World Neurosurg
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Distal junctional kyphosis (DJK) is defined as the development of a kyphotic angulation over 10 degrees below a fusion construct and has been described as a complication of the treatment of adolescent idiopathic scoliosis, Scheuermann kyphosis, adult spinal deformity, and cervical deformity. There are some inherent risk factors to DJK: multilevel fusions, damage to the midline soft tissues including interspinous/supraspinous ligaments, T5-T12 thoracic kyphosis, T11-L2 thoracolumbar kyphosis, and increased mismatch between cervical lordosis and T1 slope. A 53-year-old male presented with cervicalgia, inability to sustain horizontal gaze, and kyphosis-enabled forward head posture. ⋯ Correction for DJK encompasses sagittal alignment restoration, a stable construct, and a good biological environment for healing. Failure of DJK realignment can occur if the patient's ligaments deteriorate distal to the construct or fractures develop in vertebral bodies at the lowest instrumented vertebra or lowest instrumented vertebra +1. One year after surgery, the patient's condition improved, evidenced from both patient self-report and a standing posture radiograph.
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To investigate the continuous relationship between age and tracheostomy in patients with traumatic cervical spinal cord injury (TCSCI). ⋯ Age and tracheostomy present a dose-response relationship in patients with TCSCI. This finding could help physicians bring assistance in the early identification of tracheostomy and rationalize the allocation of medical resources.
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Review Meta Analysis
Efficacy and safety of lumbar dynamic stabilization device Coflex for lumbar spinal stenosis: A systematic review and meta-analysis.
This systematic review and meta-analysis were performed to investigate evidence for the comparison of lumbar dynamic stabilization device Coflex (Surgalign, Deerfield, IL) with posterior lumbar fusion for lumbar spinal stenosis). ⋯ Current evidence suggests that lumbar dynamic stabilization device Coflex is superior to posterior lumbar fusion in early follow-up. However, considering that the dynamic stabilization device group also has its limitations, these findings need to be further verified by multicenter, double-blind, and large-sample randomized controlled trials.
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Review Meta Analysis
Modern Management of Complex Tympanojugular Paragangliomas: a Systematic Review and Meta-Analysis.
Tympanojugular paragangliomas (TJPs) are slow-growing tumors arising within the middle ear or jugular foramen. The development of modified skull base approaches and the increasing use of stereotactic radiosurgery have provided more modern techniques in the management of TJPs. Several factors dictating approach selection, and resulting clinical outcomes have been inconsistently described. ⋯ Stereotactic radiosurgery and surgical resection for TJPs have similar rates of tumor recurrence. Radiation is associated with less risk and lower morbidity, yet there is comparably modest reduction of the tumor size. In sum, the data suggest that radiosurgery is a reasonable management option for patients with minimal symptoms who are high risk for surgery. Microsurgical resection should be reserved for patients with lower cranial neuropathies or those who have failed radiation treatment.