Spine
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Case Reports
Successful management of a large pulmonary cement embolus after percutaneous vertebroplasty: a case report.
Percutaneous vertebroplasty is increasingly used for the treatment of vertebral compression fractures. Local leakage of polymethylmethacrylate cement into the perivertebral space is a common complication, but important systemic effects have rarely been reported. ⋯ The patient made an uneventful recovery. The authors review how appropriate arthroplasty techniques might minimize the risk of this dreadful complication.
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Retrospective case series review. ⋯ Surgical correction was achieved in over half the levels that would have been operated by standard posterior segmental fixation. Bony healing due to the bone-on-bone apposition was achieved uneventfully after apical correction of the spinal curvature in all patients. Use of dual rod instrumentation (Kaneda Anterior Scoliosis System) is fundamental in maintaining the correction of the curvature achieved in the operating room. The preoperative planning technique worked well.
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Retrospective review of patient records, clinical and radiographic, and patient recall for full pulmonary function studies and surface topography. ⋯ Although these are small numbers and treatment methods have changed since the beginning of the series, the results indicate that this condition is not simple to treat and for some children still has the risk for serious deformity and respiratory compromise. There is, as yet, no evidence that early surgical intervention in this group of patients with infantile scoliosis has altered their prognosis in any meaningful way.
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Lumbar spinal instability was evaluated using radiographic parameters and intraoperative biomechanical measurement. ⋯ Disc angle in flexion and ROM were the most prognostic parameters of lumbar distraction instability. Although the option of spinal arthrodesis method should be determined based on both clinical manifestation and imaging studies, the current study demonstrated that providing of anterior column support is biomechanically reasonable for degenerative spondylolisthesis with segmental kyphosis in flexion.
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Comparative Study
Cervical disc replacement-porous coated motion prosthesis: a comparative biomechanical analysis showing the key role of the posterior longitudinal ligament.
Benchtop cadaveric biomechanical comparative testing and caprine animal model in vivo implantation. ⋯ There are two basic types of total knee replacements, posterior cruciate ligament-preserving and posterior cruciate ligament-sacrificing designs. In the cervical spine, an analogous situation exists biomechanically depending on whether the posterior longitudinal ligament needs to be removed in its entirety as part of the spinal cord decompression part of the procedure--it may be helpful to conceptually differentiate between posterior longitudinal ligament-preserving and posterior longitudinal ligament-sacrificing total cervical disc replacements.