Spine
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The medical records of 138 subjects with Early Onset Scoliosis (EOS) from 5 US institutions were reviewed to analyze their hemoglobin levels before and after surgery. Eighty-five subjects were operated with the Vertical Expandable Prosthetic Titanium Rib (VEPTR) and 53 with growing rods. ⋯ Twenty-three percent of the patients with EOS showed signs of chronic hypoxia. The hemoglobin levels decreased significantly 6 to 24 months after surgery. The greatest effect was observed in subjects with congenital scoliosis and rib fusion and who had an expansion thoracostomy with implantation of VEPTR.
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Prospective study of assessment of surgical results using a new outcome measure for cervical myelopathy, the Japanese Orthopedic Association cervical myelopathy evaluation questionnaire (JOACMEQ). ⋯ JOACMEQ offers an effective method of evaluation from the perspective of patient evaluations of QOL.
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The kinematic study of human lumbar spinal movements. ⋯ Our results support that facet joint degeneration is followed by disc degeneration according to age. Increased translational movements of the lumbar segments occurred in severe disc degeneration accompanied by facet joint degeneration or the presence of LFH even if the movements were stabilized in the advanced status. Therefore, the current status of the intervertebral discs, facet joints, and ligamentum flavum should be taken into consideration when evaluating stability within the lumbar spine.
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Assessment of different surgical approaches and procedures to remove different types of neurogenic tumors (Types I-IV). ⋯ In surgical resection of sacral neurogenic tumors, surgical approach depends on the location and size of the tumors. Intraspinal tumors should be excised from a posterior approach. For giant neurogenic tumors that arise from the sacrum and involve the spinal canal, surgical resection should be done by a combined anterior-posterior approach. Giant presacral neurogenic tumors located below the S1 level can be removed by a posterior approach. The anterior surgical approach should be used for giant presacral neurogenic tumors that are located above S1 and do not involve the spinal canal.
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Primary clinical trial of limited fixation for unstable Atlas fracture. ⋯ Osteosynthesis of the atlas by C1 lateral mass screws C2 pedicle screws and crosslink compression fixation is an ideal option for C1 burst fracture with or without rupture of the transverse ligament. The procedure allows for partially physiologic reconstruction of the C0-C1-C2 joint and shortens external fixation.