Spine
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Review Case Reports
Intraoperative visible bubbling of air may be the first sign of venous air embolism during posterior surgery for scoliosis.
Case report of two children sustaining venous air embolism (VAE) during posterior surgery for scoliosis. ⋯ Visible air bubbling at the operative site may herald the onset of massive VAE during multilevel posterior spinal fusion and instrumentation. A prospective multicenter study using precordial Doppler, central venous catheter, and end-tidal CO2 is recommended to determine the true incidence of VAE in spinal deformity surgery and to evaluate monitoring and treatment methods.
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Comparative Study
COL6A1, the candidate gene for ossification of the posterior longitudinal ligament, is associated with diffuse idiopathic skeletal hyperostosis in Japanese.
Genetic screening of collagen 6A1 gene (COL6A1) in patients with diffuse idiopathic skeletal hyperostosis (DISH) recruited in Japan and the Czech Republic. ⋯ Because COL6A1 could be a susceptibility to the occurrence of DISH and OPLL in the Japanese population, we consider that COL6A1 could be responsible for the hyperostotic state, leading to ectopic bone formation in the spinal ligament.
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A retrospective study was undertaken which evaluated the medical records and imaging studies of a subset of patients managed by the spine service at Jackson Memorial Hospital who were diagnosed with an esophageal perforation in the setting of spinal surgery. ⋯ The use of an SCM flap for the repair of esophageal injury, in the setting of anterior cervical spine surgery, is a safe and effective tool. An SCM flap appeared to improve the time in initiating oral intake without any significant morbidity.
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Review of results of patients with Marfan syndrome treated with instrumented posterior fusion alone for scoliosis. ⋯ These results seemed to demonstrate that a satisfactory stabilization of scoliosis can be achieved by posterior instrumentation alone in patients with Marfan syndrome. Instrumented posterior fusion should be extended to include vertebrae that are neutral and stable in both coronal and sagittal planes before surgery, in order to ensure stabilization of the deformity and reduce the risks of decompensation of the spine.
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An updated Cochrane review. ⋯ No conclusions are possible about the relative effectiveness of anterior, posterior, or circumferential fusion. The preliminary results of three small trials of intradiscal electrotherapy suggest it is ineffective, except possibly in highly selected patients. Preliminary data from three trials of disc arthroplasty do not permit firm conclusions.