European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Randomized Controlled Trial
No benefit of early versus late ambulation after incidental durotomy in lumbar spine surgery: a randomized controlled trial.
Incidental durotomy (ID) is a complication occurring in 4-17% of decompressive spinal surgeries. Persisting CSF leakage can occur even after ID repair and requires revision surgery. Prolonged flat bed rest (BR) to reduce the incidence of persisting CSF leakage is frequently applied but highly debated. A randomized controlled trial comparing prolonged BR versus early ambulation after ID repair is lacking. The aim of this study was to investigate the incidence of revision surgery as a result of persistent cerebro-spinal fluid (CSF) leakage and medical complications after immediate or late post-operative ambulation following ID during decompressive spinal surgery. ⋯ Level 1b (individual randomized controlled trial). These slides can be retrieved under Electronic Supplementary Material.
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To investigate the biomechanical effects of anterior column realignment (ACR) and pedicle subtraction osteotomy (PSO) on local lordosis correction, primary stability and rod strains. ⋯ Bilateral posterior fixation is highly recommended following ACR to provide adequate primary stability. However, primary rod strains in ACR were found comparable or higher than weak PSO construct associated with frequent rod failure; therefore, caution is recommended. These slides can be retrieved under Electronic Supplementary Material.
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This study was aimed to identify correlation between maximum isometric strength in five muscle groups determined by dynamometry results of muscle tests and the inclination angles of the spine. ⋯ There is a strong association between isometric strength of the muscle groups of the hip extensors and erector spinae and the inclination angles of the spine. Based on the isometric results, physical therapy can be proposed for increasing the muscular strength of those muscle groups, which can help in the prevention of more severe forms of postural deformities. These slides can be retrieved under Electronic Supplementary Material.
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Hyaluronic acid prevents tissue adhesion after different surgeries. Physical barriers and inflammatory regulation have been suggested to be involved in the mechanism of these clinical effects. However, the molecular mechanism by which hyaluronic acid prevents epidural adhesion has not yet been reported. ⋯ These results indicate that cross-linked hyaluronic acid gel can prevent epidural adhesion by inhibiting inflammatory factors, such as IL-6, and downregulating TGFβ1 and COL1A1 mRNA expression. These slides can be retrieved under Electronic Supplementary Material.