The spine journal : official journal of the North American Spine Society
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The ideal timing of surgical decompression or stabilization following combat-related spine injury remains unclear. ⋯ Our study found that instability or progressive kyphosis and incomplete decompression were the most common indications for reoperation after evacuation to the United States. Our data provide additional understanding of the potential etiologies of failure and reoperation following in-theater combat spine surgery, and may help avoid such complications.
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Hydrogen sulfide (H2S), as a novel gaseous messenger molecule, plays an important role in signal transduction and biological modulation. ⋯ With the above data, we conclude that H2S could reduce the oxidative stress and has neuroprotective effect in acute cauda equina syndrome.
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Corrective surgery for adolescent idiopathic scoliosis (AIS) leads to vertical growth arrest of the instrumented spine. This might be offset by the immediate gain in spinal height (SH) as a result of correction of the curvature. ⋯ The greatest postoperative height values following posterior spinal fusion for AIS could be expected from a patient with greater preoperative height and Cobb angle, and whose construct spans a large number of vertebrae.
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The incidence of osteoporotic and insufficiency fractures of the pelvic ring is increasing. Closed reduction and percutaneous fixation with cannulated sacroiliac screws is well-established in the operative treatment of osteoporotic posterior pelvic ring fractures. However, osteoporotic bone quality might lead to the risk of screw loosening. For this reason, cement augmentation of the iliosacral screws is more frequently performed and recommended. ⋯ Regarding iliosacral screw fixation in osteoporotic bone, the primary stability of techniques involving cement augmentation is significantly higher compared with screw fixation without cement augmentation. Perforated screws with the same primary stability as that of conventional screw fixation in combination with cement augmentation might be a promising alternative in reducing complications of cement leakage. These biomechanical results have to be transferred into clinical practice and prove their clinical value.
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Intraoperative reduction of low-grade lumbar spondylolisthesis (LGLS) remains disputed. There is currently no published data comparing midterm outcomes of reduction versus in situ fusion. ⋯ Intraoperative reduction does not improve outcomes in LGLS with neurogenic symptoms after MIS TLIF. Adequate decompression and solid fusion are likely the keys to good mid-term outcomes.