Spine
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Case Reports
Development of a new technique for pedicle screw and Magerl screw insertion using a 3-dimensional image guide.
We developed a new technique for cervical pedicle screw and Magerl screw insertion using a 3-dimensional image guide. ⋯ This method employing the device using a 3-dimensional image guide seems to be easy and safe to use. The technique may improve the safety of pedicle screw and Magerl screw insertion even in difficult cases with narrow sclerotic pedicles.
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A quantitative biomechanical analysis of mechanism of pain alteration in 4 cases of low back pain. ⋯ Immediate pain reduction can be achieved by altering muscle-activation and movement patterns. However, the combination for optimal success seems to be different for every individual. Pain provocation tests help to "tune" the intervention. This also suggests that patient-classification schemes may need more refinement to address this heterogeneity.
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Case studies of patients with cervical spondylotic amyotrophy used compound muscle action potentials (CMAPs) of deltoid and biceps brachii muscles and central motor conduction time (CMCT). ⋯ The average percentage range of deltoid and biceps brachii muscle CMAPs' amplitude determined at the onset of illness correlated significantly with postoperative recovery. Surgical intervention of the cervical spine should be performed in patients in whom the average percentage of CMAPs' amplitude in deltoid and biceps brachii muscles ranges from 30% to 50%.
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A cadaveric survey of the thoracic spines of extant species of nonbipedal primates for the presence of Scheuermann kyphosis. ⋯ Thoracic kyphotic deformity consistent with Scheuermann kyphosis exists in quadrupedal nonhuman primates. Bipedalism is not a strict requirement for the development of Scheuermann kyphosis, and the evolutionary origins of the disease predate the vertebral adaptations of bipedal locomotion.
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Multicenter Study Comparative Study
Antifibrinolytic agents reduce blood loss during pediatric vertebral column resection procedures.
Retrospective multicenter review. ⋯ EBL associated with VCR was highly variable and in many cases exceeded the patient's BV. AF agents were not routinely used and we had insufficient data to assess the efficacy of aminocaproic acid. Both aprotinin and TXA resulted in less EBL than when no AF was used; however, the effect of the reduction varied by site. Aprotinin has since been removed from the market. When normalized to patient size and levels excised, the use of TXA resulted in a reduction in intraoperative EBL.