Spine
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An updated Cochrane review. ⋯ No conclusions are possible about the relative effectiveness of anterior, posterior, or circumferential fusion. The preliminary results of three small trials of intradiscal electrotherapy suggest it is ineffective, except possibly in highly selected patients. Preliminary data from three trials of disc arthroplasty do not permit firm conclusions.
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Review Case Reports
A traumatic central cord syndrome occurring after adequate decompression for cervical spondylosis: biomechanics of injury: case report.
Case report with review of the literature. ⋯ Decompressive laminectomy provides an immediate decompressive effect on the spinal cord as seen by the dorsal migration of the cord, however, the biomechanics of the cervical spine after decompressive laminectomy remain uncertain. This case supports the ongoing research and need for more intensive research on postoperative cervical spine biomechanics, including decompressive laminectomies, decompressive laminectomy and fusion, and laminoplasty.
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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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Review Case Reports
Reduction of severe adolescent isthmic spondylolisthesis: a new technique.
The case of a 14-year-old boy with a severe-grade isthmic spondylolisthesis who underwent reduction and stabilization using this technique is described. ⋯ In severe-grade lumbosacral spondylolisthesis, isolated posterior fusion, even when supplemented with internal fixation, is not sufficient to prevent deformity progression. Therefore, a combined anterior and posterior fusion is necessary. Reduction of the deformity leads to restoration of normal sagittal alignment with an excellent cosmetic result. Reduction without release of posterior structures may lead to neurologic deficit. This 3-stage shortening procedure can provide sudden reduction of deformity with minimal risk of neurologic deficit. The procedure is technically demanding, and should be performed by spinal surgeons who are familiar with the principles of anterior and posterior fusions.