Spine
-
A long-term, population based, retrospective follow-up study. ⋯ Brace treatment does not prevent progression of the spinal deformity in patients with DD. Anteroposterior surgery is indicated in patients with severe spinal deformities. The risk for major complications is high especially in patients with marked kyphosis.
-
Retrospective study of 20 consecutive patients who underwent en bloc tumor excision of sacral chordomas and chondrosarcomas. ⋯ Wide or marginal en bloc excision of sacral chordoma and chondrosarcoma is associated with significant improvement in disease-free survival with acceptable perioperative morbidity rate.
-
Retrospective review. ⋯ There is a significant learning curve associated with thoracic pedicle screw placement in AIS. We describe several technical steps that can be taken to increase the safety of screw placement at the beginning of the learning curve. Inexperienced surgeons should expect a gradual improvement over time in radiographic and clinical outcomes.
-
Case series. ⋯ Notwithstanding high sensitivities, specificities, and negative predictive values for cervical spine imaging and "clearance" mechanisms, 4 cases that illustrate the potential for undetected unstable cervical spine injuries are presented. Tremendous advancements in medical imaging have been made. However, radiograph, CT, and MR imaging may still fail to accurately translate the anatomic and dynamic complexity of the cervical spine into digital images that accurately guide clinical practice. A full understanding of and keen appreciation for the fact that no imaging technique, classification method, or clearance protocol can produce 100% sensitivity at all times is essential. These case reports cumulatively demonstrate a 0.04% to 0.2% incidence of undetected cervical injury requiring surgical stabilization. Removing cervical collar immobilization as quickly as possible based on negative interpretation of imaging data may prove harmful in a measurable percentage of patients and must be undertaken with caution only after clinical correlation and strict follow-up is established.
-
Retrospective clinical outcome study. ⋯ Despite the perioperative difficulties seen with CP patients, the majority of the patient/parents were satisfied with the results of the spinal deformity surgery. Functional improvements were limited but 8% to 40% of the patients still perceived the results as improved. The reason for less than optimal satisfaction appears to be due to less correction of the major curve, greater residual major Cobb angle, hyperlordosis of the lumbar spine after surgery, and late postoperative complications.