Spine
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Randomized Controlled Trial Comparative Study
The effect of autologous fibrin tissue adhesive on postoperative cerebrospinal fluid leak in spinal cord surgery: a randomized controlled trial.
A prospective randomized study evaluating the efficacy of autologous fibrin tissue adhesive for decreasing postoperative cerebrospinal fluid (CSF) leak in spinal cord surgery. ⋯ We used autologous fibrin tissue adhesive as a new sealant after dural closure instead of commercial fibrin tissue adhesive. No definitive CSF leak was observed, and the volume of drainage fluid was significantly lower in the group with autologous fibrin tissue adhesive than that in the group without fibrin tissue adhesive. The use of autologous fibrin tissue adhesive was superior to that of commercial fibrin tissue adhesive in cost.
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Clinical Trial
Anatomic considerations for the pedicle screw placement in the first cervical vertebra.
Anatomic bony measurements were manually performed on 50 dry atlantoaxial vertebral complexes with an electronic digital caliper, and a reliable landmark for insertion of a pedicle screw in C1 vertebra was described and evaluated. ⋯ The heights of the C1 pedicle, the posterior arch under the groove and the posterior lamina at the screw entry point are the major determinants for the possibility of placing pedicle screws in C1 of a given patient. This study indicates that it is feasible to place a 3.5-mm pedicle screw safely in C1 in most patients, and the lateral mass of C2 is a reliable anatomic landmark that can be easily identified to help the surgeon determine the optimal screw entry portal conveniently during surgery.
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Retrospective clinical and radiographic review. ⋯ Traditional anterior/posterior fusion technique provides no additional improvement in radiographic outcome compared to posterior-only surgery for adolescent hyperkyphosis. Preliminary anterior release and fusion is no longer performed when correcting this deformity with a posterior column shortening procedure and threaded rod compression instrumentation.
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This study retrospectively reviewed 12 years of consecutive patients with cervical spine injuries. ⋯ The realistic expectation for short-term postoperative survival in the elderly patient with a cervical spine injury is 87.8%. With a complete neurologic injury, 80.0% short-term survival was observed. Incomplete neurologic injury yielded 83.3% short-term survival. Close to 100.0% survival can be expected with no neurologic injury.