Spine
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Comparative Study
Open reduction of irreducible atlantoaxial dislocation by transoral anterior atlantoaxial release and posterior internal fixation.
A retrospective study of surgical outcome of 33 patients with irreducible atlantoaxial dislocation (IAAD). ⋯ This series has demonstrated the safety and efficacy of the transoral anterior atlantoaxial release in the reduction of IAAD. Most of the so-called irreducible/fixed AAD could become reducible after anterior release without odontoid resection. The posterior short-segment atlantoaxial or occipitocervical fixation, especially the plate screw instrumentation, could achieve further reduction and provide immediate stabilization. One-stage anterior release and posterior instrumentation and fusion are a safe and reliable operation in experienced hands.
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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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Literature review and expert opinion. ⋯ The application of MIS techniques to spinal trauma is theoretically sound. However, the indications and technology are currently in evolution. Although very limited information is available, the results of current MIS techniques for the management of TL trauma are encouraging.
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Literature review. ⋯ Long constructs serve well in thoracic and thoracolumbar fractures, while short-segment fixation offers advantages in selected thoracolumbar and lumbar fractures. Anterior column integrity determines the risk of sagittal collapse and kyphosis at the thoracolumbar junction. Recognition of fundamental biomechanical principles is necessary to make either construct work reliably.
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Comparative Study
Lumbosacral hemivertebrae resection by combined approach: medium- and long-term follow-up.
Retrospective review of patients records with clinical and radiographic assessment. ⋯ This procedure offers a persistent correction with a short-segment fusion. The early surgery is able to avert severe local deformities and prevent secondary structural deformities in order to avoid extensive fusions.