Spine
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A case report of low back pain associated with a diagnosis of melorheostosis of the lumbosacral spine. ⋯ Melorheostosis rarely causes severe low back pain that can respond favorably to fusion surgery.
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Pavlov's ratio from plain radiographs in patients with neck pain but no radicular symptoms was compared with the areas of the cervical spinal cord and cerebrospinal fluid column on magnetic resonance scans. ⋯ This study shows a poor correlation between Pavlov's ratio and the space available for the cord. Therefore, this ratio cannot be solely relied upon to predict the area changes in that plane of the cervical spinal canal.
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Comparative Study Clinical Trial
Standing lateral radiographic positioning does not represent customary standing balance.
Normal cohort evaluation of the accuracy of existing methods for radiographic measurement of sagittal spinal balance. ⋯ Measurement of the sagittal vertical axis on radiographs from commonly utilized standing positions (shoulders flexed) results in an sagittal vertical axis that is at least 3 to 4 cm more posterior than a sagittal vertical axis observed during a functional position. Subject repositioning resulted in an intertrial variability of at least 0.8 cm in sagittal vertical axis, while variation as the subject held each standing posture had little contribution to overall error of measurement. Of the analyzed positions, shoulder flexion (45 degrees ) alone was the best position for a lateral radiograph due to minimal compromise to repeatability of sagittal vertical axis measurement. However, none of the radiographic positions reproduced the spinal balance of the subject's functional standing posture.
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Retrospective radiograph and chart review of 28 patients with adult idiopathic scoliosis undergoing primary corrective surgery. Clinical and radiographic parameters were assessed before surgery, after surgery, and at a 2-year follow-up assessment. A self-perceived outcome questionnaire was administered to the study patients at a minimum 2-year follow-up assessment. ⋯ Surgery for adult idiopathic scoliosis using third-generation instrumentation techniques provides significant clinical improvement, scoliosis correction, maintenance of sagittal alignment, and patient satisfaction, with an acceptable complication rate.
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This retrospective study was designed to analyze the results of 22 patients treated for postoperative soft tissue defects of the spine. ⋯ Flaps are a useful adjunct in the treatment of patients with complex spine wounds. Sliding paraspinal muscle flaps can effectively close wounds from the high cervical to the low lumbar area in one operative procedure. These patients can go on to successful spine fusion.