Spine
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Retrospective review of prospectively collected data on the neuromonitoring changes recorded during a consecutive series of cord level 3-column posterior spinal osteotomies for the correction of rigid pediatric spinal deformities in children between 2005 and 2012. ⋯ Changes unresponsive to increasing blood pressure occurring during decompression and bone resection (type II) responded well to osteotomy closure. Unresponsive changes during osteotomy closure (type III) were treated successfully with opening the osteotomy, cage adjustment, and less correction.
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Retrospective review. ⋯ The use of cell saver during a single-level PLDF does not significantly reduce the need for allogeneic blood transfusion and is not cost-effective. The high cost of cell saver in combination with the low complication rate of allogeneic blood transfusion, suggest that cell saver should not be used for single-level PLDF. Further studies are needed to evaluate the necessity for cell saver among other types of spinal surgery.
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Retrospective study from data from a single access surgeon at 2 hospitals. ⋯ The high frequency of multiple ILVs found during the anterior approach is crucial knowledge for access surgeons, as it will help them anticipate such anomalies and thus avoid the potentially catastrophic complications of an avulsion of an unexpected extra vein.
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Retrospective case control study. ⋯ Neuromuscular patients fused to the pelvis, children older than 11 years, and surgery duration greater than 6 hours were associated with positive cultures. Back acne is a preventable risk factor for P. acnes seeding. Intraoperative bacterial contamination indicates a need to consider the type of surgery and patient age to determine prophylactic antibiotics and other modalities to prevent infection.
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Seven different combinations of posterior screw fixation, with or without interbody support, were compared in vitro using nondestructive flexibility tests. ⋯ Bilateral CS-rod fixation provided about the same stability in cadaveric specimens as PS-rod fixation regardless of the presence of interbody, TLIF, or DLIF support.