Neurosurgery clinics of North America
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Neurosurg. Clin. N. Am. · Oct 2007
ReviewNewer technologies for the treatment of scoliosis in the growing spine.
Progressive scoliosis in the growing child poses a unique challenge. The surgeon aims to attain maximal curve correction while maintaining spinal and thoracic growth. Nonoperative treatments include bracing and serial casting. ⋯ These include growing rods, intervertebral body stapling, and the vertical expandable prosthetic titanium rib. Each of these offers unique advantages and disadvantages. In this article, the authors review these newer technologies for treatment of the growing spine.
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Pediatric thoracolumbar spinal trauma is a relatively rare event. It is important to understand the unique mechanical, diagnostic, and management considerations of this patient population. Inadequate recognition of thoracolumbar spinal injuries or suboptimal management may lead to less than ideal clinical outcomes in a population of patients who otherwise would have had great potential for recovery.
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The cervicothoracic junction (CTJ) represents a unique region in the spine because of its biomechanical properties. It is predisposed to various traumatic injuries, tumor, and iatrogenic instability. It is also a difficult region to access anteriorly because of the vital structures ventral to the CTJ. The development of new surgical techniques and new instrumentation has allowed better access and fixation to the CTJ.
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Neurosurg. Clin. N. Am. · Apr 2007
ReviewThe Scoliosis Research Society classification for adult spinal deformity.
The management of adult spinal deformity is characterized by significant variability in operative and nonoperative approaches. Adult spinal deformity encompasses a broad spectrum of disorders of the spine, and the disparity observed in reported clinical outcomes of operative and nonoperative care reflects the heterogeneity of the cases studied. ⋯ The Scoliosis Research Society classification for adult deformity is presented in this article. The purpose of this classification is to provide a framework for reporting similar cases and to contribute to the development of an evidence-based approach to the management of adult spinal deformity.
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Neurosurg. Clin. N. Am. · Jan 2007
ReviewRestoring function after spinal cord injury: promoting spontaneous regeneration with stem cells and activity-based therapies.
Although neural regeneration is an active research field today, no current treatments can aid regeneration after spinal cord injury. This article reviews the feasibility of spinal cord repair and provides an overview of the range of strategies scientists are taking toward regeneration. The major focus of this article is the future role of stem cell transplantation and similar rehabilitative restorative approaches designed to optimize spontaneous regeneration by mobilizing endogenous stem cells and facilitating other cellular mechanisms of regeneration, such as axonal growth and myelination.