Spine
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At the end of lumbar microdiscectomy, we administered an emulsion of low-dose epidural morphine and vaseline sterile-oil as carrier for morphine delivery. ⋯ Epidural application of morphine-vaseline sterile-oil compound after lumbar microdiscectomy proved to be safe and effective, improving postoperative pain control and return to function. At clinical and neuroradiological follow-up epidural fibrosis was acceptable. To confirm the efficacy of the compound, large prospective studies are warranted.
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Comparative Study
Restoration of thoracic kyphosis by posterior instrumentation in adolescent idiopathic scoliosis: comparative radiographic analysis of two methods of reduction.
A retrospective comparison of radiographic results for 2 consecutive series of patients treated for adolescent idiopathic scoliosis (AIS) by posterior instrumentations with thoracic screws using 2 methods of reduction: sequential approximation by cantilever reduction (CR) and simultaneous translation technique on 2 rods (ST2R). ⋯ Simultaneous translation on 2 rods provides a better correction of thoracic kyphosis than the sequential approximation by CR on patients with preoperative hypokyphosis. This surgical technique restores normal thoracic kyphosis in all cases.
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Preoperative review of a prospective study, single institution, consecutive series. OBJECTIVE.: To analyze the intermediate-term follow-up of consecutive adolescent idiopathic scoliosis (AIS) patients treated with pedicle screw constructs. ⋯ This is the largest (N = 114), consecutive series of North American patients with AIS treated with pedicle screws having a minimum of 3-year follow-up. The average curve correction was 68% for the main thoracic, 50% for the proximal thoracic, and 66% for the thoracolumbar/lumbar curve at final follow-up.
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Animal experiment using transcranial motor-evoked potentials (tcMEPs) in a pig model. ⋯ Our results validate monitoring of tcMEPs in multiple myotomes to detect nerve root injury in pigs. This model may be used for further study of the use of tcMEPs to detect predictors and risk factors of nerve root injury during spinal surgery.
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Closing-opening wedge osteotomy (COWO) had been performed by the senior author (K.C.) since 1998. A study had been conducted to evaluate the efficacy of COWO since 2000. ⋯ COWO is a useful procedure for patients with sagittal imbalance requiring more than 35 degrees lordotic correction through the osteotomy site. A worse clinical result is associated with increasing patient comorbidities, pseudarthrosis in lumbosacral fusion, and junctional kyphosis.