Spine
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A prospective analysis. ⋯ In our study the first clinical assessment of a new bone mounted robot system guiding percutaneous pedicle screw placement was done. A deviation <2 mm to the surgeon 's plan in 91.0% to 98.5% verifies the system's accuracy.
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We report the case of a 50 year-old woman with os odontoideum and posterior atlantoaxial subluxation, who underwent an occipitocervical fusion followed by endonasal endoscopic anterior decompression of the cervicomedullary junction (CMJ). ⋯ The endonasal endoscopic approach to the CMJ provides an effective and minimally invasive alternative for anterior decompression of irreducible CMJ pathology.
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Case Reports
Vascular complications from anterior spine surgery in three patients with Ehlers-Danlos syndrome.
A case report of vascular complications arising from anterior spine surgery in 3 patients with Ehlers-Danlos syndrome (EDS). ⋯ These complications may be explained by the fragility of blood vessels secondary to the collagen defect in EDS. Though methods exist to decrease these complications, they may not be enough to prevent catastrophic bleeding. For EDS patients, risk of vascular complications during anterior surgery of the spine is high and surgeons should be aware of this when developing a surgical plan.
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Experimental and intraoperative evaluation of the efficiency of a novel technique. ⋯ Intraosseous ultrasound is a highly reliable technique for the intraoperative assessment of pedicle screw holes before pedicle screw placement. Additional expenses with respect to procedure time and manpower are minimal.
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Randomized Controlled Trial
RhBMP-2 versus iliac crest bone graft for lumbar spine fusion in patients over 60 years of age: a cost-utility study.
Randomized clinical trial. ⋯ There are more complications, increased need for additional treatment and revision surgery in patients over 60 years old receiving ICBG compared with rhBMP-2/ACS. This may account for higher costs and lower improvements in utility seen in patients receiving ICBG compared with rhBMP-2/ACS in this study population.