Blevinsmogensen2620

We conclude that early consultation with plastic surgery can be greatly beneficial to effectively extirpate dead space and resolve giant sacral pseudomeningoceles, especially if there is concern of persistent cerebrospinal fluid leakage due to relatively immobile avascular soft tissue as a result of prior revision surgery.

We conclude that early consultation with plastic surgery can be greatly beneficial to effectively extirpate dead space and resolve giant sacral pseudomeningoceles, especially if there is concern of persistent cerebrospinal fluid leakage due to relatively immobile avascular soft tissue as a result of prior revision surgery.

Multiple myeloma (MM) is the most frequent primary malignancy of the spine. We aimed to investigate the clinical presentation, surgical indications and outcomes, complications, survival, and its influencing factors in surgically treated MM patients with symptomatic involvement of the spine (SIS).

Retrospective analysis of prospectively collected data. Out of 350 MM patients treated at our institution over a period of 12 years (2006-2018), we identified 24 patients who were surgically treated for SIS. We collected data on demographics, clinical presentation, comorbidities, surgical indications, and outcomes and investigated the factors predisposing to postoperative complications and survival.

The median follow-up duration was 85 months; median overall survival (OS) was 50 months. Clinical presentation at admission included pain (88%), sensory and/or motor deficit (67%), and bowel/bladder dysfunction (25%). Symptomatic pathological fractures were seen in 33%. Predominant surgical indications were rapid nea valuable option for MM patients with SIS who present with rapid neurological deterioration with or without SCC and/or mechanical instability.

Natural history studies have reported that the progression rate of juvenile idiopathic scoliosis (JIS) curves larger than 20° is high and tends to progress. The aim of this study was to investigate the outcome of bracing on JIS and to determine the prognostic factors on the success rate of brace treatment.

From March 1985 to February 2015, the clinical data of all JIS patients with referral age from 4 to 10 years who received brace treatment were reviewed. Those patients with a prebrace Cobb angle >20° and a Risser sign of 0 to 2 were included and followed up a minimum of 2 years after discontinuation of the brace or time of spinal fusion. RSV inhibitor The Cobb angle was recorded at the time of diagnosis, before initiation of bracing, weaning time, brace discontinuation, and final follow-up.

From 297 patients with JIS, a total of 75 cases (18 boys, 57 girls) with an average curve magnitude of 31.9° at the time of diagnosis met the inclusion criteria of the study. For successfully treated patients, the average best in-brace correction was 55% for Lenke I curves, 59% for Lenke II curves, 41% for Lenke III curves, and 62% for Lenke V curves. For a total of 27 patients (36%), the brace treatment failed. Of these, 21 patients (78%) reached spinal fusion, and curves of 6 patients (22%) increased to ≥50°. The progression rate was highest in patients with Lenke type III curves (67%), and also in those with a curve magnitude of ≥46° (94%).

Brace treatment is an effective strategy for controlling the curve progression and avoiding spinal fusion in JIS.

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A spinal motion segment comprises facet joints and intervertebral disc. A complex interplay of biomechanical factors occurs between them with degeneration giving rise to numerous pathological conditions. We conducted a study to find a correlation between facet joint orientation and intervertebral discs with age.

A cross-sectional study of 203 consecutive subjects undergoing a computed tomography scan of abdomen and pelvis were included. Subjects were divided into 5 groups based on age (group I 18-30 years; group II 31-40 years; group III 41-50 years; group IV 51-60 years; group V 61-70 years). Using 3-dimensional reconstruction images, orientation of lumbar facet joints at the L4-5 level was measured. Similarly, adjacent disc heights at L3-4 and L4-5 were measured and their ratio was documented.

The study included 106 males and 97 females. A positive correlation was noted between age and sagittal facet orientation until age 60 years. However, after age 60 years, a negative correlation with age was seen, which was statistically significant. Similarly, the disc height ratios show a progressive decline in their values with age. However, this decline was statistically significant only after age 60 years.

The gradual change of facet joint orientation from sagittal to coronal as the age crosses from 30 to 60, to beyond 60, with a simultaneous and parallel diminishing in the disc height probably is one of the attributes of the phenomenon of autostabilization of a motion segment.

The gradual change of facet joint orientation from sagittal to coronal as the age crosses from 30 to 60, to beyond 60, with a simultaneous and parallel diminishing in the disc height probably is one of the attributes of the phenomenon of autostabilization of a motion segment.

Pedicle screw fixation is commonly used in the treatment of spinal pathologies. While the biomechanical factors that affect bone fixation have been frequently described, questions remain as to which imaging modality is the ideal medium for preoperative planning. Due to its perceived superiority in assessing bony changes, computed tomography (CT) scan is assumed to be the gold standard for preparative planning, and we hypothesize that magnetic resonance imaging (MRI) is sufficiently accurate to predict screw length and diameter compared to CT.

We retrospectively measured the length and diameter of vertebral bodies in the lumbar region in both MRI and CT and tested for differences between the modalities as well as for confounding effects of age, sex, and the presence of spondyloarthrosis.

We found a significant difference in pedicle screw length between CT and MRI measurements for both sides. For the left pedicle, the mean difference was 1.89 mm (95% confidence interval [CI] -3.03 to -0.75;

< .002), while for the right pedicle, the mean difference was 2.