Spine
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Retrospective review of the clinical and radiographic results in adult revision spine deformity surgery using the techniques of osteotomies to effect spine balance and curve correction. ⋯ This study demonstrates multiple vertebral osteotomies (anterior and/or posterior) in the management of rigid adult spine deformities and deformity correction with an acceptable complication rate. Use of vertebral osteotomies for patients undergoing revision spine surgery is a safe and reasonable approach to obtain an arthrodesis.
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A case report of cervical myelopathy caused by ossification of the posterior longitudinal ligament in a patient with vitamin D-resistant rickets is presented together with a review of literature. ⋯ Ossification of the posterior longitudinal ligament and ossification of the posterior longitudinal ligament associated with deranged calcium or phosphate metabolism may be different pathologic entities sharing a common outcome. Adequate treatment of vitamin D-resistant rickets may not always prevent or reverse ossification of the posterior longitudinal ligament.
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A study of the transforaminal lumbar interbody fusion and the posterior lumbar interbody fusion techniques was performed. ⋯ In this comparison of patients receiving transforaminal lumbar interbody fusion versus posterior lumbar interbody fusion, no complications occurred with the transforaminal approach, whereas multiple complications were associated with the posterior approach. Similar operative times, blood loss, and duration of hospital stay were obtained in single-level fusions, but significantly less blood loss occurred with the transforaminal lumbar interbody approach in two-level fusions. The transforaminal procedure preserves the interspinous ligaments of the lumbar spine and preserves the contralateral laminar surface as an additional surface for bone graft. It may be performed at all lumbar levels because it avoids significant retraction of the dura and conus medullaris.
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A case of pyogenic spondylitis in S1-S2 is presented. ⋯ Findings from this study show that pyogenic spondylitis can occur in immobile S1-S2.
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Comparative Study
Improved lumbar vertebral interbody fusion using rhOP-1: a comparison of autogenous bone graft, bovine hydroxylapatite (Bio-Oss), and BMP-7 (rhOP-1) in sheep.
After disc removal and monosegmental instrumentation of the sheep lumbar spine, interbody fusion was compared for 6 months after administration of autogenous bone graft, hydroxylapatite, or rhOP-1. ⋯ The results indicate that rhOP-1 use is an appropriate method for improving interbody fusion in the sheep spine. In addition to offering the potential for improved bone healing, rhOP-1 use may permit less invasive surgery such as transpedicular fusion and the use of cages.