Spine
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An anatomic and biomechanical bench-top basic scientific comparative analysis to determine the appropriateness of total disc replacement (TDR) in a lumbar spine with scoliotic tendencies. ⋯ The neutral zone of the intact cervical spine was restored even using an unconstrained cervical TDR. The greater inherent rotational constraints of the cervical spine make it more amenable to stable multilevel arthroplasty compared with the lumbar spine.
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Randomized Controlled Trial
Effects of perioperatively administered bupivacaine and bupivacaine-methylprednisolone on pain after lumbar discectomy.
A prospective, randomized, controlled trial that compared the efficacy of different protocols of local tissue infiltration with bupivacaine or bupivacaine-methylprednisolone at the surgical site for pain relief after lumbar discectomy. ⋯ In addition, our data suggest that preemptive infiltration of the wound site with bupivacaine alone provides similar pain control to preemptive infiltration of the wound site with bupivacaine and methylprednisolone combined.
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Review article of medical complications related to adult spinal deformity surgery. ⋯ Awareness of the presentation, treatment, and prevention of medical complications of deformity surgery may allow minimization of their occurrence and optimize treatment should they occur.
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Author experience and literature review. ⋯ Segmental pedicle screw fixation coupled with one of four posterior osteotomy/resection techniques can be used to address most sagittal plain deformities. Careful application of these techniques is important. Smith-Petersen and Ponte osteotomies are most appropriate for long sweeping deformities with mobile anterior columns. Pedicle subtraction osteotomies and vertebral column resections are most appropriate for fixed, sharply angulated spinal deformities. The successful application of these techniques is dependent on accurate preoperative evaluation of the structural properties of the kyphosis and meticulous execution of the surgical technique.
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Review article. ⋯ An appreciation of both the coronal and sagittal plane components of spinal deformity is mandatory to achieve optimal results with surgical stabilization of adult scoliosis.