Spine
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Case Reports
Cord monitoring changes and segmental vessel ligation in the "at risk" cord during anterior spinal deformity surgery.
Retrospective analysis of all cases of anterior spinal deformity surgery that had intraoperative spinal cord monitoring (somatosensory-evoked potentials, SSEPs). ⋯ Patients with identified cords at risk should undergo spinal cord monitoring (SSEP) if they undergo anterior spinal deformity surgery. Soft clamping of segmental vessels is indicated with cord monitoring to prevent the risk of postoperative neurological sequelae.
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We propose that chronic spondylolytic defects at L5 are influenced by insufficient differential mediolateral distances between inferior articular facets of L4 and the superior facets of S1, which results in these structures impinging on adjacent sides of the par interarticularis during hyperlordosis. Individuals with adequate increase in interfacet distances from L4 through S1 are less likely to develop or maintain defects. ⋯ Spondylolysis is the direct result of contact pressures on both sides of the pars interarticularis resulting from inadequate separation between the inferior articular processes of L4 and the superior articular facets of S1. Individuals lacking sufficient increase in transverse interfacet dimensions in their lumbar columns are at greater risk of developing and maintaining spondylolytic defects.
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The study used a small animal laminectomy model with kaolin to investigate the relationship of cauda equina pathology to pain, and the effects of systemic and intrathecal drugs to reduce pain. ⋯ An animal model of adhesive lumbar arachnoiditis yields a quantifiable pain-related response that can be used to evaluate the effects of various analgesic interventions.
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Review Case Reports
Successful reduction for a pediatric chronic atlantoaxial rotatory fixation (Grisel syndrome) with long-term halter traction: case report.
Clinical case report of atlantoaxial rotatory fixation (AARF) in a girl presenting with torticollis and neck pain. ⋯ From this case, we suggest that long-term traction could be another treatment method for chronic AARF, especially in children.