Spine
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Retrospective cohort study of consecutive patients undergoing primary fusion with segmental fixation for adult spinal deformity. ⋯ Using a strict definition of reoperation for a well-defined cohort, in the presence of relevant risk factors, many patients undergoing primary fusion for adult spinal deformity required reoperation. The results indicate that complex medical and surgical factors contribute to the treatment challenges posed by patients with adult spinal deformity. This represents the largest cohort reported to date of patients undergoing primary fusion using third-generation instrumentation techniques.
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A matched cohort comparison of adult idiopathic scoliosis (AdIS) patients treated with all pedicle screw constructs compared to hook/hybrid constructs. ⋯ Pedicle screw correction of AdIS is safe and effective. Compared to hook/hybrid constructs, these patients displayed significantly improved correction of the major curve (even in the absence of anterior releases), maintenance of thoracic kyphosis, and a lower revision rate. Similar SRS scores and blood loss were noted. The hook/hybrid patients had significantly longer operative times. The use of BMP-2 in 7 patients and TLIF/ALIF also in 7 of the pedicle screw patients may have decreased the need for revision surgery up to the latest follow-up.
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A case report and clinical discussion. ⋯ This case report illustrates a rare but life-threatening complication of oxygen-ozone therapy for the cervical disc herniation. Infection is a common risk for any invasive spinal techniques involving puncture, so attention should be paid to the sterility during the procedures. A high index of suspicion along with reliance on enhanced-MRI is essential to diagnose the condition and institute appropriate treatment on an individual basis.
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An anatomic, epidemiologic study of lumbar and cervical arthrosis in cadaveric spines. ⋯ Concurrent lumbar and cervical arthrosis is a common condition. Lumbar arthrosis and advancing age are associated with cervical arthrosis independent of race and sex. Lumbar arthrosis precedes cervical arthrosis. These findings suggest an underlying systemic component for spinal osteoarthritis.
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An analysis of clinical and radiographic data of 40 consecutive patients with fixed sagittal imbalance. ⋯ PI and TK can predict the lumbar lordosis necessary to correct sagittal imbalance in patients under-going PSO with high sensitivity. Sagittal correction and clinical outcome scores were equivalent comparing PSO's performed at L2 and L3. Patients with degenerative sagittal imbalance and those with shorter fusions are more likely to lose correction with time.