Spine
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A cadaveric biomechanical experiment was conducted to assess the range of motion (ROM) and screw strain at S1 in a long instrumented spinal fusion construct to compare the effects of various surgical strategies for L5-S1 stabilization. ⋯ The results of this study indicated that iliac screws and AxiaLITR provide similar stability at L5-S1, while significantly reducing the strain on the S1 screws.
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A case report of a patient with adhesive arachnoiditis after combined spinal and epidural anesthesia. ⋯ This is the first report of a patient with a giant AASC and ES caused by spinal and epidural anesthesia. Although the optimal surgical treatment for these conditions remains unclear, shunting of the cyst effectively prevented the progression of symptoms.
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Retrospective cohort study of Medicare claims. ⋯ In this older population having fusion surgery for lumbar stenosis, uptake of BMP was rapid, and greatest among patients with prior surgery or having complex fusion procedures. BMP appeared safe in the perioperative period, with no increase in major medical complications. Use of BMP was associated with greater hospital charges but fewer nursing home discharges, and was not associated with reduced likelihood of reoperation.
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Cross-sectional study of teaching general practitioners (TGPs) in the South of France. ⋯ French TGPs believe that CLBP Web sites should focus on nonmedical, practical advice; they consider the design at least as important as the medical information. This viewpoint seems to conflict in part with patients' expectations. Good-quality and interactive Web sites could reduce this discordance. A list of approved sites should be available for general practitioners to recommend to their patients, to supplement information given during the consultation.
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A retrospective cohort study reporting the use of intraoperative computed tomography (CT) and image-guided navigation system for the placement of pedicle screws in pediatric compared with adult patients. ⋯ We report 96.4% accuracy in pediatric pedicle screw placement using intraoperative CT and a 3D navigation system. This is similar to other reports and has better accuracy than a recent meta-analysis of nonnavigated screws in children.