Spine
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A retrospective case series. ⋯ Chronic irreducible and recurrent unstable AARF can be managed successfully by careful closed manipulation followed by halo fixation, if the C1 and C2 have not been osseously fused. The remodeling of the C2 facet deformity detected on follow-up CT scans can be a useful radiographic parameter to determine the appropriate period of halo fixation in this new treatment strategy obviating the need for surgical intervention.
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A prospective observational cohort study of consecutive osteoporotic vertebral compression fractures (VCFs) in ≥ 90-year-old patients evaluated at a multidisciplinary, university spine center. ⋯ Vertebroplasty for VCFs in the very elderly appears effective and safe without increased risk of adjacent level fracture.
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Case report and review of the literature. ⋯ Patients who present with severe positional headache, altered mental status, or tonic-clonic seizures after undergoing intradural spinal procedures involving massive cerebrospinal fluid loss may be suffering from multiple supra- and infratentorial intracranial hemorrhages.
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Comparative Study Controlled Clinical Trial
Radiation exposure to the surgeon during open lumbar microdiscectomy and minimally invasive microdiscectomy: a prospective, controlled trial.
This is a prospective in vivo study comparing radiation exposure to the surgeon during 10 minimally invasive lumbar microdiscectomy cases with 10 traditional open discectomy cases as a control. ⋯ MIS lumbar microdiscectomy cases expose the surgeon to significantly more radiation than open microdiscectomy. One would need to perform 1623 MIS microdiscectomies to exceed the exposure limit for whole-body radiation, 8720 cases for the lens of the eye, and 11,235 cases for the hand. Standing in a substerile room during x-ray localization in open cases is not fully protective.
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Comparative Study
A comparison of unilateral and bilateral laminotomies for decompression of L4-L5 spinal stenosis.
A retrospective review of clinical and radiographic data was performed at a single institution. ⋯ Both unilateral and bilateral laminotomies provide sufficient decompression of spinal stenosis and excellent pain reduction. However, unilateral laminotomy can be performed with shorter operative times and less blood loss. Radiologically, the use of a unilateral laminotomy induces less translational motion increase after surgery; thus, it may reduce the risk of late instability when compared with a bilateral laminotomy.