Spine
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Comparative Study
Adolescents undergoing surgery for idiopathic scoliosis: how physical and psychological characteristics relate to patient satisfaction with the cosmetic result.
Patient satisfaction with the cosmetic result of spinal fusion surgery was studied in 42 cases of adolescent idiopathic scoliosis. Neutral or dissatisfied patients were compared with satisfied patients on several physical and psychological characteristics. ⋯ Most adolescents with idiopathic scoliosis expressed satisfaction with the cosmetic surgical result. Preoperative physical characteristics, psychological difficulties, and unrealistic expectations regarding postoperative cosmesis are associated with patient neutrality or dissatisfaction.
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An in vitro biomechanical investigation on human cadaveric specimens was conducted before and after nucleotomy. Endplate and vertebral body deformation patterns were measured under compression and shear loading, in addition to kinematics and disc pressure. ⋯ Nucleotomy resulted in decreased disc pressure, decreased endplate deformation, and modified loading patterns onto the inferior vertebra in compression loading. However, nucleotomy did not appreciably affect the behavior of the disc in shear loading.
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Blinded review of selected and un-selected computed tomographic myelograms. ⋯ The shape of the vertebral body margin at the endplate is an important factor contributing to the development of disc herniations at L4-L5 and L5-S1.
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Report of a patient with an epidural abscess after halo pin intracranial penetration at the site of a previous cranioplasty. ⋯ The halo device should not be used for patients with a previous cranioplasty, especially if the pins cannot be inserted at other safe areas of the skull. A thorough medical history and physical examination of the skull are important before the application of a halo device. Computed tomography of the skull may be necessary before elective halo application for patients with concomitant head trauma, confusion, or intoxication and for patients with a previous cranioplasty to ascertain the safest pin sites.
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Case report and literature review of cervical flexion myelopathies. ⋯ Prolonged extreme neck flexion, in association with profound muscular relaxation, can produce a severe myelopathy that is at least partly related to compromise of the spinal cord's microcirculation.