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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Case Reports
Congenital kypho-scoliosis: a case of thoracic insufficiency syndrome and the limitations of treatment.
Congenital spinal vertebral anomalies may present with deformity resulting in congenital scoliosis and kyphosis. This leads to abnormal spinal growth. The latter when combined with associated rib fusions may impair normal thoracic cage development and resultant pulmonary hypoplasia. Most congenital scoliosis can be detected in utero by ultrasound scan or recognized in the neonatal period, but a few spinal defects can remain undetected. ⋯ This article highlights the features of congenital kypho-scoliosis and TIS. The difficulties of treating kyphosis when combined with TIS are discussed together with the limitations of current surgical techniques.
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Spinal epidural lipomatosis (SEL) is a rare but well-recognized condition. In general, the onset of its symptoms is insidious and the disease progresses slowly. ⋯ These SEL patients developed neurologic symptoms after less than 5 months; these symptoms were confirmed to be due to SEL by serial MR images. After the debulking of the epidural fat, their symptoms improved.
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Although pedicle screw fixation has been increasingly used in the upper thoracic spine in recent years, controversies exist about the safety and complications such as nerve or vascular intrusion associated with the technique. In this study, an alternative method of transarticular screw fixation was validated. ⋯ The morphometric data of C7-T3 zygapophysial joints indicate the suitable screw diameter and screw length for this technique. Transarticular screw fixation proved to be a potentially safe alternative to pedicle screw fixation in this region.
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Lateral lumbar interbody fusion (LLIF) is a minimally invasive technique that has gained growing interest in recent years. We performed a retrospective review of the medical records and operative reports of patients undergoing LLIF between March 2006 and December 2009. We seek to identify the incidence and nature of neurological deficits following LLIF. ⋯ LLIF is a valuable tool for achieving fusion through a minimally invasive approach with little risk to neurovascular structures.
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Does hormone replacement therapy prevent lateral rotatory spondylolisthesis in postmenopausal women?
Degenerative scoliosis usually begins at menopause and lateral rotatory olisthesis (LRO) might be a triggering factor in the onset of degenerative scoliosis in postmenopausal women. We set out to evaluate the influence of hormone replacement therapy (HRT) on degenerative scoliosis and on LRO. ⋯ LRO was significantly lower in women who received HRT. The excess risk of LRO was dependent on both age and HRT status. These findings suggest that HRT might prevent the onset of LRO, and therefore might contribute to the prevention of low back pain.