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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Disorders in occipitocervical region are difficult to treat. Complications often occur after fusion surgery and may be life-threatening in severe cases. This study is to investigate the causes and treatment strategies for the postoperative complications of occipitocervical fusion. ⋯ The surgery of occipitocervical fusion carries a relative high risk for complications, especially if no instrumentation is used. The key points in reducing complications are the surgeon's familiarity with the anatomy of occipitocervical region and the appropriate internal fixation.
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To investigate and compare blood losses intra and postoperatively between lumbar fusion patients with and without antiplatelet use. ⋯ Aspirin significantly increases the risk of bleeding in patients undergoing lumbar fusion at two or more levels. This risk is present even in patients who discontinued aspirin 1 week prior to surgery. In patients with high risk of complications resulting from aspirin discontinuation, the use should be allowed in lumbar fusion surgery. However, strong attention must be paid to avoid excessive bleeding. Because NSAID use also increases surgical blood loss, proper interval from discontinuation to surgery must be granted to minimize the risk.
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The axis body fractures are relatively uncommon and have a variety of presentations. Surgical management to them has been only reported as case reports or included as a minor part of clinical management. The objective of this study is to summarize the indications for surgery and report the clinical outcome of surgical treatment based on different fracture patterns. ⋯ Conservative treatment is still advocated as primary management for most axis body fractures. But for patients with obvious adjacent joints instability or irreducible displaced superior articular facet fracture, surgical intervention based on the different fracture pattern is necessary.
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We document a spinal extradual arachnoid cyst treated by twist technique. The cyst is tightly adherent to the neural tissue or the dura, and the communication stalk is little or short. ⋯ Twist technique can be seen safe and effective as another surgical option for spinal extradural arachnoid cysts containing a short stalk and dense fibrous adhesion with the dura mater.
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Cervical range of motion (RoM) has been the subject of many studies. However, only very few of these studies have considered the influence of movement execution speed on the cervical kinematics. The aim of this study is to evaluate the influence of movement speed on cervical RoM. ⋯ The range of motion reported in the literature corresponds to movement carried out in a mode resembling the best possible of our study. Movements made as quickly as possible can display larger motion ranges.