Spine
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Review Case Reports
Reduction of severe adolescent isthmic spondylolisthesis: a new technique.
The case of a 14-year-old boy with a severe-grade isthmic spondylolisthesis who underwent reduction and stabilization using this technique is described. ⋯ In severe-grade lumbosacral spondylolisthesis, isolated posterior fusion, even when supplemented with internal fixation, is not sufficient to prevent deformity progression. Therefore, a combined anterior and posterior fusion is necessary. Reduction of the deformity leads to restoration of normal sagittal alignment with an excellent cosmetic result. Reduction without release of posterior structures may lead to neurologic deficit. This 3-stage shortening procedure can provide sudden reduction of deformity with minimal risk of neurologic deficit. The procedure is technically demanding, and should be performed by spinal surgeons who are familiar with the principles of anterior and posterior fusions.
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Survey-based descriptive study. ⋯ Variations in surgical approach to lumbar degenerative diseases may depend on a patient's clinical condition. This study found strong agreement in the approach to lytic spondylolisthesis but significant variation for other degenerative conditions of the lumbar spine. In addition, recommendation for fusion and instrumentation varied with surgeon age and training background. Previously documented geographic variations may result in part from a lack of consensus on appropriate treatment techniques for specific lumbar degenerative conditions, as well as surgeon-specific factors.
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Comparative Study
A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis.
A semi-prospective clinical study was conducted. ⋯ The prognostic criteria using the total scores from our revised scoring system were useful for the pretreatment evaluation of metastatic spinal tumor prognosis irrespective of treatment modality or local extension of the lesion.