Spine
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Retrospective study of posterior hemivertebra resection and osteotomies with transpedicular instrumentation in very young children. ⋯ Posterior hemivertebra resection, in case of bar formation with osteotomy of the bar, allows for excellent correction in both the frontal and sagittal planes, with a short segment of fusion. Early surgery in young children prevents the development of severe local deformities and secondary structural curves, thus allowing for normal growth in the unaffected parts of the spine.
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Meta Analysis Comparative Study
A meta-analysis of circumferential fusion versus instrumented posterolateral fusion in the lumbar spine.
A meta-analysis of circumferential fusion versus instrumented posterolateral fusion (PLF) in the lumbar spine. ⋯ Compared with instrumented PLF, circumferential fusion can increase the fusion rate and reduce the reoperation rate, but it can also increase the complication rate and the amount of blood loss. No significant difference was found in the global assessment of clinical outcome about the 2 fusion procedures.
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Review of relevant literature including personal opinions. ⋯ Growing rod technique should be used in patients where the primary problem is at the vertebral column. If the patient has rib fusions and/or TIS has developed, in other words, if the primary problem involves the thoracic cage, expansion thoracostomy and VEPTR should be an appropriate option.
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Clinical Trial
The efficacy of the synthetic interbody cage and Grafton for anterior cervical fusion.
Prospective study of 31 patients who underwent anterior cervical fusion. ⋯ ACDF using the Solis cage packed with Grafton demonstrated good clinical and radiologic outcomes. The fusion rate was comparable with the published results of the traditional ACDF using tricortical iliac crest grafts. Therefore, the results of this study suggest that the ongoing use of the PEEK cage packed with DBM and autologous bone chips in ACDF is a safe and effective alternative to the gold standard of autologous iliac bone grafts.
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Analysis of repeated cross-sectional surveys. ⋯ Although the prevalence of neck-shoulder-arm pain and concurrent symptoms decreased in 2006 compared to 2002, it is still too early to conclude that we have reached and passed the peak of the "epidemic" of neck-shoulder-arm pain.