Spine
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Retrospective case series. ⋯ The use of a 3-rod technique during hemivertebra excision in young children helped to avoid any implant failures in our series. We conclude that this technique should be used in young children whose pedicles may not be able to withstand the compressive forces needed to close down the wedge resection site.
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Randomized Controlled Trial Comparative Study
Cervical disc replacement in patients with and without previous adjacent level fusion surgery: a prospective study.
Prospective 6-center study. OBJECTIVE.: To evaluate outcomes of cervical disc replacement performed adjacent to a prior cervical fusion. ⋯ Although the level adjacent to a prior cervical fusion is subject to increased biomechanical forces, potentially leading to a higher risk of failure, the PCM disc was well tolerated in the short term. The early clinical results of disc replacement adjacent to a prior fusion are good and comparable to the outcomes after primary disc replacement surgery. However, in view of the small study population and short-term follow-up, continued study is mandatory.
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Case Reports Clinical Trial
Limaprost alfadex improves myelopathy symptoms in patients with cervical spinal canal stenosis.
Myelopathy symptoms were prospectively studied in patients with cervical spinal canal stenosis (CSCS), using objective grading systems and stabilometry, to examine the effect of administration of prostaglandin E1 derivative limaprost alfadex (limaprost). ⋯ The efficacy of oral limaprost administration for patients with CSCS was confirmed by objective scoring and quantitative data.
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Comparative Study Clinical Trial
Significantly improved outcomes with a less invasive posterior lumbar interbody fusion incorporating total facetectomy.
Original study. ⋯ Clinical outcomes were significantly improved after both ST-PLIF and LI-PLIF. However, outcomes were significantly better after LI-PLIF than after ST-PLIF. Significantly shortened hospital stay with LI-PLIF probably reflected the "less invasive" technique per se. Significantly better clinical outcomes with fewer complications after LI-PLIF, however, potentially reflected maneuvers singular to LI-PLIF: (1) preservation of posterior elements, (2) avoidance of far lateral dissection over the transverse processes, (3) bilateral total facetectomy, (4) fewer neurologic complications, and (5) avoidance of iliac crest autograft. LI-PLIF is therefore recommended over ST-PLIF.
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A retrospective review (phase 1) and prospective clinical study (phase 2). ⋯ This study identified diabetes and preoperative irradiation to be independent risk factors for SSI in patients with spinal metastasis. PGE1 administration was found to significantly decrease the incidence of SSI in patients with spinal metastasis who underwent preoperative irradiation.