Spine
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A report of a case of lumbar spine duplication with the clinical appearance of adolescent scoliosis. ⋯ This rare malformation typically has severe neurologic sequelae. Conservative management in the reported patient did not result in a progressive neurologic lesion at the time of skeletal maturity.
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A retrospective radiographic and medical record analysis of 58 patients. ⋯ The use of preoperative dynamic radiographs should improve the selection of patients undergoing laminectomy for the treatment of multilevel cervical cord compression. Dynamic radiographs may also reinforce the need for such adjunctive procedures as fusion and instrumentation, to prevent postoperative destabilization. Preoperative olisthesis with hypermobility in sagittal or horizontal planes must be fused and instrumented.
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A 1-year prospective study of the influence of surveillance methods on the surgical wound infection rates in a tertiary care spinal surgery unit. ⋯ Postdischarge surveillance, surgical procedure classification methods, and the indications for surgery (e.g., trauma, congenital deformity) influence the surgical wound infection rate. Current adjustments for some of these factors in the National Nosocomial Infection Surveillance system appear to be inadequate when used in a tertiary care facility.
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An experimental study on patients undergoing posterior lumbar spine surgery. ⋯ External compression and muscle strain from retractor blades during surgery increased intramuscular pressure in the paravertebral muscles to levels that, according to other studies, induce ischemia in the muscles.