Spine
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A cross-sectional study was conducted. ⋯ The inner transverse diameter of the lumbar pedicle, particularly in young children, is smaller than previously reported. Insertion of screws currently available commercially screws seems to be safe in the L4-L5 pedicles of children ages 5 to 8 years, and in the L3-L5 pedicles of older children. Custom-made screws might be considered for upper levels for safe application.
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A literature review and synthesis were performed. ⋯ Intraspinal medication delivery has become an effective technique for control of intractable pain in appropriately selected patients seen by spine surgeons.
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Peer-reviewed literature was reviewed and summarized. ⋯ A successful arthrodesis is the fundamental surgical goal for patients with chronic pain of spinal origin. However, a successful fusion does not always correlate with a successful clinical result.
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A case of lower-extremity myelopathy induced by physical exertion in a patient with Type 2 (failure of segmentation) congenital kyphosis is reported. ⋯ Although Type 2 congenital kyphosis is a rare entity, it should be followed carefully and corrected surgically when appropriate. A history of exertional myelopathy may be an early sign of spinal cord impingement and is an indication for surgical decompression.
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Case Reports
Metformin-associated lactic acidosis after elective cervical spine fusion: a case report.
A case of metformin-associated lactic acidosis after elective spinal surgery is reported. ⋯ Spinal surgeons should be aware of this preventable, potentially fatal side effect and stop metformin 48 hours before surgery.