Spine
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Retrospective radiographic review. ⋯ Selective thoracic or thoracolumbar/lumbar fusions of the major curve can be successfully performed even when the minor curve completely deviates from the midline, based on the Lenke classification system, the analysis of structural criteria between the planned fused and unfused regions of the spine, and the clinical examination of the patient. Selective fusions, when successfully performed, will optimize mobile segments of the spine in patients with adolescent idiopathic scoliosis.
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Carl Nicoladoni (1847-1902) studied medicine in Vienna and became Privatdozent in surgery in 1876. He accepted a chair as a Professor of Surgery at the university clinics of Innsbruck (1881) and Graz (1895). Nicoladoni has made significant contributions in the progress of surgery and performed a variety of operations in several surgical disciplines. ⋯ A larger edition printed in 1904 was part of the Bibliotheca Medica, a monumental series of various clinical books published around the beginning of the past century. The second version, a shortened one, with the same title was included in an anthology called Deutsche Chirurgie (German Surgery) and published in 1909. The purpose of this historical article is to discuss Nicoladoni's achievements in the field of scoliosis based on a detailed analysis of his books.
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Biomechanical study. ⋯ Based on the results of this biomechanical comparison, the calf spines instrumented with the wedge-rod system for fusionless correction were significantly stiffer as compared to the intact calf spine. The wedges alone were not as stiff as the intact spine. This suggests that the theory of performing transverse osteotomies of vertebral bodies with fixation with wedge-rod construct for 8 to 12 weeks, followed by removal of the rod, could provide adequate fixation and correction of a scoliotic deformity without requiring fusion of motion segments.
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Comparative Study
Biomechanical comparison of cervical spine reconstructive techniques after a multilevel corpectomy of the cervical spine.
An in vitro biomechanical study of several reconstructive techniques after a two-level cervical corpectomy. ⋯ The biomechanical results obtained suggest that posterior segmental instrumentation confers significant stability to a multilevel cervical corpectomy regardless of the presence or absence of anterior instrumentation. In cases in which the stability of a multilevel reconstruction procedure is tenuous, the surgeon should strongly consider the placement of segmental posterior instrumentation to significantly improve the overall stability of the fusion construct.
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This in vitro biomechanical study was undertaken to quantify the multidirectional intervertebral kinematics following total disc replacement arthroplasty compared to conventional stabilization techniques. ⋯ Total disc arthroplasty serves as the next frontier in the surgical management of discogenic spinal pathology. The SB Charitè restored motion to the level of the intact segment in flexion-extension and lateral bending and increased motion in axial rotation. The anterior annular resection necessary for device implantation and unconstrained design of the prosthesis account for this change in rotation. The normal lumbar flexion-extension axis of rotation is an ellipse rather than a single point. Only disc replacement rather than pedicle instrumentation or BAK interbody instrumentation preserves the kinematic properties and normal mapping of segmental motion at the operative and adjacent intervertebral disc levels.