Spine
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Retrospective clinicoradiographic analysis. ⋯ With long fusions to the sacrum, one should anticipate more perioperative complications, a higher pseudarthrosis rate, and perhaps more revision surgery than short fusions. Short fusions may result in a more proximal junctional kyphosis, only rarely requiring revision surgery.
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A retrospective cohort study comparing long-term clinical and radiographical outcomes using selective thoracic instrumented fusion versus long instrumented fusion for the treatment of adolescent idiopathic scoliosis (AIS). ⋯ Spinal balance and correction of the lumbar curve remain stable over time in selective thoracic fusion. Those with selective fusions have outcome measures comparable with those with long fusions.
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Cross-sectional survey. ⋯ Fifty-three percent of the Web sites reviewed were authorized by a private physician group, 4% by an academic physician group, 13% by industry, 16% were news reports, and 14% were not otherwise categorized. Sixty-five percent of Web sites offered a mechanism for direct contact and 19% provided clear patient eligibility criteria. Benefits were expressed in 80% of Web sites, whereas associated risks were described in 35% or less. European experiences were noted in 17% of Web sites, whereas only 9% of Web sites detailed the current US experience. CONCLUSION.: The results of this study demonstrate that much of the content of the Internet-derived information pertaining to the cervical artificial disc replacement is for marketing purposes and may not represent unbiased information. Until we can confirm the content on a Web site to be accurate, patients should be cautioned when using the Internet as a source for health care information related to cervical disc replacement.
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Finite element (FE) method was used to compare the biomechanics of L3-S1 lumbar spine with graded facetectomy before and after placement of Dynesys. ⋯ Partial facetectomy had a minimal effect on range of motion on the Dynesys-implanted segment. However, in the case of total facetectomy the motion increased by almost 40% in flexion and by 200% in axial rotation. The higher stresses applied to the screws in Dynesys in specific loadings may lead to higher risk of screw failure in Dynesys than in a generic rigid fixation construct.
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Propensity score matched retrospective cohort study. ⋯ Fusion patients had greater overall complication rates, increased length of stay, and greater resource utilization but were discharged home in a greater proportion. Both fusion and halo were associated with significant (more than 3-fold) increase in complication rates in elderly patients aged 80 years or older. Given the similar mortality rate between the fusion group and the halo group and the higher cost and complication rate in the fusion group, our study supports the use of halo-vest immobilization in patients where operative therapy is contraindicated.