Spine
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Retrospective review of a defined Marfan population with traditional indications for bracing. ⋯ The success rate for brace treatment of Marfan scoliosis is 17%, which is lower than that reported for idiopathic scoliosis. Possible reasons include increased progressive forces, altered transmission of corrective pressure to the spine, and younger age at inception of bracing. Because there was no control group, it is unknown whether bracing slowed curve progression. Physicians should understand that most patients with Marfan syndrome who have a curve of more than 25 degrees and a Risser sign of 2 or less will reach the surgical range, even with brace treatment.
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This is a retrospective analysis of 23 patients with severe neuromuscular spinal deformity treated with posterior instrumentation and fusion ending in the lumbar spine. ⋯ Posterior instrumentation and arthrodesis using lumbar lower instrumented vertebra pedicle screw anchorage can be performed safely and effectively, in selected patients patients with scoliosis and minimal pelvic obliquity.
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Prospective study. ⋯ Pulmonary function following thoracotomy with ASF with instrumentation demonstrated a significant decline of 3-month postoperative PFT values, but returned to preoperative baseline absolute values (L) by the 2-year follow-up visit. The percent predicted values returned to within 95% of baseline 2 years postoperatively. Scoliosis surgeons should be aware of these findings when deciding upon the approach (anterior versus posterior) utilized for thoracic AIS.
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Outcome study to determine response distribution, internal consistency, and validity of a Modified SRS Outcomes Instrument (MSRSI). ⋯ The SRS Outcomes Instrument is simple and internally consistent. Based on experience, a number of modifications have been made that improve the instruments scope and internal consistency. Finally, the instrument is valid in comparison to SF-36.
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The effect of intense local hypothermia was evaluated in a precision model of spinal canal narrowing and spinal cord injury in rats. The spinal cord injury was cooled with a custom cooling well used over the epidural surface. Basso, Beattie, and Bresnahan (BBB) motor scores and transcranial magnetic motor-evoked potential (tcMMEP) responses were used after injury to accurately evaluate neurologic recovery. ⋯ The results demonstrate that there is a statistically significant (P < 0.05) improvement in neurologic function in rats subjected to hypothermia (19 C) after insertion of a spacer that induced an ischemic spinal cord injury. This indicates that directly applied hypothermia may be beneficial in preventing injury secondary to ischemic cellular damage. The data demonstrated minimal therapeutic benefit of hypothermia (19 C) after a severe spinal cord injury.