Spine
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A retrospective cohort study in the general population of Switzerland. ⋯ BP history is highly predictive for future BP episodes.
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STUDY DESIGN.: Retrospective clinical data analysis. OBJECTIVE.: To investigate and verify our philosophy of spontaneous slip reduction following circumferential release via bilateral minimally invasive transforaminal lumbar interbody fusion (Mini-TLIF) for treatment of low-grade symptomatic isthmic spondylolisthesis. SUMMARY OF BACKGROUND DATA.: Symptomatic isthmic spondylolisthesis usually requires surgical intervention, and the most currently controversial focus is on method and degree of reduction; and Mini-TLIF is an attractive surgical procedure for isthmic spondylolisthesis. ⋯ The procedure can be well performed via Mini-TLIF, the outcome of which is equally gratifying to that of instrumented slip reduction and traditional midline approach. There is no need to fully reduce the slipped vertebrae. Circumferential release contributes to achieving spontaneous slip reduction partially, which aids sufficiently in the surgical treatment of low-grade isthmic spondylolisthesis.
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A prospective observational cohort study of consecutive osteoporotic vertebral compression fractures (VCFs) in ≥ 90-year-old patients evaluated at a multidisciplinary, university spine center. ⋯ Vertebroplasty for VCFs in the very elderly appears effective and safe without increased risk of adjacent level fracture.
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Case Reports
Inadvertent injection of a cervical radicular artery using an atraumatic pencil-point needle.
Case report and review of the literature. ⋯ This case demonstrates that the use of pencil-point (Whitacre) needles does not eliminate the risk of inadvertent arterial injection during cervical transforaminal epidurals. Further investigation is required to determine whether the incidence of inadvertent vascular injection is reduced with pencil-point needles compared with sharp-beveled needles.
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Randomized Controlled Trial Comparative Study
Repeat use of human recombinant bone morphogenetic protein-2 for second level lumbar arthrodesis.
Prospective randomized controlled animal model. ⋯ rhBMP-2 appears to be successful in promoting intertransverse fusions when used in both primary and repeat fusion environments. The infrequent development of antibodies to rhBMP-2 after re-exposure occurs without a predictable time course suggesting that host immunologic variation may play a role. This animal study would tend to support early clinical data emerging on the reuse of BMP-2 for lumbar fusion, suggesting an acceptable fusion rate without a high incidence of complications.