Spine
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Case Reports
Failure of standard imaging to detect a cervical fracture in a patient with ankylosing spondylitis.
Retrospective case study of 38-year-old male with ankylosing spondylitis who presented with a Brown-Séquard syndrome following a fall and an occult fracture on initial spinal imaging studies. ⋯ Occult fractures in ankylosing spondylitis may not be apparent on routine plain radiographic and MRI studies. In the setting of ankylosing spondylitis, a high index of suspicion must be maintained in all patients presenting with spinal pain following even minor trauma. High-resolution multidetector CT imaging appears to be more sensitive and accurate in the diagnosis of fractures in this patient subgroup than other contemporary imaging methods.
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A retrospective study was conducted to investigate the incidence and prognosis of postoperative lumbar nerve root palsy after surgical treatment for adult spinal deformity. ⋯ Patients with increasingly complex spinal deformities are at a higher risk for postoperative lumbar nerve root palsy. These injuries can be treated nonoperatively when there is no identifiable cause on postoperative imaging studies.
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A prospective evaluation of cardiopulmonary tolerance to maximal exercise in adolescent idiopathic scoliosis. ⋯ Although patients with mild or moderate scoliosis do not exhibit cardiopulmonary restrictions in basal static conditions, they do show a significant lower tolerance to maximal exercise. Respiratory inefficiency together with lower ventilation capacity and lower VO2 max may be responsible for reduced exercise tolerance in adolescents with idiopathic scoliosis. Exercise deconditioning in scoliotic patients cannot be attributed to brace treatment.
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A retrospective cohort study. ⋯ Adequate correction was maintained throughout an average follow-up of 4.5 years, and solid fusion was obtained in all patients. Anterior strut grafts, supplemented with posterior fusion with instrumentation provide a good treatment alternative for the treatment of kyphosis deformity of the spine as a result of various etiologies.
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Randomized Controlled Trial Multicenter Study Comparative Study
A prospective, randomized, multicenter Food and Drug Administration investigational device exemption study of lumbar total disc replacement with the CHARITE artificial disc versus lumbar fusion: part II: evaluation of radiographic outcomes and correlation of surgical technique accuracy with clinical outcomes.
A prospective, randomized, multicenter, Food and Drug Administration-regulated, investigational device exemption clinical trial. ⋯ Preoperative ROM in flexion/extension was restored and maintained in patients receiving a TDR. TDR with the CHARITE artificial disc resulted in significantly better restoration of disc space height, and significantly less subsidence than anterior interbody fusion with BAK cages. Clinical outcomes and flexion/extension ROM correlated with surgical technical accuracy of CHARITE artificial disc placement. In the majority of cases, placement of the CHARITE artificial disc was ideal.