The spine journal : official journal of the North American Spine Society
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Acute correction of severe spinal deformities significantly increases the risk of neurologic complications. Previously used methods to safely correct these deformities include halo-traction devices and internal distraction rods. ⋯ This report is the first to note the safety and efficacy of the MCGR in treating young patients with severe spinal deformities. This technique allows correction of the deformity while the patient is awake so that neurology can be continuously monitored. The patient is also ambulatory throughout the distraction process and can be distracted on an outpatient basis. Repeated surgery can be avoided, and the MCGR has been shown to be safe and effective with this case illustration.
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Neuromuscular scoliosis could develop at a young age and progress beyond skeletal maturity. An early spinal fusion arrests growth of the spine and thorax, risking the development of secondary thoracic insufficiency syndrome. Vertical expandable prosthetic titanium rib (VEPTR) is a fusionless technique aiming at correction of the deformity with preservation of growth potential. ⋯ Early results of VEPTR for neuromuscular scoliosis are encouraging. Follow-up till skeletal maturity will best determine future indications.
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Plasmablastic lymphoma (PBL) is a rare aggressive variant of diffuse large B-cell lymphoma. ⋯ We report the case of an aggressive PBL presenting as acute spinal cord compression requiring urgent surgical intervention, on a background of undiagnosed HIV infection.
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The existing evidence suggests that, although older spinal cord injury (SCI) patients experience a similar degree of neurologic recovery to younger patients, older patients experience diminished functional outcomes at follow-up. However, all studies have assumed that the impact of age on functional outcome is the same across the spectrum of injury severity. ⋯ Overall, advanced age is associated with worse functional outcome after SCI; however, this effect varies across the spectrum of injury severity. These results will help to facilitate enhanced clinical communication as well as potentially aid in the development of customized treatment and rehabilitation protocols.
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Among the various forms of laminoplasty fixation, plate augmentation provides a semirigid arch reconstruction and is gaining popularity as the result of its safety and effectiveness. However, the effects of this procedure on hinge status and subsequent bony healing remain unclear. ⋯ Although plate-only, open-door laminoplasty is a safe and reliable surgery for decompression of multilevel cervical disease, the fixation that it provides on the open side may not be sufficiently stable to allow successful primary healing. Additional attention should be paid to the hinged side to prevent delayed fracture in the early postoperative period and to reduce postoperative axial pain.