Spine
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Multicenter Study
Identification of decision criteria for revision surgery among patients with proximal junctional failure after surgical treatment of spinal deformity.
Multicenter, retrospective, consecutive case series. ⋯ The decision to perform revision surgery is complicated and varies by surgeon. Factors that seem to influence this decision include traumatic etiology of PJF, severity of proximal junctional kyphosis angulation, higher SVA, and female sex. Factors that were expected to influence revision but had no statistical effect included soft tissue versus bony mode of failure, age, levels fused, and upper thoracic versus thoracolumbar proximal junction.
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Randomized Controlled Trial
A randomized prospective evaluation of 3 techniques of postoperative pain management after posterior spinal instrumentation and fusion.
Randomized prospective trial. ⋯ These data document that the double CEA most effectively controls postoperative pain after surgery for AIS. The single CEA trended toward having the fewest side effects when compared with the other techniques. On the basis these findings, we now routinely use the double CEA technique for all patients having surgery for AIS.
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Secondary analysis of the prospectively collected Veterans Affairs National Surgical Quality Improvement Program database. ⋯ ASA class, age, type of surgery, insulin or corticosteroid use, and functional status were independent risk factors for major medical complications. These factors may help in selecting patients and planning procedures, improving patient safety.
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A cross-sectional study. ⋯ The prevalence of thoracic OYL in Japanese was 36%. A further study disclosing the association between clinical manifestations and size and/or morphology of OYL is warranted.
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A computed tomography study. ⋯ In addition to the smaller preoperative CWA and higher apex location, lesser correction of vertebral rotation, if accompanied by great surgical correction of apical VT, could also largely result in a poor postoperative anterior chest wall contour.