The spine journal : official journal of the North American Spine Society
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A previous study showed subtle biomechanical changes in the gait of unbraced adolescent idiopathic scoliosis (AIS) patients such as a reduction of pelvic, hip, knee, and ankle displacements. However, lumbopelvic muscles' timing activity was bilaterally increased during gait and correlated to excessive oxygen consumption as compared with healthy subjects. Usually, a brace, when indicated, is worn strictly for 22 hours every day in skeletally immature idiopathic scoliotic girls. To our knowledge, no study has assessed the long-term brace effect (6 months) on functional activities such as level walking. ⋯ After 6 months of orthotic treatment, in an out-brace situation, the main structural thoracolumbar/lumbar curve remained partly corrected. Frontal pelvis and hip motion increased, contributing to an improvement of muscular mechanical work during walking. EMG activity duration of lumbopelvic muscles did not change except for the erector spinae muscles, which was decreased but without any beneficial change in the energy cost of walking. In summary, brace treatment, after 6 months, did not significantly influence the gait variables in AIS girls deleteriously, but did not reduce the excessive energy cost, which was 30% above the values of normal adolescents.
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Randomized Controlled Trial
Intraoperative systemic infusion of lidocaine reduces postoperative pain after lumbar surgery: a double-blinded, randomized, placebo-controlled clinical trial.
Analgesic effect of lidocaine infusion on postoperative pain. ⋯ Intraoperative systemic infusion of lidocaine decreases pain perception during microdiscectomy, thus reducing the consumption of opioid and the severity of postoperative pain. This effect contributes to reduce the length of HS.
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Randomized Controlled Trial
The effect of milrinone on induced hypotension in elderly patients during spinal surgery: a randomized controlled trial.
Induced hypotension is widely used intraoperatively to reduce blood loss and to improve the surgical field during spinal surgery. ⋯ We conclude that milrinone is useful for induced hypotension in elderly patients during spinal surgery.
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Obesity has been associated with adverse surgical outcomes; however, limited information is available regarding the effect of obesity on cervical spinal fusion outcomes. ⋯ High BMI, regardless of obesity class, does not appear to be associated with increased complications after cervical fusion in the 30-day postoperative period.
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Vertebral artery injuries (VAIs) are rare but serious complications of cervical spine surgery, with the potential to cause catastrophic bleeding, permanent neurologic impairment, and even death. The present literature regarding incidence of this complication largely comprises a single surgeon or small multicenter case series. ⋯ The overall incidence of VAI during cervical spine surgery reported from this survey was 0.07%. Less experienced surgeons had a higher rate of VAI compared with their more experienced peers. The results of VAI are highly variable, resulting in no permanent harm most of the time; however, permanent neurologic injury or death occur in 10% of cases.