Spine
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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
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.
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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.