Spine
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Case Reports
Spine-shortening vertebral osteotomy for tethered cord syndrome: report of three cases.
Retrospective case series. ⋯ Spine-shortening vertebral osteotomy can be a safe and alternative surgical technique for tethered cord syndrome.
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Biomechanical study using human cadaver spines. ⋯ Cervical TDR at 2 levels can provide near-normal mobility at both levels without destabilizing the implanted segments or affecting adjacent segment motions. These observations lend support to the notion that single or multilevel cervical TDR may be advantageous when compared to fusion.
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Experimental study. ⋯ The biomechanical stability of the same size screws inserted at the expanded and nonexpanded pedicles are the same after 3 months. Even dilation of the pedicle decreases the pullout strength of the screw at the beginning, and the pull out strength of both sides became equal after 3 months. The remodeling capacity of pedicles and overgrowth of bone on screws may have an effect on this result.
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Technical note. ⋯ This technique greatly supports surgeons inexperienced in the anterior approach to the upper cervical spine or surgeons at revision surgery who may be lost in and daunted by an unfamiliar operation field surrounded by important structures. Although an anterior approach to the upper cervical spine in the patient with O-C fusion may rarely be required, this application should be considered.
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A retrospective histologic evaluation of biopsies obtained during percutaneous vertebroplasty (PVP) procedures as treatment for presumed osteoporotic vertebral compression fractures. ⋯ Obtaining bone biopsies during PVPs does not lead to increased morbidity and can verify the pathologic process underlying the vertebral compression fractures. Since this study showed an unsuspected malignancy rate of 3.8%, we recommend routine obtainment of a vertebral body bone biopsy, preferably using a biopsy needle with a diameter larger than 14 Gauge (>2.1 mm/0.083 inch), during every PVP procedure.