Spine
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This is a prospective study. ⋯ The incidence of ED in patients younger than 50 years with nonfracture-related lumbar spine disease undergoing surgery without risk factors was 34.3%. Despite improvement in VAS, ODI, and NS scores postoperatively, ED did not improve. Patients with NS > 70 postoperatively were more likely to have ED reflecting possible permanent nerve damage from lumbar spine pathology.
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A prospective study. ⋯ Prophylactic bilateral C4/C5 microforaminotomy significantly decreased the incidence of postoperative C5 palsy. These results suggest that the main etiology of C5 palsy was C5 root impairment. However, 2 patients experienced C5 palsy despite undergoing prophylactic foraminotomy, which indicated that other factors including spinal cord impairment after acute decompression against cervical canal stenosis may also be considered as minor etiologies of C5 palsy. We conclude that prophylactic C4/C5 foraminotomy was an effective preventive measure against postoperative C5 palsy after laminoplasty.
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Retrospective study of surgery for spondylolysis patients. ⋯ Although symptoms were significantly ameliorated in all groups, the bilateral group showed the greatest improvement ratio in JOA score showing bony union to be an important factor in clinical outcome. However, there were a few exceptional cases with contradictory clinical and radiological outcomes. Thus, further studies are required to gain a better understanding of the other multiple factors affecting clinical outcome after spondylolysis repair.
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Prospective study. ⋯ The midline anterior retroperitoneal approach from the right side is a safe alternative compared with the classical approach from the left side. The low rate of venous injury is explained by the sidewall thickness of the vena cava compared with the left iliac vein sidewall. Contrary to what happens by left-sided approach, the vascular retraction required for access to L4-L5 and above does not lead to arterial occlusion and therefore diminishes the risk in atheromatous patients. The absence of retrograde ejaculation confirms previous studies conducted on the left anastomosis of the superior hypogastric plexus, suggesting that its approach and mobilization by the left side are delicate.
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This is a cohort investigation of 2 categories of patients with adult lumbar scoliosis. ⋯ Categorization of patients into 2 groups, 1 with primarily stenosis symptoms and 1 with primarily deformity symptoms, may be effective for surgical decision making. These 2 categories of patients may be expected to enjoy similar clinical improvements after surgical treatment.