Spine
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A retrospective study investigated the progression risk of juvenile scoliosis until skeletal maturity or spinal fusion. ⋯ Curve pattern, Cobb angle at onset of puberty, and curve progression velocity are strong predictive factors of curve progression. Juvenile scoliosis > 30 degrees increases rapidly and presents a 100% prognosis for surgery (curve > 40 degrees to 45 degrees ). Anticipation is necessary if the scoliosis progresses during the first year of puberty. The prediction is difficult for curves of 21 degrees to 30 degrees during the first 2 years of puberty. Curve pattern and curve progression velocity are useful to detect which curves are likely to progress. From this retrospective analysis, spinal fusion could have been indicated earlier sometimes. An earlier intervention is probably preferable to obtain better curve reduction on a supple spine, even if a perivertebral fusion is necessary. We use the 3 parameters for operative indications. If an early spinal fusion leads to better curve correction needs to be verified on prospective data.
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A retrospective review of neurophysiologic alerts during anterior cervical surgery. ⋯ Diagnosis of cervical spondylotic myelopathy or trauma and cervical corpectomy procedures increase the risk for having major intraoperative alerts. In case of persistent tceMEP/SSEP amplitude loss, consider delaying potentially harmful interventions, such as premature termination of the procedure or methylprednisolone infusion, until a new neurologic deficit is verified with an awake-clinical examination.
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A cross-sectional comparative study between healthy controls and two subgroups of nonspecific chronic low back pain (LBP) patients. ⋯ Subclassifying nonspecific chronic LBP patients revealed clear differences in sEMG activity during sitting between pain-free subjects and subgroups of nonspecific chronic LBP patients.
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Prospective clinical study. ⋯ These findings are important for the operating room personnel, which is exposed daily to radiation intraoperatively, as well as the patients, when using CAS procedures.