Neurology India
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Fractures of the odontoid process are common, accounting for 10% to 20% of all cervical spine fractures. Odontoid process fractures are classified into three types depending on the location of the fracture line. ⋯ For example, type II odontoid fractures treated within the first 6 months of injury with direct anterior odontoid screw fixation have an 88% fusion rate, whereas fractures treated after 18 months have only a 25% fusion rate. In this review, we discuss the etiology, biomechanics, diagnosis, and treatment (including factors affecting fusion such as timing and fracture orientation) options available for odontoid process fractures.
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Video-assisted thoracoscopic surgery (VATS) has become an alternative treatment tool for a variety of spinal conditions in the last two decades. This endoscopic or "keyhole" approach minimizes the chest wall morbidity related to the traditional thoracotomy. ⋯ This article reviews the outcomes of VATS treatments in thoracic disc diseases, fractures, tumors and vertebral osteomyelitis. In addition, we have described our "learning curve" and surgical techniques using video-assisted thoracoscopic spinal releases and instrumentation in the treatment of 50 patients with adolescent idiopathic scoliosis.
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Kyphoplasty provides a minimal-invasive surgical technique for the cement augmentation of vertebral bodies following osteoprotic compression fractures or malignant processes. Kyphoplasty has been developed as an advancement of vertebroplasty. Both procedures feature high-success rates in terms of reliable and lasting reduction of pain. ⋯ Thus indications and possibilities have to be judged realistically. Conditions, which have to be considered before performing kyphoplasty or vertebroplasty include age of the patient, age of the fracture, degree of deformation and additional degenerative changes of the spine. This article summarizes the present research and literature as well as indications and contraindications and is thought to provide guidelines for the aforementioned decision-making processes.