Spine
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A clinical and cohort study. ⋯ The 10-second step test reflected the severity of thoracic compressive myelopathy. Moreover, this test was useful for evaluating surgical outcome in patients with thoracic compressive myelopathy.
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A retrospective case-control analysis of prospectively collected data. ⋯ This study shows that young males with JHM were found to have excessive lumbar segmental motion that was associated with increased low back pain, disability, and limited physical activity.
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Retrospective national database analysis. ⋯ Our results demonstrated an overall incidence of 6.7 cardiac complications per 1000 lumbar spine surgical procedures from 2002 to 2009. Patients undergoing lumbar fusion were more likely to experience cardiac events than lumbar decompression patients. Cardiac events tend to occur in patients with noted risk factors and result in increased hospitalizations, costs, and mortality. On the basis of these findings, we think that patients with specified risk factors should be monitored closely and medically optimized in the perioperative period.
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Case Reports
Use of extracorporeal membrane oxygenation support during an emergent decompression of a thoracic epidural abscess.
Case report. ⋯ The use of ECMO support in adult spinal surgery has not been previously reported in the literature. Therefore we describe the first reported use of ECMO to maintain cardiopulmonary support in a patient unable to tolerate prone positioning during spine surgery. ECMO support can be a viable option in adult patients who need emergent spinal surgery but are unable to tolerate prone positioning secondary to cardiopulmonary complications.
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Retrospective review. ⋯ The use of chemoprophylaxis appears to be safe in at-risk patients in the immediate postoperative period after spinal trauma surgery. No epidural hematomas occurred, and the risk of wound drainage is small. Body mass index, injury severity score, presence of neurological deficits, and number of spinal levels fused should be considered when determining which patients should receive chemoprophylaxis after surgical stabilization.