Spine
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Retrospective review of medical records. ⋯ Infection, medical complications after surgery, and surgical complications requiring revision of implants are the primary causes of unplanned early readmissions and spine surgery. Further studies are necessary to identify patients and procedures most associated with readmission.
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Prospective, longitudinal cohort (nonrandomized). ⋯ Our results suggest that Th alone, DVBD alone, or both Th and DVBD provide equivalent inclinometer results in patients with mild preoperative rib prominences (≤ 9°), but higher SRS-22 self-image scores are achieved using both Th and DVBD. For larger rib prominences, better inclinometer readings are achieved with Th, although SRS-22 self-image scores are comparable.
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Case Reports
Cervical neurofibromatosis with tetraplegia: management by cervical suspensory traction.
A case report. ⋯ Cervical suspensory traction is a viable and safe adjunct technique for applying gradual and sustained effort to maximize postoperative correction in the treatment of NF-1 patients with severely rigid and large curves. This report should contribute to expanding the alternative method for the staged treatment strategy to complex abnormalities.
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Case Reports
Epidural hematoma and intraoperative hemorrhage in a spine trauma patient on Pradaxa (dabigatran).
The authors present a case report of a 72-year-old man who presented with back pain and lower extremity weakness after a fall from his roof. ⋯ As dabigatran (Pradaxa) has recently been approved by the Food and Drug Administration, many spine specialists are not familiar with this agent. Many of the reversal agents (e.g., vitamin K and protamine), useful for other classes of anticoagulants, have no impact on Pradaxa. Similarly, prothrombin time and partial thromboplastin times have limited utility in estimating the patient's true clotting status. The purpose of this case report is to alert spine specialists to this drug and its implications on spine care. The drug's pharmacokinetics, clinical assessment of clotting status, and reversal options are discussed.
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A retrospective review. ⋯ The use of wider intervertebral cages leads to a significantly lower rate of subsidence, but a longer cage does not necessarily offer a similar advantage. Wide cages are protective against subsidence, and the widest cages should be used whenever feasible for interbody fusion in the lumbar spine to protect indirect compression and promote arthrodesis.