Journal of spinal disorders
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Case Reports
Spontaneous correction of a traumatic kyphosis after posterior spinal fusion in an infant.
Posterior spinal fusion of presumed traumatic kyphosis at T11-T12 in a 23-month-old child resulted in spontaneous correction of a major angular deformity. Considerable resorption of the T12 body occurred. The remodeling process was largely completed by 8 years and 8 months of age.
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We report the development of a new laminoplasty for the thoracic and lumbar spine. In this method, after two or three laminae are subjected to en bloc laminectomy using a surgical air drill, median longitudinal incisions are made in the laminae from the ventral side with a microsurgical saw and then the resected laminae are put back in place, like pitching a tent. ⋯ This method is useful as a form of anatomical repair after laminectomy. Because it preserves the posterior element, it helps to prevent shrinkage of the laminectomy membrane mass and postoperative spinal column deformity.
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Twelve bony pelves were used in this study. S1 dorsal screws were inserted in the anteromedial, anterior, anterolateral, and anteroinferior directions. When the screws were inserted within 5-10 mm beyond the anterior sacral cortex, radiographs were obtained in the anteroposterior, modified inlet, modified outlet, and lateral projections to evaluate the position of the screws and penetration of the anterior cortex. ⋯ This study suggested that the modified inlet and lateral radiograph views are most useful for detecting screw penetration of the anterior cortex of the sacrum. The modified outlet projection is the best for determination of a screw violating the S1 anterior foramen. Also, the modified inlet projection will show the screw orientation relative to the mediolateral plane (the sacral canal and sacroiliac joint), and the lateral view will show the screw direction relative to the superoinferior plane.
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Surgical correction of kyphotic deformity of the cervical spine caused by ankylosing spondylitis is usually done using local anesthesia to prevent undue spinal cord compression and paralysis followed by a sudden-extension maneuver. We report a case of kyphotic deformity that was corrected while the patient was under general anesthesia. ⋯ Somatosensory evoked potential and wake-up tests were also performed. Our successful result shows that correction of kyphotic deformity of the cervical spine in ankylosing spondylitis can be done more accurately and without discomfort using the present method.
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Carboxyhemoglobin levels were measured in patients undergoing posterior lumbar spine surgery with use of intraoperative cell saver blood salvage. Increased carboxyhemoglobin levels were demonstrated in cell saver salvaged blood. Systemic blood carboxyhemoglobin levels increased with cell saver blood transfusion. No patient demonstrated clinical effects of carbon monoxide toxicity.