Spine
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Case report and literature review. ⋯ Right-to-left atrial shunts may predispose to cerebral emboli during scoliosis surgery. These emboli may be a cause of postoperative visual field defects.
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Light microscopy study of the lumbar spinal meninges of a murine model of Marfan syndrome. ⋯ These morphologic findings in the Marfan phenotype mouse mimic the findings of disordered elastic-fibers in other Marfan tissues and demonstrate gross attenuation of the tissue architecture, corroborating the theory that dural ectasia in Marfan syndrome results from hydrostatic pressure on weakened dura. These changes may be due in part to transforming growth factor beta overactivation and gelatinase-A-mediated elastolysis and collagen breakdown.
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Retrospective study to gather long-term data clinical, paraclinical, and radiographic data on nonoperatively managed cases of childhood spondylodiscitis. ⋯ Our study shows that the course of childhood spondylodiscitis is generally benign. Segmental orbony ankylosis may occur during the healing process but normally does not lead to serious functional deficits. Neurologic deficits were not observed in any of our patients. Conservative management must be intensive, but the results are good. Biopsy is not required except in the few cases where diagnostic uncertainty prevails.
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Multicenter Study
Differences in the work-up and treatment of conditions associated with low back pain by patient gender and ethnic background.
Retrospective review comparing physician workup of degenerative lumbosacral pathologies between different genders and ethnic groups. ⋯ This study suggests that ethnicity and gender affect the workup and surgical management of degenerative spinal disorders. However, it should be noted that there are a number of confounding factors not identified in the database, including managed care and insurance status and cultural differences, which may affect both test ordering and treatment recommendations. Further study of bias in clinical decision-making is indicated to assure equal delivery of quality care.
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A prospective radiographic study of 160 volunteers without symptoms of spinal disease was conducted. ⋯ Understanding the patterns of variation in sagittal alignment may help to discover the association between spinal balance and the development of degenerative changes in the spine.