Spine
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Review Case Reports
Intraoperative visible bubbling of air may be the first sign of venous air embolism during posterior surgery for scoliosis.
Case report of two children sustaining venous air embolism (VAE) during posterior surgery for scoliosis. ⋯ Visible air bubbling at the operative site may herald the onset of massive VAE during multilevel posterior spinal fusion and instrumentation. A prospective multicenter study using precordial Doppler, central venous catheter, and end-tidal CO2 is recommended to determine the true incidence of VAE in spinal deformity surgery and to evaluate monitoring and treatment methods.
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A prospective cohort. ⋯ Lifetime prevalence of back pain increased sharply during nursing school but slowly after that. Back pain at entering the nursing school was a predictor for back-related pain and disability. Self- reported occupational physical work load was associated with back pain and related disability. The nature of the association is unclear, but it is likely that back pain is exacerbated during nursing.
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A prospectively maintained database-generated retrospective review and cross-sectional outcome analysis was performed at a single academic center. ⋯ Although the majority of patients improve to an AMS between 90 and 100, many have significant disability and are less functional than the general population. Significant predictive variables include the initial motor score, formal education, comorbidities, age at injury, and development of spasticity. An assessment of more than just the motor score is required to obtain an appreciation of the function and outcomes in this population.
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Comparative Study
COL6A1, the candidate gene for ossification of the posterior longitudinal ligament, is associated with diffuse idiopathic skeletal hyperostosis in Japanese.
Genetic screening of collagen 6A1 gene (COL6A1) in patients with diffuse idiopathic skeletal hyperostosis (DISH) recruited in Japan and the Czech Republic. ⋯ Because COL6A1 could be a susceptibility to the occurrence of DISH and OPLL in the Japanese population, we consider that COL6A1 could be responsible for the hyperostotic state, leading to ectopic bone formation in the spinal ligament.
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Comparative Study
Cervical pedicle screws: conventional versus computer-assisted placement of cannulated screws.
Prospective clinical study with postoperative radiologic control of pedicle screw placement in the cervical spine. ⋯ Transpedicular screws in the cervical spine and cervicothoracic junction can be applied safely and with high accuracy in a conventional technique. Cannulated screws and the use of separate stab incisions from C3-C6 with a trocar system allow for reduced screw misplacement rates. The CAS system leads to significantly reduced screw misplacement rates. Therefore, because of the potential risk of injury to the vertebral artery and neural elements, the use of a CAS system seems to be beneficial, especially for pedicle instrumentation C3-C6.