Spine
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Randomized Controlled Trial Clinical Trial
Periradicular infiltration for sciatica: a randomized controlled trial.
A randomized, double-blind trial was conducted. ⋯ Improvement during the follow-up period was found in both the methylprednisolone and saline groups. The combination of methylprednisolone and bupivacaine seems to have a short-term effect, but at 3 and 6 months, the steroid group seems to experience a "rebound" phenomenon.
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A new surgical technique of cervical osteotomy to correct an extension deformity of the cervical spine is described, and a case is reported. ⋯ Osteotomy at a higher level in the spine for correction of global kyphotic deformity may result in a significant overcorrection of the gaze angle upward. The authors believe that the new technique described in this report is a technically demanding but adequate and safe approach for correcting such a rare deformity.
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Case Reports
Early retropulsion of titanium-threaded cages after posterior lumbar interbody fusion: a report of two cases.
Two patients had postoperative posterior migration of titanium fusion cages after posterior lumbar interbody fusion. They underwent a repeat posterior procedure and posterior fusion with pedicle screws. ⋯ A repeat posterior approach and repositioning of the retropulsed titanium fusion cages in addition to posterior fusion with pedicle screws successfully managed this complication.
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Comparative Study
Influence of different types of progressive idiopathic scoliosis on static and dynamic postural control.
Balance control assessment of static and dynamic conditions was performed to study the effects of progressive idiopathic scoliosis on postural control in 102 adolescents. ⋯ These data demonstrate that idiopathic scoliosis indeed alters balance control, with different hierarchies, from the best to the worst as follows: double major, thoracic, thoracolumbar, and lumbar curves in the static test and double major, lumbar, thoracolumbar, and thoracic curves in the slow dynamic test. The location of the major curve appeared to be important, with an effect on lateral disequilibrium and vestibular symmetry. The absence of anomaly in the fast dynamic test suggests that the type of scoliosis does not impair proprioception.
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Transient paraparesis during the operative management of a 16-year-old patient with Scheuermann's kyphosis secondary to thoracic stenosis is reported. ⋯ A treatable cause for paraparesis secondary to the surgical treatment of Scheuermann's kyphosis is presented. The author currently obtains a thoracic magnetic resonance image (MRI) before the surgical correction of any patients with Scheuermann's kyphosis.