Spine
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OBJECTIVES AND SUMMARY OF BACKGROUND DATA: Cerebrospinal fluid fistula after spinal surgery is associated with a definite risk of meningitis or discitis, and as a result, early active intervention usually is recommended. ⋯ The techniques involved in performing a blood patch after spinal surgery may well differ from those usually recommended in the management of spinal headache resulting from other causes of dural puncture.
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A retrospective study of all patients who underwent spinal fusion between 1986 to 1989 with inexpensive, locally made unconventional pedicle spinal instrumentation systems was undertaken. Implants were made with passivated 316L stainless steel, and a single level of instrumentation cost +f430. ⋯ Anterior column reconstruction in anterior column deficient spines will re-create the normal biomechanics and significantly reduce the incidence of implant failures and loss of sagittal alignment with these systems. Pedicle screw failure in itself is not necessarily associated with a bad result. These inexpensive, locally made unconventional systems, with the proper understanding of biomechanics and creation of appropriate load-sharing constructs, are as good as the conventional systems available today.