Eur J Orthop Surg Tr
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Eur J Orthop Surg Tr · Jul 2014
Usefulness of full spine computed tomography in cases of high-energy trauma: a prospective study.
At this hospital, computed tomography (CT) of the full spine is performed on all patients who have sustained high-energy trauma because spinal fractures can be overlooked by referring only to clinical findings and plain X-rays of the spine. The goal of this study is to prospectively detect the occurrence of spinal fractures in cases of high-energy trauma using full spine CT and to evaluate the usefulness of it. ⋯ In patients who have sustained high-energy trauma, spinal fractures may be overlooked during primary care by a diagnosis based only on plain X-rays and clinical manifestations. Therefore, patients who have sustained high-energy trauma should be evaluated with full spine CT during primary care.
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Eur J Orthop Surg Tr · Jul 2014
Comparative StudyComparison of vertebroplasty and kyphoplasty in the treatment of osteoporotic vertebral compression fractures with intravertebral clefts.
Few studies have compared the surgical outcomes of vertebroplasty (VP) and kyphoplasty (KP) in the treatment of osteoporotic vertebral compression fractures (VCFs) with intravertebral clefts. ⋯ Intravertebral clefts occur primarily at the thoracolumbar junction and can be detected easily by CT and magnetic resonance imaging scans. Both VP and KP are effective in the treatment of clefts, but patients in KP group tend to have a better pain relief at the medium and long-term follow-up. However, the better pain relief effect of KP cannot be attributed to the higher magnitude of deformity correction.
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Eur J Orthop Surg Tr · Jul 2014
Midterm outcomes of total cervical total disc replacement with Bryan prosthesis.
Short-term results have indicated that the Bryan cervical total disc replacement (TDR) favorably compares to anterior cervical decompression and fusion, while it is associated with fewer complications and higher levels of satisfaction. The aim of the present work was to assess the safety and efficacy of the device in the treatment for cervical degenerative disc disease, at 6-year follow-up. Fifty-eighty patients have performed their 6-year follow-up visit and have been analyzed clinically and radiologically. ⋯ No case showed evidence of subsidence, wear of the implant. At a 6-year follow-up, the cervical TDR using Bryan prosthesis displayed satisfactory clinical and radiographic outcomes without any significant complication. However, future efforts need to be directed toward the evaluation of a larger number of patients with longer follow-up.
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Eur J Orthop Surg Tr · Jul 2014
Active thoracic and lumbar spinal tuberculosis in children with kyphotic deformity treated by one-stage posterior instrumentation combined anterior debridement: preliminary study.
The aim of this study was to retrospectively evaluate the safety, feasibility and efficacy of one-stage posterior instrumentation combined anterior debridement and interbody fusion for treatment of active thoracic and lumbar spinal tuberculosis (TB) in children with kyphotic deformity. A total of 20 children (12 boys, 8 girls) were enrolled in this study from January 2006 to January 2011. All patients underwent one-stage posterior instrumentation combined anterior debridement and interbody fusion. ⋯ Erythrocyte sedimentation rate and C-reactive protein returned to normal in all patients within 6 months after surgery. All patients acquired bony fusion, and no major complications were observed through the final follow-up visit. One-stage posterior instrumentation combined anterior debridement and fusion were demonstrated to be a safe and effective method to achieve spinal decompression and kyphosis correction in children with thoracic and lumbar spinal TB.
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The spinal deformities in paediatric population differ from those in the adult population. Vertebral osteotomies are indicated when the deformity is too rigid to be corrected either with instrumentation alone or with the addition of soft tissue releases. When surgical intervention is to be carried out, correcting the deformity and ceasing progression should be aimed at as well as allowing further growth and improving pulmonary function. ⋯ Appropriate selection of the type of the osteotomy depends on the surgeons' experience, type of the deformity, magnitude of the curve, remaining growth potential and operative goals. Neuromonitoring should be an indispensible part of the procedure. Spine osteotomies are effective procedures for the treatment of paediatric spine deformities if experienced surgical team performs them.