The spine journal : official journal of the North American Spine Society
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Thoracolumbar extension-distraction fractures are rare injuries mainly restricted to patients suffering from ankylosing spinal disorders. The most appropriate surgical treatment of these unstable spinal injuries remains to be clarified. ⋯ In fragile patients with ankylosing spinal disorders and thoracolumbar extension-distraction fractures, closed reduction and percutaneous dorsal instrumentation provide a satisfying midterm functional outcome while minimizing perioperative risks compared with conventional dorsoventral procedures.
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A narrow cervical spinal canal (CSC) is a well-known risk factor for cervical myelopathy (CM). However, no epidemiologic data of the CSC based on a population-based cohort are available. ⋯ This study firstly confirmed the age-related differences in CSC diameters and the significant association of the narrow CSC diameter with CM in a population-based cohort.
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Comparative Study
Evaluation of scoring systems and prognostic factors in patients with spinal metastases from nasopharyngeal carcinoma.
The decision for operative treatment of patients with spinal metastases is dependent on the patient's predicted survival. Tokuhashi, Tomita, Bauer, and Oswestry scores have been devised for survival prediction; however, none of these systems have been evaluated in nasopharyngeal carcinoma (NPC). ⋯ Patients with spinal metastases from NPC have relatively good survival prognosis. All four scoring systems could be used to prognosticate these patients. The modified Tokuhashi score is the best in doing so.
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Treadmill training after traumatic spinal cord injury (SCI) has become an established therapy to improve walking capabilities. The hybrid assistive limb (HAL) exoskeleton has been developed to support motor function and is tailored to the patients' voluntary drive. ⋯ Hybrid assistive limb exoskeleton training results in improved over-ground walking and leads to the assumption of a beneficial effect on ambulatory mobility. However, evaluation in larger clinical trials is required.
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Intraoperative imaging is essential in spinal surgery to both determine the correct level and place implants safely. Surgeons have a variety of options: C-arm fluoroscopy (C-arm), portable X-ray (XR) radiography, and portable cone-beam computed tomography (O-arm). Although these modalities have their respective advantages and disadvantages, direct comparison of radiation exposure to either the patient or the operating room (OR) staff has not been made. ⋯ Assessment of radiation risk to the patient and OR staff should be part of the decision for utilization of any specific imaging modality during spinal surgery. This study provides the surgeon with information to better weigh the risks and benefits of each imaging modality.