Spine
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Retrospective case series of surgically treated adult scoliosis patients. ⋯ Despite the occurrence of PJK in 20% of adult scoliosis patients undergoing long fusion, no significant differences were found in SRS outcome scores and ODI in PJK and non-PJK patients. Fusion to the sacrum and posterior fusion with segmental instrumentation were identified as risk factors. PJK can be minimized by post-operative normalization of global sagittal alignment. A simplified classification based in severity type of PJK showed the majority in class 1A (ligamentous lesion and mild deformity).
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Prospective analysis of 600 extreme lateral interbody fusion (XLIF) approach procedures for intraoperative and perioperative complications. ⋯ Compared with traditional open approaches, the MIS lateral approach to fusion by using the XLIF technique resulted in a lower incidence of infection, visceral and neurologic injury, and transfusion as well as markedly shorter hospitalization. Complications in MIS XLIF compare favorably with those from other MIS fusion procedures; duration of hospitalization is shorter than with any previously reported technique.
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Comparative Study
Strengths and limitations of International Classification of Disease Ninth Revision Clinical Modification codes in defining cervical spine surgery.
Retrospective study. ⋯ The use of our ICD9-CM algorithm to define spine surgery at the cervical spine level, and degenerative cervical spine surgery is highly accurate. Although specific diagnoses codes are mostly insensitive, an ICD9-CM algorithm can be used to study these procedures with reasonable precision.
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Comparative Study
Comparison of magnetic resonance imaging and computed tomogram-myelography for evaluation of cross sections of cervical spinal morphology.
Comparison of magnetic resonance imaging (MRI) and computed tomography-myelography (CTM) for cervical intracanalar dimensions. ⋯ Both CTM and MRI provided reproducible measurements of cervical intracanalar dimensions. Measurements of dura were slightly larger in CTM, whereas measurements of spinal cord were slightly larger in MRI, making stenosis more severe in MRI than in CTM. The clinical relevance of these slight differences requires further examination.
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Cross-sectional study with prospective recruitment. OBJECTIVE.: To determine the accuracy of the physical examination for the diagnosis of midlumbar nerve root impingement (L2, L3, or L4), low lumbar nerve root impingement (L5 or S1) and level-specific lumbar nerve root impingement on magnetic resonance imaging, using individual tests and combinations of tests. ⋯ Individual physical examination tests may provide clinical information that substantially alters the likelihood that midlumbar impingement, low lumbar impingement, or level-specific impingement is present. Test combinations improve diagnostic accuracy for midlum-bar impingement.