Spine
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A systematic literature review and consensus using Delphi method. ⋯ Pediatric age is a modifier for the management of Chiari Malformation (CM). Prompt diagnosis and appropriate decompressive surgery with duraplasty before puberty are essential to mitigate the impact of the condition on the child's well-being. Increased awareness among healthcare professionals, timely access to specialized expertise in neurosurgical interventions are crucial, especially for type 2 CM patients that require urgent decompression of CVJ and cervical spine.
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Systematic review plus expert opinion framed on Delphi Method. ⋯ Consent was achieved on treatment recommendations for patients with syndromic disorders of the CVJ, with special focus laid on participation in physical activity and sports competitions. This should help spine surgeons and sports medicine doctors decide on a management path for each individual patient.
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Retrospective cohort study. ⋯ Receiving ketorolac within two days after ACDF does not appear to be associated with an increased risk of pseudoarthrosis through four years follow-up in adults. Furthermore, there appears to be no meaningful difference in risk of reoperation, severe bleeding, and oral opioid prescriptions, although secondary outcomes should be interpreted with caution. Further corroboration is warranted.
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A systematic literature review and consensus using Delphi method. ⋯ The consensus statements created by a collaborative work provide useful information for surgeons treating CM worldwide in order to achieve better surgical outcomes and avoid complications.
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Systematic literature review plus expert opinion framed on Delphi method. ⋯ In patients with BI, concomitant CMI is a modifier of surgical management. In BI with AAD, an additional foramen magnum decompression should be added to posterior C1-C2 realignment and fusion. In BI without AAD, whether treatment is restricted to FMD or C1/2 fusion is required on top or alternatively, demands further studies. Odontoid resections are reserved for patients with insufficient alignment after posterior surgery.