Spine
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Multicenter Study
Preoperative bracing affects postoperative outcome of posterior spine fusion with instrumentation for adolescent idiopathic scoliosis.
STUDY DESIGN.: Multicenter, prospective clinical series. OBJECTIVE.: To investigate the effect of preoperative bracing on postoperative outcome of posterior spine fusion with instrumentation for adolescent idiopathic scoliosis. SUMMARY OF BACKGROUND DATA.: Bracing is the standard of care for adolescent idiopathic scoliosis between 25° and 45°, yet the efficacy of bracing is questionable. ⋯ Braced patients also have more "spine-specific" appearance concerns compared to nonbraced patients. These results suggest a negative impact of preoperative bracing on outcomes after posterior spinal fusion for adolescent idiopathic scoliosis. This "brace signature" should be taken into account when brace treatment is being considered.
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Multicenter Study
Changes in radiographic and clinical outcomes with primary treatment adult spinal deformity surgeries from two years to three- to five-years follow-up.
Retrospective analysis of data entered prospectively into a multicenter database-clinical and radiographic outcomes assessment. ⋯ Contrary to our hypothesis, we could not establish deterioration in mean radiographic or clinical outcomes between the 2-year and 3- to 5-year follow-up points when analyzing the group as a whole. However, for the 9 patients who experienced complications between 3- and 5-year follow-up, their outcomes were significantly worse than for the other 104 patients.One should not anticipate an overall radiographic and clinical deterioration of the outcomes of surgically treated primary presentation adult spinal deformity patients in this studied time interval. However, close to 10% of patients will experience a new complication at the 3- to 5-year point, most commonly implant failure/nonunion and/or junctional kyphosis, which will negatively effect the patient-reported outcome.
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Review Case Reports
Metastatic epithelioid trophoblastic tumor involving the spine.
This is a single case-based report. ⋯ This first report of metastasis of ETT to the spine adds significant new information to the growing literature of this rare and newly identified tumor. It also alerts the neurosurgeon into considering the diagnosis with appropriate clinical presentation. As more number of cases of nervous system involvement with this tumor are reported, crucial information on prognostic factors and treatment regimens will emerge.
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Comparative, prospective follow-up study. ⋯ No major differences in clinical outcome after PVP in OVCFs using low and medium viscosity PMMA bone cement were found. Viscosity of PMMA bone cement was identified as an independent predictor of cement leakage.
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This was a 23-year retrospective study of 3436 consecutive pediatric orthopedic spinal surgery patients between 1995 and 2008. ⋯ The combined use of somatosensory-evoked potentials, transcranial electric motor-evoked potentials, descending neurogenic-evoked potentials, and electromyography monitoring allowed accurate detection of permanent neurologic status in 99.6% of 3436 patients and reduced the total number of permanent neurologic injuries to 6.