Spine
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Review Case Reports
Transient blindness after lumbar epidural steroid injection: a case report and literature review.
A case report of transient blindness after lumbar epidural steroids is presented. ⋯ Transient blindness is a rare complication of lumbar epidural injection. The pathophysiology and prevention of this rare entity is reviewed.
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Outcomes of transpedicular decompression and/or osteotomy were analyzed retrospectively. ⋯ Overall, the results suggest that the "eggshell" procedure is a reliable and safe technique to achieve anterior decompression of the spinal canal and posterior stabilization through a single approach.
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Comparative Study
The feasibility of anterior thoracoscopic spine surgery in children under 30 kilograms.
A retrospective comparison of pediatric patients weighing less than 30 kg who underwent thoracoscopic anterior spinal release and fusion for deformity correction. This group was compared to two control groups: patients weighing over 30 kg (thoracoscopic) and patients under 30 kg (open). ⋯ Despite the decreased working space within the chest and difficulties of selective intubation, anterior thoracoscopic surgery for spinal release and fusion can be performed as safely in "small" children as in "large" children; however, additional intraoperative challenges should be anticipated. Although the outcomes were similar in the small thoracoscopic children compared to the small open children, the authors believe that very small patients (under 20 kg) should remain a relative contraindication to thoracoscopic surgery, especially during a surgeon's learning curve.
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A retrospective evaluation of radiographs in patients with idiopathic scoliosis was undertaken to assess predictors of flexibility. ⋯ We have shown that curve magnitude and patient age are the main predictors of structural flexibility. Every 10 degrees increase in curve magnitude over 40 degrees results in a 10% decrease in flexibility; every 10-year increase in age decreases flexibility of the structural curve by 5% and the lumbosacral fractional curve by 10%. Curve magnitude and age of the patients are significant predictors of curve flexibility. The demonstration of this association offers useful information in estimating how surgical options for deformity correction may change over time.
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A retrospective study of 19 consecutive cases (1991-2001) where 91 thoracic and lumbar pedicle screws were used in the treatment of various pediatric spinal disorders in 1- and 2-year-old children. ⋯ The results suggest that pedicle screw fixation can be performed safely in 1- and 2-year-old children without negative effects on vertebral growth. In various pediatric spinal disorders, transpedicular screw fixation is the only procedure that provides a secure anchorage in short-segment instrumentation.