Spine
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Multicenter Study Comparative Study
Restoration of thoracic kyphosis after operative treatment of adolescent idiopathic scoliosis: a multicenter comparison of three surgical approaches.
Multicenter analysis of 3 groups of patients who underwent surgical treatment for adolescent idiopathic scoliosis (AIS). OBJECTIVE.: To evaluate 3 surgical approaches to determine the modality that has the greatest influence on improving thoracic kyphosis. ⋯ ASFI is the best method to restore thoracic kyphosis when compared with posterior approaches using only hooks or a hybrid construct in the treatment of thoracic adolescent idiopathic scoliosis.
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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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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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Comparative Study
Thoracic pedicle screws: comparison of start points and trajectories.
Experimental design using cadaveric computerized tomography (CT) scans and a computer-assisted image guidance system to compare various thoracic pedicle screw start points and trajectories. ⋯ EPD and MIA are trajectory (EPD) and start point (MIA) dependent. In the axial plane, anatomic EPD was greater than straight ahead EPD. In the sagittal plane, anatomic EPD was greater than straight forward EPD. Using anatomic start points in the sagittal plane, a greater MIA is achievable. These data suggest that in the diminutive thoracic pedicle or when a larger screw is needed, an anatomic trajectory using anatomic start points may allow a larger bone channel for intrapedicular placement of instrumentation.