Spine
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Comparative Study
Effects of pelvic skeletal asymmetry on trunk movement: three-dimensional analysis in healthy individuals versus patients with mechanical low back pain.
Comparative analysis and correlational research design were used to investigate the association between anthropometry and biomechanical performance among asymptomatic subjects and patients with low back pain (LBP). ⋯ This study demonstrates objective differences in patterns of lumbar movement between asymptomatic subjects and patients with LBP. The study also demonstrates that subtle anatomic abnormality in the pelvis is associated with altered mechanics in the lumbar spine. We suggest that asymmetry of lumbar movement may be a better indicator of functional deficit than the absolute range of movement in LBP.
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Case Reports
Epidural varix at the cervicothoracic junction: unusual cause of quadriplegia: a case report.
A case report describing an unusual incident of quadriplegia in a young adult male caused by an epidural varix at the cervicothoracic junction. ⋯ In the absence of other precipitating factors, the cord injury was attributed to the epidural varix. A temporary impedance to the venous outflow with the increase in the venous pressure has been hypothesized as the mechanism of cord injury.
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Comparative Study
Three-dimensional analysis of 2 fusionless scoliosis treatments: a flexible ligament tether versus a rigid-shape memory alloy staple.
Experimental scoliosis was created and subsequently corrected in goats. The 3-dimensional (3-D) effects of the treatments were analyzed. ⋯ The data in this study show the ability of a ligament tether attached to a bone anchor to correct scoliosis modestly in the coronal plane, but not in the sagittal or transverse plane. In addition, although a significant decrease in the deformity score was shown initially in this group (P < 0.001), the effect was lost over time. The final deformity in the bone anchor/ligament tether group wassignificantly less than either the stapled or untreated groups (P < 0.03). Further study is warranted to provide a better understanding of the 3-D effects of fusionless scoliosis treatments.
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A retrospective review of the clinical and radiographic outcomes of reduction by temporary instrumentation of L4 and monosegmental fusion of L5/S1 in patients with high-grade developmental spondylolisthesis. ⋯ Reduction of L5/S1 with temporary instrumentation of L4 and monosegmental fusion of L5/S1 is an effective technique for the treatment of high-grade developmental spondylolisthesis. A complete reduction of local deformity and excellent correction of overall sagittal profile can be achieved. Fusion of the primarily healthy segment L4/5 can be avoided.
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The Morbidity and Mortality database of the Scoliosis Research Society (SRS) was queried as to the incidence and type of complications as reported by its members for the treatment of adolescent idiopathic scoliosis (AIS) with spinal fusion and instrumentation procedures regarding surgical approach (anterior, posterior, or combined anterior-posterior) during a recent 3-year period. ⋯ This study shows that complication rates are similar for anterior versus posterior approaches to AIS deformity correction. Combined anterior and posterior instrumentation and fusion has double the complication rate of either anterior or posterior instrumentation and fusion alone. Combined anterior and posterior instrumentation and fusion also has a significantly higher rate of neurologic complications than anterior or posterior instrumentation and fusion alone.