Spine
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Comparative Study
Preoperative evaluation of the cervical spondylotic myelopathy with flexion-extension magnetic resonance imaging: about a prospective study of fifty patients.
The authors evaluated preoperative modifications of the cervical spinal canal in flexion and extension in 50 patients with cervical spondylotic myelopathy (CSM) and looked for impingement of the spinal cord not diagnosed in the neutral position. ⋯ Cervical spondylotic myelopathy results from the synergistic action of static and dynamic factors, the latter of which play an important role. In some patients, IHIS on T2 images is only visible with the neck in flexion. That might explain why IHIS is first detected after surgery in some patients in whom MRI was obtained before surgery only in the neutral position. Dynamic MRI is useful to determine more accurately the number of levels where the spinal cord is compromised, and to better evaluate narrowing of the canal and IHIS. New information provided by flexion-extension MRI might change our strategy for CSM management.
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Randomized Controlled Trial Comparative Study
Low back pain in adolescents: is quality of life poorer in those seeking medical attention?
Paired case-control study. ⋯ Adolescents with LBP seeking specialized medical attention have better HRQOL than symptomatic peers from the general population but report worse clinical and functional status.
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Comparative Study
Kinematics of cervical total disc replacement adjacent to a two-level, straight versus lordotic fusion.
In vitro biomechanical study. ⋯ TDR placed adjacent to a two-level fusion is subjected to a more challenging biomechanical environment as compared to a stand-alone TDR. An artificial disc used in such a clinical scenario should be able to accommodate the increased moment loads without causing impingement of its endplates or undue wear during the expected life of the prosthesis.
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Randomized Controlled Trial Comparative Study
Postoperative surgical site infections in patients undergoing spinal tumor surgery: incidence and risk factors.
We conducted a retrospective, case control study on patients undergoing surgery for spinal tumors. OBJECTIVE.: Our aim was to determine the incidence and to identify risk factors for surgical site infections (SSIs) in patients undergoing surgery for spinal tumors. ⋯ Surgery for spine tumors appears to be associated with a higher incidence of SSI than nontumor spine surgery. Identification of perioperative risk factors will help delineate this subset of patients with high risk for developing SSIs thus potentially allowing perioperative modification for such factors, which may lead to an overall better clinical outcome and patient satisfaction.
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Comparative Study
Dysphagia after anterior cervical spine surgery: a prospective study using the swallowing-quality of life questionnaire and analysis of patient comorbidities.
Prospective study of 29 patients who underwent anterior cervical (AC) or posterior lumbar (PL) spinal surgery. A validated measure of dysphagia, the Swallowing-Quality of Life (SWAL-QOL) survey, was used to assess the degree of postoperative dysphagia. ⋯ Patients undergoing AC surgery had a significant increase in the degree of dysphagia 3 weeks after surgery compared with patients undergoing PL surgery. By final follow-up, swallowing in the AC group recovered to a level similar to preoperative and comparable to that in patients undergoing lumbar surgery at 1.5 years. Smoking, chronic obstructive pulmonary disease, and female sex are possible factors in the development of postoperative dysphagia.