World Neurosurg
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Type 1 Chiari malformation (CM-I) is a craniospinal disorder historically defined by cerebellar tonsillar position greater than 3-5 mm below the foramen magnum (FM). This definition has come under question because quantitative measurements of cerebellar herniation do not always correspond with symptom severity. Researchers have proposed several additional radiographic diagnostic criteria based on dynamic motion of fluids and/or tissues. The present study objective was to determine if cardiac-related craniocaudal spinal cord tissue displacement is an accurate indicator of the presence of CM-I and if tissue displacement is altered with decompression. ⋯ These results support SCM measurement by PC-MRI as a possible noninvasive radiographic diagnostic for CM-I. Dynamic measurement of SCM provides unique diagnostic information about CM-I alongside static quantification of tonsillar position and other intracranial morphometrics.
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To investigate the impact that chronic obstructive pulmonary disease (COPD) has on postoperative complication rates, ambulation, and hospital length of stay for elderly spinal deformity patients after elective spinal fusion (≥3 levels). ⋯ Our study demonstrates that elderly patients with COPD have increased lengths of stay and higher rates of postoperative pneumonia after spinal fusion. This determination identifies a potentially modifiable risk factor for increased utilization of health care resources.
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To radiologically measure the parameters of endplates and the apophyseal ring and to suggest an applicable length for a lumbar interbody cage for Chinese patients. ⋯ The choice of an appropriate length for a lumbar interbody cage should be based on the procedure and fusion level, which can match the endplates anatomically. The size of the lumbar interbody cage is affected by many factors, and a simple calculation may not be clinically relevant.
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There is a strong relationship between lower back pain and paraspinal muscle atrophy. In this study, we aimed to investigate the prevalence of lumbar paravertebral muscle atrophy in patients with and without single-level disc herniation. ⋯ The MM and erector spinae muscle groups are innervated by the dorsal root of the spinal nerve arising from the same level; therefore, long-term pressure on the root caused by disc herniation can cause atrophy and degeneration of that muscle group.
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A frequently encountered problem during posterolateral fusion (PLF) is bone graft displacement from the posterolateral space during closure. Commercially available solutions to this problem are seldom used because of their exceptionally high cost. The purpose of this report is to describe 3 novel, low-cost techniques we developed for bone graft containment during PLF. ⋯ These 3 novel surgical techniques for bone graft containment in the posterolateral space add minimally to the cost and length of the procedure. Our early clinical experience suggests that these techniques are safe and effective. Additional clinical experience is warranted, and prospective data collection is ongoing.