Spine
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Retrospective review of the medical, radiographic, surgical, and postoperative records of patients who underwent resection of multilevel intradural extramedullary spinal cord tumors of the ventral cervical and cervicothoracic spine via a modified paramedian transpedicular approach at the University of California, San Francisco, between 2003 and 2005. ⋯ The modified paramedian transpedicular approach with partial dorsal corpectomy we describe here is a variation of traditional thoracic posterolateral transpedicular extracavitary approaches and offers direct access to lesions of the ventral cervicothoracic spinal canal. This approach avoids the morbidity of anterior transcervical, transoral, or transthoracic procedures, while providing a view of the entire ventral cervicothoracic canal, and can be performed safely and effectively in select patients.
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This is an in vitro biomechanical study. ⋯ Results from our study revealed greater adjacent level motion following all 3 fixation types. No consistent significant intergroup differences in neighboring segment kinematics were detected among reconstructions. Circumferential fixation provided the greatest level of segmental stability without additional significant increase in adjacent level ROM.
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Retrospective clinical and radiologic evaluation of posterior C1-C2 fusion by transarticular screw (TAS) with morselized autograft and without additional internal fixation. ⋯ Bilateral transarticular screws alone and morselized grafts have high fusion rate in atlantoaxial arthrodesis without instrument failure. TAS fixation could provide stability that is clinically equivalent to the standard screws plus tension band construct as described by Magerl. With anatomic reduction and ideal screw position, additional internal fixation and postoperative collar are not necessary.
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Comparative Study
Long-term results of one-level lumbar arthroplasty: minimum 10-year follow-up of the CHARITE artificial disc in 106 patients.
A retrospective chart and radiographic review. ⋯ This retrospective study demonstrates the safety and efficacy of the CHARITE Artificial Disc at one level, either L4-L5 or L5-S1, in the long-term. Clinical outcomes and the rate of return to work were excellent overall. The rate of adjacent-level disease requiring surgical intervention was considerably lower (2.8%) compared with reports in the literature for lumbar fusion. As with any surgical procedure, proper indications play a pivotal role in clinical success.
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A prospective, cohort clinical and magnetic resonance imaging (MRI) study of patients with low back pain. ⋯ Early DD in adolescent patients with low back pain predicted the evolution of enhanced DD and herniation in adulthood, but it was not associated with severe low back pain or increased frequency of spinal surgery.