Spine
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Randomized Controlled Trial Comparative Study
Two-year outcome after lumbar microdiscectomy versus microscopic sequestrectomy: part 2: radiographic evaluation and correlation with clinical outcome.
Single-center randomized prospective study at a university hospital. ⋯ Nondiscal pathologies, in particular Modic type endplate changes, seem to play an important role in the etiology of unfavorable clinical outcome after surgery for disc herniations. Sequestrectomy demonstrated significantly less postoperative disc degeneration than standard microdiscectomy after 2 years and may thus represent an attractive treatment alternative.
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Randomized Controlled Trial Comparative Study
Two-year outcome after lumbar microdiscectomy versus microscopic sequestrectomy: part 1: evaluation of clinical outcome.
Single-center randomized prospective study at a university hospital. ⋯ Reherniation rates within 2 years after sequestrectomy and microdiscectomy are comparable. However, outcome after microdiscectomy seems to worsen over time, whereas it remains stable after sequestrectomy. Thus, 2-year follow-up revealed clinical results favoring sequestrectomy. Performing sequestrectomy alone may therefore represent an advantageous alternative to standard microdiscectomy.
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A retrospective review of surgical outcomes in adolescents with idiopathic scoliosis. ⋯ Overweight adolescents (BMI % >or=85) had a greater thoracic kyphosis before surgery compared with their healthy weight peers. Body mass, however, did not affect the ability to achieve coronal or sagittal scoliotic deformity correction, and did not increase perioperative morbidity or mortality. These findings were either influenced by the small sample size of this cohort, or because the comorbidities responsible for increased perioperative complications in adults, had not yet developed in this adolescent population.
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Prospective clinical study. ⋯ The reported biomechanical principles of Dynesys do not reflect advantages in outcome compared with none or others stabilization systems after microsurgical radicular decompression reported in the literature.
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A consecutive series of 22 giant cell tumor (GCTs) of the cervical spine which underwent surgical treatment was observed from 1990-2003. ⋯ GCT of the cervical spine easily onsets between 20 and 40 years of age. As a kind of benign but local aggressive or low potential malignancy tumor, we should take an aggressive attitude to excise the tumor as much as possible while reserving the neural function as a precondition. Unlike in the thoracic and lumbar spine, a strictly "en bloc" resection is often not a feasible option because of the involvement of critical neurovascular structures. Total spondylectomy (even intralesional) with radiation therapy as an adjunctive treatment has significantly lowered the local recurrence rate of the GCT in the special segments.