Spine
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This study is a prospective review of all spinal cord monitoring procedures in our unit from 1999 to 2004 in patients undergoing spinal deformity correction surgery. ⋯ The monitoring criteria are sufficiently strict to achieve a sensitivity of 1.0 and a specificity of 0.97. Monitoring of CMAPs alone has been adequate to avoid clinical neurological deficits.
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Single-surgeon retrospective case series of 303 consecutive operative patients with idiopathic scoliosis (IS). ⋯ The experience level of surgical assistant had little bearing on perioperative morbidity or radiographic outcomes in scoliosis surgery. Marginally increased operative times and EBL, without an increase in transfusions or complications, is an acceptably safe tradeoff for educating orthopedic residents and fellows.
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Multicenter Study Comparative Study
Adolescent idiopathic scoliosis patients report increased pain at five years compared with two years after surgical treatment.
A multicenter study of changes in Scoliosis Research Society (SRS) outcome measures after surgical treatment of adolescent idiopathic scoliosis (AIS). ⋯ There was a statistically significant increase in reported pain from 2 to 5 years after surgical treatment; however, the etiology of worsening pain scores could not be elucidated. Given continued patient satisfaction, the clinical relevance of this small reduction remains unknown. Nevertheless, this observation deserves further evaluation and must be considered in relation to the natural history of this disease.
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Preoperative somatosensory-evoked potentials (SEPs) were retrospectively analyzed and classified, and compared with surgical outcome. ⋯ SEP classification correlates well with CSM disability and postoperative recovery ratio. Median nerve SEP recordings would be a valuable and practical tool for the diagnosis and prognosis of myelopathy.