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.
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A prospectively maintained database-generated retrospective review and cross-sectional outcome analysis was performed at a single academic center. ⋯ Although the majority of patients improve to an AMS between 90 and 100, many have significant disability and are less functional than the general population. Significant predictive variables include the initial motor score, formal education, comorbidities, age at injury, and development of spasticity. An assessment of more than just the motor score is required to obtain an appreciation of the function and outcomes in this population.
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A retrospective study of 15 cases of pure foraminal type cervical disc herniation (CDH) was performed. ⋯ Pure foraminal-type CDH may be overlooked with conventional MRI or CTM, so CTD should be performed. It provides valuable and additional information in difficult or ambiguous cases such as pure foraminal type.
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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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A retrospective, long-term follow-up study. ⋯ Our study revealed that incidental durotomy in lumbar disc surgery was associated with long-term clinical sequelae. We therefore conclude that dural tears bring about poor clinical outcome at the long-term follow-up.