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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We have revealed that the cause of postoperative dyspnea and/or dysphagia after occipito-cervical (O-C) fusion is mechanical stenosis of the oropharyngeal space and the O-C2 alignment, rather than total or subaxial alignment, is the key to the development of dyspnea and/or dysphagia. The purpose of this study was to confirm the impact of occipito-C2 angle (O-C2A) on the oropharyngeal space and to investigate the chronological impact of a fixed O-C2A on the oropharyngeal space and dyspnea and/or dysphagia after O-C fusion. ⋯ The O-C2A established at O-C fusion dictates the patient's destiny in terms of postoperative dyspnea and/or dysphagia. Surgeons should pay maximal attention when establishing the O-C2A during surgery, because their careless decision for the O-C2A may cause persistent dysphagia or a life-threatening consequence. We recommend that the O-C2A in O-C fusion should be kept at least at more than the preoperative O-C2A in the neutral position.
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The purpose of this study was to report the incidence of dural tear (DT) in spine surgery, risk factors, and patient outcomes on a national level. ⋯ The reported incidence of DT in spine surgery was 2.7 % in the US. Risk factors included older age, female gender, increased comorbidities, and high hospital caseload. DT increased the rate of in-hospital complications and mortality and health care burdens.
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Assessment of the integrity of the multifidus muscles and corresponding nerve roots, post-open (OSS) versus minimally invasive spinal surgery (MISS) for lumbar spine fractures. ⋯ Posterior instrumented MISS demonstrates a significantly superior preservation of the medial branch of the posterior ramus of the spinal nerve and less muscle atrophy, particularly at adjacent levels when compared to OSS.
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To summarise our experience treating patients with spinal angiolipomas (SAs) and to evaluate factors relating to its prognosis. ⋯ Diagnosis of SAs should be made with reference to clinical, radiological, and pathological findings. Application of different methods is needed to treat SAs.
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Previous work has suggested that progression of experimental scoliotic curves in pinealectomized chicken and bipedal C57BL6 mice models may be prevented and reversed with Tamoxifen treatment. Raloxifene is another Selective Estrogen Receptor Modulator (SERM) with estrogen agonist effects on bone and increases bone density but with fewer side effects on humans. To investigate whether scoliosis progression in bipedal C57Bl6 mice model could be prevented with SERM treatment and the mechanisms associated with this effect. ⋯ Treatment with TMX or RLX did not reduce the incidence of scoliosis but decreased the curve magnitudes at 40 weeks. The underlying mechanism associated with the decrease in curve magnitudes may be the early maturation of growth plates, thereby possible deceleration of the growth rate of the vertebral column and increase in bone density. RLX is as effective as TMX in preventing the progression of scoliotic curves in melatonin deficient bipedal mice.