European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Surgical treatment of spinal deformities in Duchenne muscular dystrophy (DMD) is influenced by a number of factors which have proven to be a difficult challenge. Each case should be carefully evaluated, considering not only the natural history of the spinal deformity, but also the patient's general condition. These should be thoroughly assessed through clinical and radiographic investigations together with other medical specialists. Life expectancy should be determined according to the cardio-respiratory function, and both preoperative and postoperative quality of life should be taken into consideration, trying to imagine the functional status of each patient after surgery. ⋯ According to the present study, an early surgery (angular value lower than 35-40 degrees) dramatically reduces the rate of risk factors associated with spinal deformities in DMD, and its advantages far exceed the disadvantages, above all in terms of quality of life.
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To date, only three cases of artificial disc prosthesis dislocation have been reported in the literature. We present in detail two additional cases of prosthesis dislocation and discuss the surgical interventions undertaken that resulted in a good clinical outcome in both patients.
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We studied the relationship between whiplash injury and personality in 40 whiplash patients who admitted the hospital within 8 h from the car accident and 80 age- and gender-matched controls. For this purpose we used the Temperament and Character Inventory (TCI). ⋯ According to our results personality symptoms related to whiplash injury is probably not a secondary phenomenon. Whiplash patients were normally developed in character, i.e., self-directedness (SD), and CO (cooperativeness) and therefore in general are capable of coping with their somatic problems.
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The recommended surgical options for postoperative wound infections after instrumented spine surgery include a wide debridement and irrigation with antibiotics. In most cases, implant removal is not recommended for a solid fusion. However, there are few reports on the treatment choices for persistent postoperative wound infections following a posterior lumbar interbody fusion (PLIF) using cages. ⋯ Despite the anterior interbody fusion with an autogenous iliac bone graft, all cases had a complete collapse of the intervertebral disc space, without a dislodgement or collapse of the graft bone. The mean loss of the height and lordosis in the involved segment was 12.7 mm (range 4-46 mm) and 5.6 degrees (range 0-15 degrees ), respectively. Anterior radical debridement with the removal of all implants would be an effective way to manage patients with postoperative spondylitis after a PLIF using cages.