The spine journal : official journal of the North American Spine Society
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Incidental durotomies occur in up to 17% of spinal operations. Controversy exists regarding the short- and long-term consequences of durotomies. ⋯ Within the context of an on-going debate on the consequences of incidental durotomy, we found no difference in neurologic symptoms, infection, reoperation, back pain, leg pain, or functional disability over a 2-year follow-up period.
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Traditionally, the "dynamic" and "static" types of spondylolisthesis have been lumped into a single group in the literature. The goal of this study was to define the radiographic characteristics of "dynamic" and "static" spondylolisthesis with the use of magnetic resonance imaging (MRI) and flexion/extension radiographs. ⋯ The presence of FF and/or ISF is associated with instability greater than 3 mm in flexion/extension radiographs.
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There is a persistent trend for more outpatient lumbar discectomies in the United States. ⋯ Access to ambulatory lumbar discectomies appears to be more common for younger, white, male patients, with private insurance and less comorbidities, in the setting of higher volume hospitals. Further investigation is needed in the direction of mapping these disparities for appropriate resource utilization.
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Perioperative visual loss (POVL) is a rare but devastating complication that may follow spinal surgeries. The incidence of POVL after spinal fusion is not well characterized during the past decade. ⋯ Our findings demonstrated an overall POVL incidence of 1.9 events per 10,000 spinal fusions. Patients undergoing thoracic fusion for deformity correction accounted for the majority of cases of POVL. Despite being a rare complication after spinal fusion, POVL is an adverse event that may not be entirely preventable. Patients undergoing long-segment fusions for deformity and those with certain risk factors should be counseled regarding the risks of POVL.
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Hypoalbuminemia is associated with increased morbidity and mortality in various clinical settings and several major diseases. Albumin has multiple physiologic properties that could be beneficial in central nervous system injury. ⋯ Similar to the ASIA scale and neurologic level, persistent hypoalbuminemia seems to be an independent predictor of outcome in patients with CSCI. Thus, a randomized trial assessing albumin in the treatment of cervical spinal cord injury is warranted.