Spine
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Randomized Controlled Trial
Clinical outcomes of 3 fusion methods through the posterior approach in the lumbar spine.
This prospective randomized study compared 3 fusion methods: posterolateral fusion (PLF), posterior lumbar interbody fusion (PLIF), and PLIF combined with PLF (PLF+PLIF). ⋯ No significant differences in clinical results and union rates were found among the 3 fusion methods. PLIF had better sagittal balance than PLF. PLIF without PLF had advantages of the elimination of donor site pain, shorter operating time, and less blood loss.
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Randomized Controlled Trial
Effect of prone positioning systems on hemodynamic and cardiac function during lumbar spine surgery: an echocardiographic study.
Prospective randomized study of patients undergoing spine surgery. ⋯ Adequate fluid replacement reduced hypotension and hemodynamic instability after prone positioning. The Jackson spine table and longitudinal bolsters had minimal effects on cardiac function, and should be considered in patients with limited cardiac reserve.
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The position of a needle tip displayed on a navigation system after transpedicular introduction into a vertebral body is compared with the real position of the needle tip when using a direct navigation coupling between a three-dimensional rotational X-ray (3DRX) system and a navigation system. ⋯ Accuracy of 3DRX-guided navigation is 2.5 +/- 1.5 mm in a clinically relevant setting, which is less than the accuracy determined in phantom experiments.
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Retrospective case study of 13 cases of Paget sarcoma of the spine accrued from a prospectively collected Tumor Registry database. ⋯ This series confirmed that Paget sarcoma of the spine has a very poor prognosis. We found a constellation of symptomatology in patients with sarcomatous Paget spine resulting from radiculomedullary compression, primarily lumbosacral involvement and predominantly osteosarcomatous histology. There was no significant difference observed on the overall prognosis of the patients with Paget sarcoma of the spine in the last 6 decades.
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Case Reports
A novel "four-rod technique" for lumbo-pelvic reconstruction: theory and technical considerations.
Surgical technique with case example. ⋯ Longer follow-up is necessary, and biomechanical and finite element studies are needed to show long-term efficacy of this technique, however, early results indicate that such a construct is feasible. Furthermore, depending on the general medical condition of the patient, immediate postoperative weight bearing is possible and reasonable.