Spine
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A clinical retrospective study was conducted. ⋯ Partial reduction followed by posterior interbody fusion is an effective technique for the management of high-grade spondylolisthesis in pediatric and adult patient populations, as assessed by radiographic and clinical criteria. Pedicle screw instrumentation with the sacral screws capturing L5 is recommended when this technique is used for the treatment of high-grade spondylolisthesis. According to the clinical and radiographic results from this study, partial reduction and posterior fibula interbody fusion supplemented with pedicle screw instrumentation is an effective technique for select patients with high-grade spondylolisthesis at L5-S1.
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Human cadaver lumbar spines were used to assess the acute effects of intradiscal electrothermal therapy in vitro. ⋯ The data from this study suggest that the temperatures developed during intradiscal electrothermal therapy are insufficient to alter collagen architecture or stiffen the treated motion segment acutely.
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Case Reports
Transpedicular eggshell osteotomies for congenital scoliosis using frameless stereotactic guidance.
Three cases of multiplanar congenital scoliosis corrected by a transpedicular eggshell osteotomy using frameless stereotactic guidance are reported. ⋯ One-stage posterior reduction eggshell osteotomy can be used to correct a sagittal and/or coronal congenital spinal curve imbalance. Frameless stereotactic guidance for solid pedicle screw fixation was essential to the achievement of rigid spinal stabilization before arthrodesis. Transpedicular eggshell osteotomy is a technique that should be considered for older patients who have congenital scoliosis with multiplanar spinal abnormalities.
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Comparative Study
Biomechanical evaluation of stand-alone interbody fusion cages in the cervical spine.
An in vitro biomechanical investigation of the immediate stability in cervical reconstruction. ⋯ The increased motion adjacent to C4-C5 may provide an argument for acceleration of disc degeneration. From the biomechanical point of view, this study suggests that the cervical interbody fusion cage should be supplemented with additional external or internal supports to prevent excessive motion in flexion-extension.
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A retrospective study of surgery for congenital kyphosis and kyphoscoliosis. ⋯ All patients with a Type I or Type III congenital kyphosis or kyphoscoliosis should be treated by a posterior arthrodesis before the age of 5 years and before the kyphosis exceeds 50 degrees. A kyphosis that does not reduce to less than 50 degrees as measured on the lateral spine radiograph made with the patient supine requires an anterior release and arthrodesis with strut grafting followed by posterior arthrodesis with instrumentation (if possible).