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.
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Evaluation of diagnostic imaging. ⋯ The possibility of ICA injury can be excluded by correct insertion of the screw 10 degrees inward. Although bicortical purchase with adequately medially angulated trajectory might be safe enough, we must remember the possibility to violate the ICA in bicortical purchase, because the intended screw trajectory never be assured.
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Biomechanical analysis. ⋯ The larger diameter screws were equivocal or significantly more resilient than the cement augmented standard diameter screws at the strongest of the insertion angles for all values. Since rigidity of the instrumentation construct is one of the very few factors that is surgeon controlled, this could influence the choice of instrumentation in revision spinal arthrodesis.
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Retrospective clinical study. ⋯ Our clinical observation suggests that patients with spinal metastases and a high Tokuhashi score benefit from surgical treatment with moderate improvement in sensomotoric function even in a heterogenic collective.
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A retrospective case-control study. ⋯ Amicar was highly effective in decreasing perioperative blood loss and transfusion requirements in patients with neuromuscular scoliosis undergoing PSF and SSI. It was most effective in decreasing estimated intraoperative blood loss. This results in decreased transfusion requirements, costs, and potential transfusion-related complications.