Spine
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Systematic review. ⋯ Despite the lack of well-designed prospective studies to establish the efficacy of instrumentation in these cases, there remains very low evidence that supports the use of instrumentation in unstable pediatric spines to prevent neurologic injury and maintain spinal alignment. The very low evidence of benefits from early bracing clearly outweighs the risks and complications associated with its use. Close monitoring should be initiated early so as to delay surgical correction as late as possible. There is very low evidence to support the use of surgery for the treatment of deformity triggered by a SCI. There may be evidence suggesting that the correction techniques used for neuromuscular deformities are useful for SCI patients. In conclusion, there is a strong recommendation for the use of instrumentation in the unstable pediatric spinal injured population, and there is a strong recommendation for traditional neuromuscular spinal deformity treatment techniques to be adopted as a treatment of progressive spinal deformities after a neurologic injury.
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Literature review of basic scientific and clinical research in spinal cord injury (SCI). ⋯ The SCI community is encouraged by the progression of novel therapies from "bench to bedside" and the initiation of clinical trials for a number of different treatments. The task of clinical evaluation, however, is substantial, and many years will be required before the actual efficacy of the treatments currently in evaluation will be determined.
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A case report is presented. ⋯ Although so-called "en bloc" lumbar fractures have been previously described, the authors were unable to find any injury of this degree in the literature. This rare injury seems to show a pattern of spinal injury previously undescribed.
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Retrospective case series review. ⋯ At least 1 myelopathic sign is universal in severe SCM patients. However, individual myelopathic signs cannot alone diagnose disease in all patients. The benefit of laminoplasty is apparent in immediate postoperative period (<7 days), but it is maximum in first 6 months after which the recovery stabilized or these are a marginal improvement. Similarly, the resolution of signs is maximum in period of first 6 months, which parallels recovery. Babinski and inverted brachioradialis reflex revert to normal in most patients and can serve as markers of relapse in long follow-up. Hoffman is not a sensitive test and is likely to persist in patient with severe cord changes.