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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Comparative Study
Comparison of aprotinin and tranexamic acid in adult scoliosis correction surgery.
A retrospective review of consecutive adult patients undergoing scoliosis correction surgery was performed to compare the effects of aprotinin and tranexamic acid in blood conservation and to define a comprehensive blood conservation strategy for such surgery. ⋯ Aprotinin and tranexamic acid reduce blood loss in adult spinal deformity correction surgery. With aprotinin being unavailable for clinical use, we recommend the use of tranexamic acid along with other blood conservation measures for adult spinal deformity correction surgery.
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To estimate the heritability of scoliosis in the Swedish Twin Registry. ⋯ Using self-reported data on scoliosis from the Swedish Twin Registry, we estimate that 38% of the variance in the liability to develop scoliosis is due to additive genetic effects and 62% to unique environmental effects. This is the first study of sufficient size to make heritability estimates of scoliosis.
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When the intervertebral disc is removed to relieve chronic pain, subsequent segment stabilization should restore the functional mechanics of the native disc. Because of partially constrained motions and the lack of intrinsic rotational stiffness ball-on-socket implants present many disadvantages. Composite disc substitutes mimicking healthy disc structures should be able to assume the role expected for a disc substitute with fewer restrictions than ball-on-socket implants. ⋯ All device versions altered the coupled intersegmental shear deformations affecting facet joint contact through contact area displacements. Loads in the bony endplates adjacent to the implants increased as the implant stiffness decreased but did not appear to be a strong limitation for the implant biomechanical and mechanobiological functionality. In conclusion, numerical results given by biomimetic composite disc substitutes were encouraging with greater potential than that offered by ball-on-socket implants.
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Case Reports
Growth hormone supplement treatment reduces the surgical risk for Prader-Willi Syndrome patients.
Many complications have been reported to occur with surgery for scoliosis in Prader-Willi Syndrome (PWS). However, growth hormone (GH) treatment has contributed to improvements in height, body composition, bone density and breathing functions in PWS patients. The purpose of this study was to investigate patients who underwent surgery for scoliosis in PWS. ⋯ There were no severe complications such as deep infections or neurovascular damage. A few obese patients underwent surgery, but there were no dangerous complications. Overall, we consider that GH treatment before surgery may reduce postoperative complications. The growing rod method was effective for PWS patients who resisted brace treatment owing to mental retardation.
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Spinal epidural lipomatosis (SEL) is a rare but well-recognized condition. In general, the onset of its symptoms is insidious and the disease progresses slowly. ⋯ These SEL patients developed neurologic symptoms after less than 5 months; these symptoms were confirmed to be due to SEL by serial MR images. After the debulking of the epidural fat, their symptoms improved.