Spine
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Sagittal balance is an important concept in spinal coronal and kyphotic deformity correction. Sagittal alignment/lumbar lordosis is increasingly recognized and discussed in terms of surgical outcomes. ⋯ This concept is no longer associated only with deformity. Spine surgeons have learned that sagittal alignment/lumbar lordosis is very important even in 1-level or 2-level interbody fusion procedures, and that it can be attained, maintained, or lost during any procedure, resulting in complications.
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Researchers are seeking ways to heal bone better and faster. Cellular grafts can accelerate bone healing and promote bone formation. Immediately after injury, blood clot formation yields inflammatory cells; an influx of mesenchymal stem cells (MSCs) and osteogenic cells follows. ⋯ Osteoinduction stimulates stem cells to differentiate into osteoblasts and promotes cell migration. Osteoinductive agents include demineralized bone matrices () and bone morphogenetic proteins, which are extremely potent but are associated with risks and high costs. Amniotic tissue is relatively unregulated and has strong anti-inflammatory effects but has not been well studied in relation to bone formation and healing.
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Technique report and case series. ⋯ 5.
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Open surgical procedures have been the mainstay of spinal surgery for decades, but minimally invasive spinal surgery (MIS) has recently gained traction. Translaterally placed cages permit insertion of large cages and promote skeletal realignment and fusion. ⋯ MIS and open surgical procedures are reported to have similar outcomes at 1 year; in the first 6 weeks, patients undergoing open surgery often need blood transfusion, develop infection, and use more narcotics. Spine surgery has been associated with modulus mismatch between osteoporotic bone and titanium and the need for multiple painful and traumatic surgical procedures, and spine surgeons continue the quest to find better ways to do things.
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We investigate on the surgical reliability of nasal palatine line for the transnasal approach and introduce a conceptually analogue radiological line as a reliable predictor of the maximal superior extension of the transoral approach. We have also compared radiological and surgical lines to find possible radiological references points to predict preoperatively the maximal extent of superior dissection for the transoral approach. ⋯ 3.