Spine
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A case report of a patient with a congenital anomaly of the posterior arch of the atlas and review of the literature are reported. ⋯ This case illustrates a symptomatic congenital deformity of the posterior arch of the atlas due to a mobile, isolated fragment. These anomalies are exceedingly rare. To date, only 17 patients, including ours, have been described in the literature as having myelopathy related to an isolated posterior tubercle. Of these, only two patients had documented movement of this tubercle before our report. Recognizing the anomaly is crucial because treatment is relatively simple, produces resolution of symptoms, and prevents major neurologic deficits from occurring after trauma.
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Comparative Study
Comparison of one-stage versus two-stage anteroposterior spinal fusion in pediatric patients with cerebral palsy and neuromuscular scoliosis.
A retrospective study was performed including 45 pediatric patients with spastic quadriplegic cerebral palsy and neuromuscular scoliosis who underwent anteroposterior spinal fusion. ⋯ Two-stage anteroposterior spinal fusion provides safer and more consistent results with several advantages over the single-stage procedure in the management of patients with cerebral palsy and neuromuscular scoliosis.
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A retrospective investigation of the L5-S1 motion segment after an isolated L4-L5 posterior lumbar fusion. ⋯ There appears to be no need to routinely include the L5-S1 segment when performing a posterior lumbar fusion for patients with instability or stenosis at L4-L5 if no symptoms are attributed to the lumbosacral level. At an average of 7.3 years, there was neither increased symptomatic disc degeneration nor symptoms necessitating the need for an L5-S1 fusion.
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A case report. ⋯ We emphasize the advantages of our method in comparison with nonoperative treatment or multisession surgery. The single stage surgical solution led to a shortening of hospitalization time with no need for halo bracing, to excellent results with respect to C-spine stability and to better compliance from the patients.
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This retrospective study analyzed the effects of cervical alignment on surgical results of expansive laminoplasty (ELAP) for cervical spondylotic myelopathy (CSM). ⋯ The influence of cervical malalignment on neurologic recovery after ELAP for CSM was shown. When patients have local kyphosis exceeding 13 degrees, anterior decompression or posterior correction of kyphosis as well as ELAP should be considered. Expansive laminoplasty for CSM is best indicated for patients with local kyphosis less than 13 degrees.