Spine
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Prospective analysis of a consecutive series of adult patients with adolescent idiopathic scoliosis of the adult and de novo degenerative scoliosis. ⋯ This quantitative analysis identified several clinically relevant radiographic parameters in adult scoliosis patients. Additionally, excellent predictive formulas for self-reported pain levels were obtained.
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A retrospective radiographic evaluation of 32 patients with hyperrotatory scoliosis accompanied by paradoxic hyperkyphosis, who were treated with posterior multilevel hook instrumentation. ⋯ If the apex of the scoliosis and the kyphosis are on the same level, the vertebral hyperrotation is responsible for the sagittal malalignment. Satisfactory results can be achieved with posterior multilevel hook instrumentation.
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Cadavers were dissected anatomically to identify the course of the superior laryngeal nerve relative to the spinal column. ⋯ The internal branch of the superior laryngeal nerve supplies innervation to the mucosa of the larynx and has an important sensory reflex that serves to protect the lungs from aspiration. Injury to this nerve can predispose the patient to life-threatening pneumonia. It is therefore imperative for the surgeon to recognize the location and course of this nerve to avoid injuring it. Injury most commonly occurs either by excessive retraction in different planes or by accidental ligation of the nerve.
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A rabbit and rhesus monkey model of posterolateral intertransverse process spine arthrodesis was used. ⋯ The new compression-resistant biphasic ceramic phosphate/collagen sponge matrices were biologically compatible with recombinant human bone morphogenetic protein 2 bone formation, resulted in biomechanically stiffer fusion masses than autograft, better space maintenance than plain collagen sponges, and improved handling and radiographic resorption properties over the ceramic carriers previously tested.
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An in vitro human cadaveric study comparing the effects of anterior and posterior sequential destabilization conditions on thoracic functional unit mechanics was studied. ⋯ The rib head joints serve as stabilizing structures to the human thoracic spine in the sagittal, coronal, and transverse planes. In anterior scoliosis surgery additional rib head resection after discectomy may achieve greater curve and rib hump correction. The lateral portion of the facet joints plays an important role in providing spinal stability and should be preserved to minimize postoperative kyphotic deformity and segmental instability when performing decompressive wide laminectomy.