Spine
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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.
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Comparative Study
Predictable correction of the unfused lumbar lordosis after thoracic correction and fusion in Scheuermann kyphosis.
A retrospective examination of preoperative and postoperative radiographs of the sagittal spine of 30 patients with Scheuermann kyphosis. ⋯ This study shows a significant correlation between kyphosis and lordosis before and after surgery. Surgical correction of thoracic hyperkyphosis gives a predictable spontaneous decrease of lumbar lordosis. Correction of lordosis occurs mainly in the upper segment of lumbar lordosis.
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A systematic search of three electronic databases was done to identify randomized controlled trials on the effect of written or audiovisual information in low back pain. ⋯ Information based on a biopsychosocial model is recommended in primary care to shift patient beliefs on low back pain. Nevertheless, information delivery alone is not sufficient to prevent absenteeism and reduce healthcare costs.
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: Literature review. ⋯ : While many advances in the basic science of spinal cord injury provide optimism for future treatments, clinical science lags. At present, there are no pharmacologic strategies of proven benefit. Although steroids continue to be given to patients with spinal cord injury in many institutions, evidence of deleterious effects continues to accumulate. Current standard of care management includes support of arterial oxygenation and spinal cord perfusion pressure.
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Evidence-based literature review. ⋯ There are currently no standards regarding the role and timing of decompression in acute SCI. We recommend urgent decompression of bilateral locked facets in a patient with incomplete tetraplegia or in a patient with SCI with neurologic deterioration. Urgent decompression in acute cervical SCI remains a reasonable practice option and can be performed safely. There is emerging evidence that surgery within 24 hours may reduce length of intensive care unit stay and reduce post-injury medical complications.