Spine
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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.
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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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Bench-top and retrospective analysis to assess vertebral rotation based on the appearance of bilateral pedicle screws in patients with adolescent idiopathic scoliosis (AIS). ⋯ An accurate assessment of vertebral rotation can be performed radiographically, using screw lengths and screw tip-to-rod distances of bilateral segmental pedicle screws and a trigonometric calculation. These data support the use of a simple radiographic grading system to approximate apical vertebral rotation in AIS patients treated with bilateral apical pedicle screws.
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Retrospective study with clinical and radiologic evaluation of 15 patients with congenital kyphosis or kyphoscoliosis who underwent anterior instrumented spinal fusion for posterolateral or posterior hemivertebra (HV). The management of congenital kyphosis has been described in the literature using a variety of techniques. The presentation of patients at diagnosis is discussed. The question of when to begin treatment is reviewed. The pitfalls in the management and how to avoid these are discussed. The different published techniques are reviewed. We present our own techniques and our results of treatment of congenital kyphosis in very young children. ⋯ The average operating time of procedure was 150 minutes (range, 130-210 minutes). The average blood loss was 180 mL (range, 100-330 mL), equivalent to a mean external blood volume loss of 15% (range, 11%-24%).Preoperative segmental Cobb angle averaging 34 degrees at last follow-up. Compensatory coronal cranial and caudal curves were corrected by 50%. The angle of segmental kyphosis averaged 39 degrees (range, 20 degrees-80 degrees) before surgery and 21 degrees (range, 11 degrees-40 degrees) at last follow-up. This represents a 43% of improvement of the segmental kyphosis, and a 64% of improvement of the segmental scoliosis at last follow-up. One case with initial kyphosis of 80 degrees continued to progress and required revision anterior and posterior surgery. There were no neurologic complications.
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A measurement and analysis of the orientation of the lumbar facet joints at the L4-L5 level of different age groups. ⋯ The coronal orientation of the L4-L5 facet joints was negatively correlated to age (r = -0.456, P = 0.000), which could be one of the explanations that the aging people are prone to degenerative spondylolisthesis.