Spine
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A radiographic and morphologic study was conducted to investigate low-grade spondylolisthesis in cases with preexisting isthmic spondylolysis of L5. ⋯ The authors considered that the slips with and those without deformities of the sacral table had developed in adolescence and adulthood, respectively. Using new radiographic parameters that indicate widening and tilting of the sacral table, low-grade isthmic spondylolis thesis can be categorized into "adolescent and adult vertebral slips."
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A test-retest design was used. ⋯ Interexaminer reliability of the McKenzie lumbar spine assessment in performing clinical tests and classifying patients with low back pain into syndromes were good and statistically significant when the examiners had been trained in the McKenzie method.
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The assignment of idiopathic scoliosis curves to the curve types,1-6 to the lumbar spine modifier (A, B, or C), and to the sagittal thoracic modifier (-, N, +), as recently described by Lenke et al, was evaluated by five observers on two occasions. ⋯ Lenke's new classification system is more reliable than the older King classification, but proper classification of high thoracic and lumbar curves seems to be difficult.
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A case report of craniocervical spine lesions including basilar impression, atlantoaxial dislocation, and syringomyelia, with osteogenesis imperfecta is presented, and the literature is reviewed. ⋯ For patients with atlantoaxial dislocation, syringomyelia, and basilar impression without clinical symptoms or signs of brain stem compression, occipitocervical spine fusion alone at the reduction of the atlantoaxial dislocation may be indicated because these procedures improve neurologic deficits and prevent postoperative development of basilar impression and enlargement of syringomyelia.
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Comparative Study
Factors related to false- versus true-positive neuromonitoring changes in adolescent idiopathic scoliosis surgery.
A retrospective study of 134 adolescent patients who underwent surgical correction of idiopathic scoliosis between June 1992 and August 1998 was conducted. ⋯ Questions remain about the predictive accuracy of somatosensory-evoked and neurogenic motor-evoked potentials. According to the findings in this study, in which there were no false-negative readings and a modest false-positive rate, continued use of these methods is recommended. Higher false-positive rates were seen in patients with greater lability in mean arterial pressure. A wake-up test is recommended for all cases in which threshold monitoring changes occur because cases of spinal cord injury may exist even when monitored variables return to baseline.