Spine
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Retrospective matched cohort analysis. ⋯ Post-only adult scoliosis surgery achieved similar correction to A/P surgery while decreasing blood loss, operative time, length of stay, and avoiding additional anesthesia. Complications, radiographic, and clinical outcomes were similar at over 2-year follow-up.
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Retrospective case-control study. ⋯ Cell saver use decreased allogeneic transfusion, particularly in surgeries >6 hours with estimated blood loss >30% of total blood volume. This study confirms the utility of routine cell saver use during PSF with segmental spinal instrumentation for idiopathic scoliosis.
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Case Reports
Anteroposterior spondyloschisis of atlas with incurving of the posterior arch causing compressive myelopathy.
A case report of a patient with a combined anterior and posterior arch anomaly of atlas leading to compressive myelopathy. ⋯ We describe the association between compressive myelopathy and combined anteroposterior spondyloschisis of an atlas with incurving of the arch at defect site. Both computed tomography and magnetic resonance image were required to demonstrate the bony configuration and cord compression. And decompressive laminectomy of atlas was effective as a treatment for this compressive myelopathy caused by midline defect in the posterior atlantal arch with bony incurving.
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Comparative Study
Can we safely reduce blood loss during lumbar pedicle subtraction osteotomy procedures using tranexamic acid or aprotinin? A comparative study with controls.
Retrospective, observational study. ⋯ The aprotinin treatment group lost significantly less blood and received significantly fewer blood transfusions than both the tranexamic acid and control groups without significant differences in intra- and postoperative complications. These results may justify further study of aprotinin and other antifibrinolytics for this specific indication (3-column lumbar osteotomies in the adult spinal deformity population). A multicenter randomized comparative analysis would be ideal.
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A retrospective study. ⋯ Dynamic stabilization with pedicle screws in addition to decompressive laminectomy resulted a safe procedure in elderly patients with degenerative lumbar scoliosis; it was able to maintain enough stability to prevent progression of scoliosis and instability, enabling a wide laminectomy in cases of associated lumbar stenosis. This nonfusion stabilization technique was less aggressive than instrumented fusion and obtained a statistically significant improvement of the clinical outcome at last follow-up.