Spine
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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.
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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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A retrospective clinical study was conducted. ⋯ Posterior decompression and partial reduction followed by circumferential stabilization performed in one stage combining pedicle fixation with trans-sacral titanium cage interbody fusion is an effective and safe technique for the management of severe spondylolisthesis.
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A case report of distant discitis and vertebral osteomyelitis involving skip levels after caudal epidural steroid injection. ⋯ Distant discitis and vertebral osteomyelitis involving skip levels and without the occurrence of epidural abscess formation is a serious but rare complication after epidural injection.