Spine
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This study described and compared retroperitoneal and transperitoneal laparoscopic approaches to the lumbar vertebrae in pigs. Technical and perioperative complications were evaluated for each approach. ⋯ The retroperitoneal approach was difficult because of the degree of muscle dissection required for exposure of the lumbar vertebrae. Complications associated with the retroperitoneal approach included loss of pneumoretroperitoneum because of entry into the peritoneal cavity, hemorrhage, and limited exposure of the lumbar vertebrae. The transperitoneal approach was easier technically, allowing identification and access to lumbar vertebral bodies and intervertebral discs from L1-L6/L7. Operative complications associated with the transperitoneal laparoscopic approach were minimal.
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Comparative Study
The morbidity of heparin therapy after development of pulmonary embolus in patients undergoing thoracolumbar or lumbar spinal fusion.
The postoperative course of patients who developed a pulmonary embolus after thoracolumbar or lumbar spinal fusion treated with heparin was studied to quantify the morbidity risk of anticoagulation. ⋯ Heparinization after the development of pulmonary embolus in patients recently undergoing spinal fusion is associated with a high complication rate. The morbidity of vena cava filter placement is low and should be considered a treatment alternative in the treatment of patients who experience pulmonary embolus after surgery.
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Two separate experiments (A and B), each involving six human cadaveric torsos with intact rib cages and sternums, were done to determine the effect of two different sequences of surgical releases (at T8-T9) on thoracic spinal motion. ⋯ These experiments indicate that the combination of rib head resection and radical discectomy may be the optimal thoracic spinal release.
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Biography Historical Article
Description of variations of the sciatica stretch phenomenon.
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This article discusses emerging and conflicting trends in recent Americans with Disabilities Act discrimination legal decisions in which plaintiffs seek compensatory or punitive damages directly from supervisors and their employers, creating potential issues of personal liability for physicians or hospital administrators, for example. Also addressed in the article are potential problems employers face if supervisors are held personally liable for Americans with Disabilities Act discrimination.