Spine
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The medical records of 138 subjects with Early Onset Scoliosis (EOS) from 5 US institutions were reviewed to analyze their hemoglobin levels before and after surgery. Eighty-five subjects were operated with the Vertical Expandable Prosthetic Titanium Rib (VEPTR) and 53 with growing rods. ⋯ Twenty-three percent of the patients with EOS showed signs of chronic hypoxia. The hemoglobin levels decreased significantly 6 to 24 months after surgery. The greatest effect was observed in subjects with congenital scoliosis and rib fusion and who had an expansion thoracostomy with implantation of VEPTR.
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Prospective inter-rater and intrarater reliability analysis. ⋯ The current grading system for facet arthropathy has only fair agreement. CT is slightly more reliable for grading. Intrarater reliability was only fair for MRI and moderate for CT. Only limited agreement existed between surgeons as to the extent of facet disease that would pose as a contraindication for TDR.
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Prospective study of assessment of surgical results using a new outcome measure for cervical myelopathy, the Japanese Orthopedic Association cervical myelopathy evaluation questionnaire (JOACMEQ). ⋯ JOACMEQ offers an effective method of evaluation from the perspective of patient evaluations of QOL.
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Assessment of different surgical approaches and procedures to remove different types of neurogenic tumors (Types I-IV). ⋯ In surgical resection of sacral neurogenic tumors, surgical approach depends on the location and size of the tumors. Intraspinal tumors should be excised from a posterior approach. For giant neurogenic tumors that arise from the sacrum and involve the spinal canal, surgical resection should be done by a combined anterior-posterior approach. Giant presacral neurogenic tumors located below the S1 level can be removed by a posterior approach. The anterior surgical approach should be used for giant presacral neurogenic tumors that are located above S1 and do not involve the spinal canal.
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Primary clinical trial of limited fixation for unstable Atlas fracture. ⋯ Osteosynthesis of the atlas by C1 lateral mass screws C2 pedicle screws and crosslink compression fixation is an ideal option for C1 burst fracture with or without rupture of the transverse ligament. The procedure allows for partially physiologic reconstruction of the C0-C1-C2 joint and shortens external fixation.