Spine
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Retrospective review of 61 consecutive patients. ⋯ These results suggest that intraoperative electromyographic monitoring provides a real-time measure of impending spinal nerve root injury during instrumented posterior lumbar fusion, allowing for timely intervention and minimization of negative postoperative sequela.
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Review Case Reports Meta Analysis Comparative Study
Eosinophilic granuloma of the cervical spine.
A meta-analysis was performed based on 53 cases of cervical eosinophilic granuloma reported in the literature and 1 in an adult treated by the authors. ⋯ In most cases of cervical eosinophilic granuloma, immobilization is an adequate therapy. If the process continuous to progress, radiotherapy is recommended. Surgical treatment should be reserved for cases with instability or neurologic defects.
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Review Case Reports
Chiari I malformation associated with syringomyelia and scoliosis: a twenty-year review of surgical and nonsurgical treatment in a pediatric population.
Retrospective review of patients with Chiari I malformation with or without associated scoliosis. ⋯ Early decompression of Chiari I malformation with syringomyelia and scoliosis resulted in improvement or stabilization of the spinal deformity in 5 cases. Each of these patients underwent decompression before 8 years of age and before the curve was severe. However, this series represents a few patients demonstrating this trend, and further follow-up and investigation are warranted.
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Clinical Trial Controlled Clinical Trial
Segmental recording of cortical motor evoked potentials from thoracic paravertebral myotomes in complete spinal cord injury.
A study of thoracic paravertebral muscle motor-evoked potentials using transcranial magnetic stimulation in spinal cord injury patients and control participants. ⋯ Paravertebral muscle motor-evoked potentials can be elicited below the level of a complete spinal cord injury. Possible reasons for this include the multisegmental innervation of these muscles and the long muscle fiber conduction. Stretch reflex activation elicited by contraction of muscles above the lesion is thought to be an unlikely mechanism because of the latency of the response. Although the presence or absence of muscle motor-evoked potentials does not appear to be a sensitive indicator of the level of thoracic spinal cord injury lesion, analysis of muscle motor-evoked potentials reveals abnormal patterns that may assist in defining lesions. Finally, lower threshold above the lesion suggests corticospinal hyperexcitability of this pathway as a result of central plasticity after spinal cord injury.
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Clinical Trial
Laparoscopic anterior lumbar interbody fusion at L4-L5: an anatomic evaluation and approach classification.
An anatomic classification system was devised on the basis of operative reports and preoperative magnetic resonance imaging or computerized tomography from 139 patients who underwent laparoscopic anterior lumbar interbody fusion involving L4-L5. ⋯ The laparoscopic approach to L4-L5 is complicated by the variability of the vascular anatomy encountered during the exposure. Routine magnetic resonance imaging or computed tomography can be used to classify the vascular anatomy and plan the optimal approach. Avoiding the left side of the aorta or the left iliac artery may minimize the risk of ejaculatory dysfunction.