The spine journal : official journal of the North American Spine Society
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There have been no previous studies looking at the outcome of surgical decompression (+/-stabilization) for various grades of epidural spinal cord compression (ESCC) due to spinal metastases. ⋯ Surgery can achieve improvements in neurology even in higher grades of cord compression. There is a trend toward more complications and worse survival with spinal surgery in patients with higher grades of compression.
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Short-segment pedicle screw instrumentation constructs for the treatment of thoracolumbar fractures gained popularity in the 1980s. The load-sharing classification (LSC) is a straightforward way to describe the extent of bony comminution, amount of fracture displacement, and amount of correction of kyphotic deformity in a spinal fracture. There are no studies evaluating the relevance of fracture comminution/traumatic kyphosis on the long-term radiologic outcome of burst fractures treated by short-segment instrumentation with screw insertion in the fractured level. ⋯ The six-screw construct is effective for treating thoracolumbar junction burst fractures. The medium-to-long-term loss of correction is affected by the amount of bony comminution of the fracture, objectified through the LSC score.
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There is little information regarding the surgical outcomes with regard to the timing of surgery in children under age 10 years for congenital scoliosis with a long-term follow-up. ⋯ In congenital scoliosis patients, posterior hemivertebra resection after pedicle screw fixation before the age of 6 years had significantly better deformity correction and did not cause a negative effect on the growth of vertebral body or spinal canal compared with the group treated after 6 years of age. Therefore, early surgical correction of a congenital hemivertebra in children under 6 years of age, before structural changes occur, effectively achieves a more satisfactory correction without causing iatrogenic spinal stenosis or neurologic complications compared with children older than 6 years but under 10 years of age.
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Proteus syndrome (PS) is an extremely rare congenital disorder causing asymmetric overgrowth of different tissues. The etiology remains unclear. Limb deformities are common and often necessitate amputations. Only a few cases associated with spinal deformities have been described. ⋯ Proteus syndrome can be associated with spinal stenosis and deformity. Although the syndrome can be progressive in nature, the symptomatic spinal pathology should be treated appropriately.
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Previous studies have reported position-dependent changes of the lumbar intervertebral foramen (LIVF) dimensions at different static flexion-extension postures. However, the changes of the LIVF dimensions during dynamic body motion have not been reported. ⋯ Human lumbar foramen dimensions show segment-dependent characteristics during the dynamic weight-lifting activity.