Spine
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Retrospective follow-up study of patients undergoing multiple (two or more) reoperations after initial lumbar discectomy using an administrative database. ⋯ Patients with one reoperation after lumbar discectomy are at considerable risk of further spinal surgery.
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Descriptive case report. ⋯ This was a very rare case of medial compartment syndrome of the foot following spine surgery. We believe that the patient had a predisposition, whether neurologic or vascular, toward cramping in the foot and that this activity was stimulated by the nerve stimulation during the evoked potential monitoring. Although the patient had thoracic epidural analgesia after surgery, it was not felt to have contributed to the development or result of the compartment syndrome. We strongly advocate for checking patients feet and legs during surgery for overactivity and stress the need for a high index of suspicion for compartment syndrome for unexplained pain after surgery.
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A retrospective review of patients undergoing C1-C2 posterior fusion during childhood was undertaken. ⋯ In children, a spontaneous realignment of the subaxial kyphosis observed after C1-C2 posterior fusion can be noted at follow-up, when a postoperative deformity occurs (33% in the present series). According to the present findings, it is not always mandatory to perform occipitocervical fusion in children with atlantoaxial instability just to prevent subaxial deformity in the cervical spine.
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Case Reports
Nontraumatic acute complete paraplegia resulting from cervical disc herniation: a case report.
A case report of nontraumatic acute complete paraplegia resulting from cervical disc herniation. ⋯ We emphasize that there is a possibility of acute, irreversible progression of paralysis secondary to nontraumatic enlargement of cervical disc herniation with canal stenosis. In these cases, immediate early decompressive surgery is crucial to the prevention of severe myelopathy.
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Cultured annulus fibrosus cells within an atelocollagen honeycomb-shaped scaffold with a membrane seal were allografted into the lacunas of intervertebral discs of which the nucleus pulposus had been vaporized using an indocyanine green dye-enhanced laser. Regeneration of the intervertebral disc was assessed based on the viability and histologic status of the allografted annulus fibrosus cells, as well as the prevention of narrowing disc space. ⋯ The annulus fibrosus cells cultured in an ACHMS-scaffold were allografted into the lacunae of nucleus pulposus (obtained using laser vaporization), as well as the hole of annulus fibrosus (obtained by laser fiber insertion) of rabbit intervertebral discs. These cells were viable and showed cell proliferation in the disc tissues of recipients.