Spine
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Retrospective series. ⋯ It was observed that the Lenke description for structurality of proximal thoracic curves can effectively determine which curves need fusion and which curves do not. Because there was no difference among inclusion of a nonstructural proximal thoracic curve into fusion or solely fusing the main thoracic curve in terms of outcomes, extension of fusion to T2 or T3 is unnecessary. In this patient population, the question of what the upper extent of instrumentation should be could not be answered.
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Comparative Study
In vitro stabilizing effect of a transforaminal compared with two posterior lumbar interbody fusion cages.
An in vitro biomechanical flexibility test on different lumbar interbody fusion cages using monosegmental lumbar spine specimens. ⋯ In terms of its stabilizing effect, TLIF using the MOON cage can be recommended as an alternative to PLIF using the cubic Stryker cages. Compared with the threaded BAK PLIF cages, however, the MOON TLIF cage provides a lower primary stability in lateral bending, flexion, and extension.
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Intermittent pneumatic compression stockings (IPC) alone were prospectively used to avoid deep venous thrombosis (DVT) and pulmonary embolism (PE) in 100 consecutive patients undergoing single-level anterior corpectomy/fusion (ACF) and in 100 patients having multilevel ACF/posterior fusion. ⋯ IPCs were as effective for prophylaxis against DVT/PE for 100 patients undergoing single-level ACF and for 100 having circumferential procedures as existing therapies (mini-heparin and low-dose heparin), without the risk of hemorrhage. However, the 1% and 2% respective rates of PE were comparable to frequencies of PE encountered in other cranial/spinal series using mini-heparin and/or low-dose heparin regimens but avoided the 2% to 4% risk of major postoperative hemorrhage.
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Case Reports
Anterior cervical screw extrusion leading to acute upper airway obstruction: case report.
Case report of late postoperative complication. ⋯ We report a case of acute upper airway obstruction from prevertebral abscess, likely secondary to a loosened anterior cervical screw penetrating the prevertebral soft tissue. In contrast to case reports in the literature involving instrumentation extrusion with a usually benign outcome, our case presented with a life-threatening condition.
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Clinical Trial
The use of magnetic resonance imaging to evaluate lumbar muscle activity during trunk extension exercise at varying intensities.
Descriptive, repeated measures analysis of exercise-induced changes in lumbar muscle transverse relaxation time (T2). ⋯ Muscle functional MRI can be used to characterize lumbar muscle function during trunk extension exercise. The levels and recruitment patterns of the lumbar extensors, as measured by muscle T2 shifts, vary with exercise intensity. Future research is needed to assess the mechanism of the nonlinear relationship between T2 shifts and exercise intensity, and to clarify the effects of fatigue and the order of exercise presentation on the T2 response of the lumbar extensors.