Spine
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A retrospective review of patient outcomes after lumbar spinal fusion. ⋯ This retrospective review of patients who underwent lumbar fusion for degenerative instability demonstrated no adverse impact on clinical outcomes when the lumbar fusion ended adjacent to a degenerative motion segment. Although a power analysis validated these results with 98% certainty, larger prospective studies are needed to confirm that there is no benefit to include degenerated adjacent segments in a lumbar fusion for degenerative instability.
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Randomized Controlled Trial Comparative Study Clinical Trial
Aprotinin reduces blood loss during spinal surgery in children.
A prospective blinded, randomized controlled study compared the effect of a perioperative infusion of aprotinin versus placebo during long segment spinal fusions in children. ⋯ This randomized, blinded study suggests that aprotinin significantly decreased blood loss and transfusion requirements in pediatric and adolescent scoliosis surgical patients at increased risk for intraoperative bleeding.
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This prospective cohort study evaluated four office tests of quadriceps strength in symptomatic adults with radiographic evidence of L3 or L4 nerve root compression. ⋯ In L3 and L4 radiculopathies, unilateral quadriceps weakness was best detected by a single leg sit-to-stand test. Patients of similar age with radicular pain caused by L5 or S1 radiculopathies could perform this test. As the interrater reliability of the single leg sit-to-stand test is high, clinicians should consider utilizing this test for assessing quadriceps strength in cases of L3 and L4 radiculopathies.
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A literature review was conducted to integrate and compile available reports on postoperative C5 palsy. ⋯ The incidence of postoperative C5 palsy has been reported at 4.6% after surgery for cervical compression myelopathy and this value has not varied with different surgical procedures or disease etiologies. The pathogenesis of postoperative C5 palsy remains unclear at the present time. Patients with postoperative C5 palsy generally have a good prognosis for functional recovery, but the severely paralyzed cases required significantly longer recovery times than the mild cases.
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Retrospective review. ⋯ Closed reduction and casting of thoracolumbar and lumbar burst fractures is a safe treatment method that yields acceptable functional and radiographic results.