Spine
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Case Reports
Atypical syringomyelia without cavity in a patient with Chiari malformation and hydrocephalus.
A case report is presented. ⋯ Obstruction of the cerebrospinal fluid pathways in the upper spine may result in spinal cord gray matter T2 prolongation that is reversible after restoration of patency of cerebrospinal fluid pathways and stress the importance of timely intervention to limit progression to syringomyelia.
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A retrospective review. ⋯ Percutaneous vertebroplasty and kyphoplasty have been reported to be safe options for the treatment of painful osteoporotic vertebral fractures. Although complications are infrequent, there remains the potential for catastrophic neurologic injury. Physicians performing these procedures need to be aware of these potential complications and be prepared to respond in an emergent manner (surgically) if a need arises.
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The results for 37 surgical interventions in 31 consecutive patients with non-small cell lung cancer (NSCLC) with symptomatic spinal cord compression were reviewed retrospectively. ⋯ Even though lung cancer is considered an aggressive tumor, it is justifiable to aggressively treat patients with symptomatic spinal cord compression. Surgery by PTA can lead to good results in these patients.
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In vivo degenerative changes of rabbit intervertebral discs after partial disc replacements were evaluated radiologically and histologically in a controlled trial. ⋯ The antidegenerative effects of partial disc replacement surgery were demonstrated by quantitative radiologic and histologic analyses. Degeneration of the anulus fibrosus after the replacement treatment was delayed by preserving disc height and occupying the space of the nucleus pulposus. Properly designed implants and minimally invasive techniques are necessary for long-term success.
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Randomized Controlled Trial
The efficacy of rhBMP-2 for posterolateral lumbar fusion in smokers.
Retrospective review of prospectively collected data, as part of an IRB-approved, FDA-regulated, randomized, nonblinded IDE trial of rhBMP-2 matrix for lumbar spinal fusion. ⋯ The results of this study suggest that rhBMP-2 may enhance fusion rate in cigarette smokers undergoing single-level instrumented posterolateral lumbar fusion. Despite the improvement in fusion rate with rhBMP-2, clinical outcomes measures were still adversely affected in smokers.