Spine
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A methodological systematic review. ⋯ Given the plethora of previously hypothesized confounding risk factors for a spinal SSI, conduct of nonrandomized comparative therapeutic studies is strongly discouraged. On the other hand, methodological safeguards, including use of standardized definitions of putative confounders and outcomes, should be considered in more detail during the design phase of a randomized trial.
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A methodological systematic review. ⋯ There is an abundance of conflicting data on risk factors for SSI after spinal surgery. Given various sources of heterogeneity observed in observational literature, there is a paucity of solid evidence for the proof of robust risk factors. The authors recommend the introduction, validation, and use of a standardized set of strongly justified eligibility criteria and well-defined candidate risk factors and spinal SSI outcomes.
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A single-center prospective case series. ⋯ Our analysis suggests that there are 2 distinct regions (lateral and medial) of shoulder height asymmetry. Medial differences reflected in trapezial prominence relate to deformity created by upward tilted proximal ribs and T1 tilt. Lateral differences in shoulder symmetry as reflected in the clavicle angle correlate weakly with radiographical measures. This suggests that correction of trapezial prominence may be more predictable compared with clavicle angulation after scoliosis surgery.
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Prospective cohort study. ⋯ The VITOM system for spinal surgery provides outstanding image quality and an ease of manipulation rivaling the OM. There were no statistically significant differences in mean operative room time, intraoperative complications, or total hospital length of stay when using this novel system in several common spinal procedures relative to the OM.
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Computer modeling and simulations to analyze correction forces at the bone-screw interface in scoliosis instrumentation. ⋯ Bone-screw forces to achieve desired corrections can be minimized. However, EF are inevitable to secure the locking of all screws. Higher EF were associated with pedicle screws, with less degrees of freedom for connecting screw body to rod, that is, monoaxial followed by polyaxial and then by dorsoaxial screws.