Spine
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Case Reports Comparative Study
Can intramedullary signal change on magnetic resonance imaging predict surgical outcome in cervical spondylotic myelopathy?
A retrospective study evaluating magnetic resonance imaging, computed tomographic myelography, and clinical parameters in patients with cervical spondylotic myelopathy. ⋯ Patients with multisegmental areas of high signal intensity on T2-weighted magnetic resonance images tended to have poorer surgical results. However, the transverse area of the spinal cord at the level of maximum compression was a better prognostic indicator.
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Comparative Study
The publication rates of presentations at major Spine Specialty Society meetings (NASS, SRS, ISSLS).
A review of all the presentations at three major spine specialty meetings held over a 3-year period. ⋯ The publication rates of presentations at three major spine specialty meetings are high and quite comparable with the publication rates of meetings in other medical subspecialties. This reflects the high quality of the meeting programs and validates their selection process.
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Comparative Study
Biomechanical analysis of anterior versus circumferential spinal reconstruction for various anatomic stages of tumor lesions.
Spinal reconstruction procedures for metastasis evaluated biomechanically using human cadaver specimens. ⋯ For corpectomy or subtotal spondylectomy, anterior reconstruction alone can provide stiffness equivalent to circumferential reconstruction. However, total spondylectomy significantly reduces the anterior reconstruction stiffness, suggesting the need for combined anterior and posterior procedures.
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Multicenter Study Comparative Study Clinical Trial
Laparoscopic fusion of the lumbar spine: minimally invasive spine surgery. A prospective multicenter study evaluating open and laparoscopic lumbar fusion.
Two hundred-forty consecutive patients underwent laparoscopic instrumented interbody fusion using custom-designed instrumentation and BAK (Sulzer Spine Tech, Minneapolis, MN) fusion cages. The surgeries were performed at eight spine centers during U.S. Food and Drug Administration investigational device evaluation clinical trials. This cohort was compared with 591 consecutive patients undergoing open anterior fusion with the same device. ⋯ The laparoscopic procedure is associated with a learning curve, but once mastered, it is effective and safe when compared with open techniques of fusion.
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Comparative Study
Nonsurgical treatment of three-column thoracolumbar junction burst fractures without neurologic deficit.
Retrospective review of the outcome of neurologically intact patients with three column thoracolumbar junction burst fractures that were treated nonsurgically. ⋯ Despite the use of less restrictive criteria, no brace, and early activity as tolerated, the results are similar to those obtained with more restrictive protocols. The presence of vertical lamina fracture, spinous process fracture, and transverse process fracture are not contra--indications. Activity restriction and bracing may be important for pain control but probably does not change the long-term result.