Spine
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Comparative Study
Development of an index to characterize the "invasiveness" of spine surgery: validation by comparison to blood loss and operative time.
Prospective cohort study. ⋯ An "invasiveness" index based on the number of vertebrae decompressed, fused, or instrumented showed the expected associations with both blood loss and surgery duration. This quantitative description of surgery invasiveness may be useful to adjust for surgical variations when making safety comparisons in spine surgery.
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Review Case Reports
Natural killer/T-cell nasal-type lymphoma: unusual primary spinal tumor.
A natural killer/T-cell lymphoma originating in the spine of a 60-year-old man is first reported, along with a brief review of the literature on the topic. ⋯ NK/T-cell lymphomas originated at other sites but nasal cavity/nasopharynx do not present typical clinical features and symptoms in the absence of lymphadenopathy. There are possibilities for misdiagnosis of NK/T-cell lymphoma that originates at other sites. The unfavorable prognosis of this tumor emphasized the need for novel molecular targets and more effective therapies.
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Clinical Trial
Patient preferences and expectations for care: determinants in patients with lumbar intervertebral disc herniation.
Prospective observational cohort. ⋯ Patient expectations, particularly regarding the benefit of nonoperative treatment, are the primary determinant of surgery preference among patients with lumbar intervertebral disc herniation. Demographic, functional status, and prior treatment experience had significant associations with patients' expectations and preferences.
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Comparative Study
Computed tomography and biomechanical evaluation of screw fixation options at the cervicothoracic junction: intralamina versus intrapedicular techniques.
In vitro cadaveric biomechanical analysis. ⋯ Our results suggest that lamina screws, used as a salvage technique in the proximal thoracic spine, provide stronger fixation than transpedicular screws when using standard 4.5-mm cervical screws. In-tralamina screws appear to be a biomechanically sound salvage technique in the region, and appear to be a safe, effective technique for instrumenting the proximal thoracic spine.
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Retrospective case review of children with eosinophilic granuloma of the cervical spine. ⋯ Management of pediatric patients with EG of the cervical spine is challenging, especially when there is neurologic involvement. Observation alone, prolonged immobilization, systemic chemotherapy, curettage with or without bone grafting, corticosteroid injection, and low dose radiation therapy have been proposed for the management of patients with EG. Surgery is required when the child presents neurologic involvement. Children who received a vertebral interbody fusion can show, at long period follow-up, normal shape of the neck, with maintenance of the normal motion of the adjacent segments.