Spine
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Wedging of apical spinal segments was measured during creation and correction of an experimental scoliosis in a goat model. ⋯ This study demonstrates the ability to create wedge deformities at the apex of an experimental scoliosis in a large animal model and to control the progression of these deformities using anterior thoracic staples.
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Comparative Study
Open reduction of irreducible atlantoaxial dislocation by transoral anterior atlantoaxial release and posterior internal fixation.
A retrospective study of surgical outcome of 33 patients with irreducible atlantoaxial dislocation (IAAD). ⋯ This series has demonstrated the safety and efficacy of the transoral anterior atlantoaxial release in the reduction of IAAD. Most of the so-called irreducible/fixed AAD could become reducible after anterior release without odontoid resection. The posterior short-segment atlantoaxial or occipitocervical fixation, especially the plate screw instrumentation, could achieve further reduction and provide immediate stabilization. One-stage anterior release and posterior instrumentation and fusion are a safe and reliable operation in experienced hands.
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: Literature review. ⋯ : While many advances in the basic science of spinal cord injury provide optimism for future treatments, clinical science lags. At present, there are no pharmacologic strategies of proven benefit. Although steroids continue to be given to patients with spinal cord injury in many institutions, evidence of deleterious effects continues to accumulate. Current standard of care management includes support of arterial oxygenation and spinal cord perfusion pressure.
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Evidence-based literature review. ⋯ There are currently no standards regarding the role and timing of decompression in acute SCI. We recommend urgent decompression of bilateral locked facets in a patient with incomplete tetraplegia or in a patient with SCI with neurologic deterioration. Urgent decompression in acute cervical SCI remains a reasonable practice option and can be performed safely. There is emerging evidence that surgery within 24 hours may reduce length of intensive care unit stay and reduce post-injury medical complications.
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Comparative Study
Supplementary stabilization with anterior lumbar intervertebral fusion--a radiologic review.
A radiologic assessment of the success of anterior lumbar interbody fusion (ALIF) using thin-section computerized tomography (CT) was performed. ⋯ The addition of pedicle screw fixation at ALIF produces a significant increase in the rate of interbody fusion.