluoroscopically assisted surgical treatments of spinal disorders are well within tolerance levels provided that rigorous confinement to all pertinent occupational dose constraints is established.