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[PMID]:29200854
[Au] Autor:Qu Y; Wang Z; Zhou H; Kang M; Dong R; Zhao J
[Ad] Endereço:Department of Orthopedics, The Second Hospital of Jilin University, Changchun, People's Republic of China.
[Ti] Título:Oligosaccharide nanomedicine of alginate sodium improves therapeutic results of posterior lumbar interbody fusion with cages for degenerative lumbar disease in osteoporosis patients by downregulating serum miR-155.
[So] Source:Int J Nanomedicine;12:8459-8469, 2017.
[Is] ISSN:1178-2013
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:Degenerative lumbar disease (DLD) is a significant issue for public health. Posterior lumbar intervertebral fusion with cages (PLIFC) has high-level fusion rate and realignment on DLD. However, there are some complications following the surgery. Alginate oligosaccharides (AOS) have antioxidant and anti-inflammatory activities and may be suitable for infection therapy. MiR-155 is a biomarker associated with inflammatory and oxidative stress. AOS may promote PLIFC therapy by regulating miR-155. Pluronic nanoparticles and oligosaccharide nanomedicine of alginate sodium (ONAS) were prepared with ampicillin at size <200 nm. Ninety-six DLD osteoporosis patients received PLIFC and were evenly assigned into ONAS group (OG, oral administration of 100 mg ONAS daily) and control group (PG, 100 mg pluronic nanoparticles). Serum miR-155 level was measured by real-time quantitative PCR. The levels of superoxide dismutase (SOD), glutathione (GSH), aspartate aminotransaminase (AST), alanine aminotransferase (ALT), interleukin-1ß (IL-1ß), and interleukin-1 receptor antagonist (IL-1ra) were measured. Weighted mean difference (WMD), relative risk (RR), complications, surgery infection rate, fusion rate, and Japanese Orthopaedic Association (JOA) scores were used to evaluate therapeutic efficacy. After 1-month therapy, infection rates and side effects were lower in OG than those in PG (RR =0.64, 95% confidence interval [CI] [0.48, 0.84], =0.001). The fusion rates were higher in OG than in PG (WMD =21.96, 95% CI [-0.24, 37.62], =0.021). The JOA scores were higher in OG than in PG (RR =0.52, 95% CI [0.33, 0.84], =0.007), and no significant difference was found for the visual analog scale and Oswestry Disability Index. Serum levels of miR-155, ALT, AST, and IL-1ß were lower while SOD, GSH, and IL-1ra were higher in OG than in PG. MiR-155 mimic increased the levels of ALT, AST, and IL-1ß and reduced the levels of SOD, GSH, and IL-1ra. In contrast, miR-155 inhibitor had reverse results. Therefore, ONAS has better improvement in complications and therapeutic effects on DLD by regulating serum miR-155.
[Mh] Termos MeSH primário: Alginatos/farmacologia
Degeneração do Disco Intervertebral/terapia
Vértebras Lombares/patologia
MicroRNAs/sangue
Nanomedicina/métodos
Oligossacarídeos/farmacologia
Osteoporose/complicações
Fusão Vertebral
[Mh] Termos MeSH secundário: Idoso
Antioxidantes/farmacologia
Linhagem Celular Tumoral
Citocinas/metabolismo
Regulação para Baixo/efeitos dos fármacos
Regulação para Baixo/genética
Feminino
Ácido Glucurônico/farmacologia
Ácidos Hexurônicos/farmacologia
Seres Humanos
Degeneração do Disco Intervertebral/sangue
Degeneração do Disco Intervertebral/genética
Masculino
MicroRNAs/genética
Nanopartículas/ultraestrutura
Estresse Oxidativo/efeitos dos fármacos
Garantia da Qualidade dos Cuidados de Saúde
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Alginates); 0 (Antioxidants); 0 (Cytokines); 0 (Hexuronic Acids); 0 (MIRN155 microRNA, human); 0 (MicroRNAs); 0 (Oligosaccharides); 8A5D83Q4RW (Glucuronic Acid); 8C3Z4148WZ (alginic acid)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.2147/IJN.S143824


  2 / 20871 MEDLINE  
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[PMID]:29480873
[Au] Autor:Makino T; Honda H; Fujiwara H; Yoshikawa H; Yonenobu K; Kaito T
[Ad] Endereço:Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita.
[Ti] Título:Low incidence of adjacent segment disease after posterior lumbar interbody fusion with minimum disc distraction: A preliminary report.
[So] Source:Medicine (Baltimore);97(2):e9631, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:STUDY DESIGN: A retrospective review of prospectively collected data. OBJECTIVE: To investigate the incidence of radiographic and symptomatic adjacent segment disease (ASD) and identify possible risk factors for ASD after posterior lumbar interbody fusion (PLIF) with minimum disc distraction by selecting low-height interbody cages. SUMMARY OF BACKGROUND DATA: Excessive disc space distraction is reportedly 1 of the risk factors for ASD after PLIF; however, the incidence and other risk factors of ASD after PLIF with minimum disc distraction remain unclear. METHODS: Forty-one consecutive patients who underwent PLIF at L4-L5 and were postoperatively followed up for a minimum of 2 years were included. The height and shape (box or bullet shape) of interbody cages was determined according to the disc height and morphology of the intervertebral space assessed on preoperative computed tomography scans to avoid excessive distraction. The incidence of radiographic and symptomatic ASD was evaluated and all demographic and radiographic parameters were compared between patients with and without ASD. Multivariate logistic regression analysis was performed to identify risk factors for ASD among the variables with P < .20 in univariate analysis. RESULTS: The overall incidence of ASD was 12.2% (5/41 patients): radiographic ASD, 7.3% (3 patients); symptomatic ASD, 4.9% (2 patients). Multivariate analysis revealed preoperative retrolisthesis of L3 on extension as the sole risk factor for ASD after PLIF with minimum disc distraction (odds ratio, 2.13; 95% confidence interval, 1.00-4.05; P = .049). CONCLUSIONS: The incidence of ASD in this study was lower than that of ASD in our previous study about PLIF with distraction of disc space (12.2% vs. 31.8%). Minimum disc distraction by selection of low-height interbody cages is a simple and effective method to prevent ASD at the surgeons' discretion, although preexisting retrolisthesis at the adjacent upper segment should be taken into consideration.
[Mh] Termos MeSH primário: Degeneração do Disco Intervertebral/epidemiologia
Degeneração do Disco Intervertebral/etiologia
Vértebras Lombares/cirurgia
Complicações Pós-Operatórias/epidemiologia
Fusão Vertebral
Estenose Espinal/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seguimentos
Seres Humanos
Incidência
Degeneração do Disco Intervertebral/diagnóstico por imagem
Vértebras Lombares/diagnóstico por imagem
Masculino
Meia-Idade
Análise Multivariada
Razão de Chances
Complicações Pós-Operatórias/diagnóstico por imagem
Dados Preliminares
Estudos Prospectivos
Estudos Retrospectivos
Fatores de Risco
Estenose Espinal/diagnóstico por imagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180227
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009631


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[PMID]:29431968
[Au] Autor:Barta A
[Ti] Título:Back to the Basics on ICD-10-PCS Spinal Fusion Coding.
[So] Source:J AHIMA;87(10):84-7, 2016 10.
[Is] ISSN:1060-5487
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Codificação Clínica/normas
Classificação Internacional de Doenças
Fusão Vertebral/classificação
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:180213
[St] Status:MEDLINE


  4 / 20871 MEDLINE  
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[PMID]:28464186
[Au] Autor:Chmielnicki M; Prokop A
[Ad] Endereço:Klinik für Unfall- und Wiederherstellungschirurgie, Klinikverbund Südwest, Kliniken Sindelfingen, Sindelfingen.
[Ti] Título:Minimalinvasive thorakoskopische Wirbelkörperersatzoperation durch Implantation eines Obelisken..
[So] Source:Z Orthop Unfall;155(2):229-231, 2017 04.
[Is] ISSN:1864-6743
[Cp] País de publicação:Germany
[La] Idioma:ger
[Mh] Termos MeSH primário: Placas Ósseas
Procedimentos Cirúrgicos Minimamente Invasivos/métodos
Implante de Prótese/métodos
Fusão Vertebral/instrumentação
Fusão Vertebral/métodos
Cirurgia Torácica Vídeoassistida/métodos
[Mh] Termos MeSH secundário: Medicina Baseada em Evidências
Seres Humanos
Procedimentos Cirúrgicos Minimamente Invasivos/instrumentação
Cirurgia Assistida por Computador/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1055/s-0043-105498


  5 / 20871 MEDLINE  
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[PMID]:27779603
[Au] Autor:Cuneo JG; DeBerard MS; Wheeler AJ
[Ad] Endereço:*Department of Psychology, Utah State University, Logan, UT †VA San Diego Healthcare System, San Diego, CA.
[Ti] Título:Lumbar Fusion in Utah Workers' Compensation Patients: Changing Outcomes Across a Decade.
[So] Source:Spine (Phila Pa 1976);42(9):692-699, 2017 May 01.
[Is] ISSN:1528-1159
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:STUDY DESIGN: This study was a retrospective-cohort design involving a review of patient medical and cost records and a 2-year postsurgery follow-up outcome survey. OBJECTIVE: To evaluate the functional and cost outcomes associated with recent lumbar fusion surgeries in Utah workers and compare these outcomes with a comparable prior study cohort. SUMMARY OF BACKGROUND DATA: Lumbar fusion performed on injured workers has dramatically increased over the past 2 decades and this likely coincided with the increased use of more advanced surgical instrumentation. Considering the recent changes in lumbar fusion surgery, there is a need to identify how patient outcomes have changed among injured workers. MATERIALS AND METHODS: Retrospective chart review and 2-year postsurgery follow-up survey of patient outcomes were performed. Postsurgical outcomes for this sample were compared with established norms for back pain patients and a previous cohort of compensated lumbar fusion patients obtained from Workers' Compensation Fund of Utah. RESULTS: The current cohort evidenced a solid fusion rate of 89% and significant increase in the use of surgical instrumentation, particularly titanium fusion cages. Despite increased solid fusion rates, injured workers who have undergone lumbar fusion in Utah demonstrated equivalent and in some cases worse outcomes than those documented a decade ago. Specifically, there were significant increases in back pain dysfunction and narcotic medication usage in the current versus the past cohort. Medical and compensation costs for compensated lumbar fusion patients in Utah also significantly increased since the mid-1990s. CONCLUSION: Over the past decade, injured workers who have undergone lumbar fusion in Utah showed an increase in solid fusion rates and costs without a corresponding improvement in patient outcomes. LEVEL OF EVIDENCE: 3.
[Mh] Termos MeSH primário: Vértebras Lombares/cirurgia
Fusão Vertebral
Indenização aos Trabalhadores
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Estudos Retrospectivos
Fusão Vertebral/economia
Fusão Vertebral/estatística & dados numéricos
Resultado do Tratamento
Utah/epidemiologia
Indenização aos Trabalhadores/economia
Indenização aos Trabalhadores/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1097/BRS.0000000000001964


  6 / 20871 MEDLINE  
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[PMID]:29443765
[Au] Autor:Kim TH; Lee SH; Yang JH; Hong JY; Suh SW
[Ad] Endereço:Department of Orthopedic Surgery, Konkuk University Medical Center, Konkuk University School of Medicine.
[Ti] Título:Clinical significance of superior articular process as a reference point for free-hand pedicle screw insertion in thoracic spine.
[So] Source:Medicine (Baltimore);97(7):e9907, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The trajectory of the pedicle screw perpendicular to the SAP (superior articular process) is consistent with the universal trajectory presented in the previous study of the entry point using computed tomography. The ideal entry point and trajectory of pedicle screw insertion have been a matter of considerable debate. We attempted to find the relationship between SAP and entry point and trajectory of the pedicle screw.Thoracic spine CT (computed tomography) scans of 9 volunteers were studied. A safe zone for the trajectory of the screw in the axial (MarginAx) and sagittal (MarginSag) was defined as the zone between lines perpendicular to the SAP along the medial and lateral cortex of the pedicle in the axial section, and the superior and inferior cortex in the sagittal section without violation of the pedicle walls. The midline of MarginAx and MarginSag was defined as the safe entry point of the trajectory in the axial and sagittal planes (TrajectoryAx and TrajectorySag), respectively.MarginAx and MarginSag were 4.14 ±â€Š0.99 and 9.03 ±â€Š2.01 mm, respectively. There was a statistically significant difference in TrajectoryAx between the upper and middle, and between the upper and lower (P = .0076 in both cases), but not between the middle and lower thoracic spine (P = .066). TrajectorySag was within 1 mm at the levels of T4, T8, T11 vertebrae and at 0 mm at the other levels. Thus, the midpoint of MarginSag was within 1 mm from the SAP base.There was a constant angular relationship with the SAP and the pedicle axis; the line perpendicular to the SAP can act as a trajectory. Therefore, we suggest that the SAP might be the only accurate and safe reference for pedicle screw insertion in the thoracic spine perpendicular to the SAP using freehand technique.
[Mh] Termos MeSH primário: Complicações Pós-Operatórias/prevenção & controle
Fusão Vertebral
Vértebras Torácicas
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Parafusos Pediculares
Complicações Pós-Operatórias/etiologia
Falha de Prótese/etiologia
Ajuste de Prótese/métodos
Ajuste de Prótese/normas
Reprodutibilidade dos Testes
República da Coreia
Fusão Vertebral/instrumentação
Fusão Vertebral/métodos
Vértebras Torácicas/diagnóstico por imagem
Vértebras Torácicas/cirurgia
Tomografia Computadorizada por Raios X/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009907


  7 / 20871 MEDLINE  
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[PMID]:29384883
[Au] Autor:Lu Y; Bao W; Wang Z; Zhou F; Zou J; Jiang W; Yang H; Zhang Z; Zhu X
[Ad] Endereço:Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou.
[Ti] Título:Comparison of the clinical effects of zero-profile anchored spacer (ROI-C) and conventional cage-plate construct for the treatment of noncontiguous bilevel of cervical degenerative disc disease (CDDD): A minimum 2-year follow-up.
[So] Source:Medicine (Baltimore);97(5):e9808, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Comparing the clinical and radiographic outcomes in anterior cervical discectomy and fusion (ACDF) using a zero-profile anchored spacer (ROI-C) or a conventional cage-plate construct (CPC) for treating noncontiguous bilevel of cervical degenerative disc disease (CDDD).Overall, 46 patients with 2 noncontiguous segments of CDDD, treated with ACDF from January 2011 to October 2015, were included in this study. ROI-C was used in 22 patients (group A) and CPC in 24 patients (group B). The clinical and radiographic outcomes and complications were compared pre- and postoperatively. All patients were followed up for at least 24 months after surgery.No significant difference was found in fusion rate, cervical curvature, height of fused segment (FSDH), intraoperative blood loss, and Japanese Orthopaedic Association (JOA), and Neck Disability Index (NDI) scores between the 2 groups. Group A had a shorter operation time and significantly lower incidence of dysphagia (3 and 24 months postoperatively) than group B (P < .001 and P < .05, respectively). Moreover, group A had a higher loss of FSDH than group B, but with no difference between the 2 groups (P > .05). Two cages developed subsidence in group A (4.5%) and 2 adjacent levels developed degeneration in group B (2,8%).ACDF with ROI-C device was superior to CPC for noncontiguous bilevel of CDDD because it avoided postoperative dysphagia and required a shorter operation time. Moreover, the clinical outcomes were comparable. Prospective trials with larger samples and longer follow-up are required to confirm the results.
[Mh] Termos MeSH primário: Vértebras Cervicais
Fixadores Internos
Degeneração do Disco Intervertebral/cirurgia
Fusão Vertebral/instrumentação
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seguimentos
Seres Humanos
Degeneração do Disco Intervertebral/diagnóstico por imagem
Masculino
Meia-Idade
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009808


  8 / 20871 MEDLINE  
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[PMID]:29443791
[Au] Autor:Zhang H; Jiang Y; Wang B; Zhao Q; He S; Hao D
[Ad] Endereço:Department of Spine Surgery.
[Ti] Título:Direction-changeable lumbar cage versus traditional lumbar cage for treating lumbar spondylolisthesis: A retrospective study.
[So] Source:Medicine (Baltimore);97(7):e9984, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Despite the diverse designs for the lumbar interbody fusion cage, there is no consensus on the optimal design to date. The current study aimed to compare the efficacy and complications associated with the direction-changeable and traditional lumbar cages for treating lumbar spondylolisthesis.We conducted a retrospective study including 109 patients with lumbar spondylolisthesis, who were admitted to our hospital from January 2013 to December 2014. The patients were divided into the direction-changeable (group A) and traditional (group B) lumbar cage group.All patients underwent single-level transforaminal lumbar interbody fusion and were followed up for 12 to 24 months. There were 52 cases in group A and 57 cases in group B. Surgery-related parameters, including operation time, bleeding volume, and hospitalization time, were recorded; there was no significant difference between the 2 groups regarding these parameters. The visual analog scale and Oswestry disability index at the last follow-up showed significant improvement compared with preoperative values in both groups (P < .05). Patients in group A demonstrated more intervertebral space height maintenance postoperatively than patients in group B but the difference was not statistically significant (P > .05). In group A, complications included 3 cases of nonunion (5.77%) and 1 case of cerebrospinal fluid leakage (1.92%). In group B, complications included 9 cases of nonunion (15.79%) and 1 case of postoperative infection (1.75%). There was a significant difference between both groups in terms of the nonunion rate and total complication rate (P < .05).The direction-changeable lumbar cage has merits such as a higher bone fusion rate and fewer postoperative complications compared to the traditional lumbar cage.
[Mh] Termos MeSH primário: Fusão Vertebral/instrumentação
Espondilolistese/cirurgia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Tempo de Internação
Masculino
Meia-Idade
Duração da Cirurgia
Complicações Pós-Operatórias
Estudos Retrospectivos
Fusão Vertebral/efeitos adversos
Fusão Vertebral/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009984


  9 / 20871 MEDLINE  
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[PMID]:29443779
[Au] Autor:Zhang J; Xu R; Li Z; Zha W
[Ad] Endereço:Department of Orthopaedics, Mingzhou Hospital of Zhejiang University, Ningbo, Zhejiang Province, China.
[Ti] Título:Cerebral infarction due to malposition of cervical pedicle screw: A case report.
[So] Source:Medicine (Baltimore);97(7):e9937, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Malposition of cervical pedicle screw (CPS) has a risk of vertebral artery (VA) injury which sometimes may cause unexpected and catastrophic outcome. A rare case of delayed onset of cerebral infarction caused by malposition of CPS was reported. PATIENT CONCERNS: A 23-year-old man who underwent a posterior cervical reduction and fusion of C4-5 using CPS fixation and allograft for cervical spine injury is presented. The patient suffered progressively weakness and numbness for both of upper and lower extremities 1 day after the operation. Computed tomography scans revealed bilateral occupation of the pedicle screws in the foramen of C4 and C5 and the magnetic resonance imaging (MRI) displayed several areas of infarction in the brainstem and cerebellum. DIAGNOSES: Plain radiographs of the cervical spine revealed the C4 vertebral body and MRI displayed a disruption of the anterior longitudinal ligament on the level of C4-5 and severe injury to the soft tissues of the cervical spine at admission. Brainstem and cerebellum infarction was diagnosed at postoperative. INTERVENTION: A revision surgery was decided to remove all of the pedicle screws and place lateral mass screws instead. OUTCOMES: The patient felt better on his all of 4 extremities following revision surgery. Fortunately, he was neurologically close to normal at a 3-month follow-up. LESSONS: Delayed onset of cerebral infarction is rarely reported complication caused by malposition of CPS. When a CPS perforates the transverse foramen and causes symptom of cerebral infarction, a revision surgery in time is strongly recommended to prevent further sequelae.
[Mh] Termos MeSH primário: Infarto Cerebral/etiologia
Vértebras Cervicais/lesões
Vértebras Cervicais/cirurgia
Parafusos Pediculares/efeitos adversos
Complicações Pós-Operatórias/etiologia
Fusão Vertebral/efeitos adversos
[Mh] Termos MeSH secundário: Acidentes de Trânsito
Adulto
Infarto Cerebral/cirurgia
Seres Humanos
Masculino
Complicações Pós-Operatórias/cirurgia
Reoperação
Estudos Retrospectivos
Fusão Vertebral/instrumentação
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009937


  10 / 20871 MEDLINE  
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[PMID]:29384864
[Au] Autor:Zhao J; Chen Z; Yang M; Li G; Zhao Y; Li M
[Ad] Endereço:Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai.
[Ti] Título:Does spinal fusion to T2, T3, or T4 affects sagittal alignment of the cervical spine in Lenke 1 AIS patients: A retrospective study.
[So] Source:Medicine (Baltimore);97(5):e9764, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this stusy was to investigate whether spinal fusion to T2, T3, or T4 affects sagittal alignment of the cervical spine in Lenke 1 adolescent idiopathic scoliosis (AIS) patients.A retrospective study comprised of 64 Lenke 1 AIS patients was performed to assess the radiographic and clinical outcome. According to the upper instrumented vertebrae (UIV) (T2, T3, or T4), the patients were divided into 3 groups. Comparison analyses were performed among these 3 groups of patients as between pre-op, immediate post-op, and final follow-up, as well as between these groups.Between groups, comparison analyses did not detect a statistical difference in cervical lordosis (CL) preoperatively (P = .501), immediately after surgery (P = .795), and at follow-up (P = .510). Immediately after surgery, CL increased significantly in all groups (T2, P = .004, T3, P < .001 and T4, P = .002 respectively). Compared with immediate postoperatively, CL at final follow-up increased in T2 group (P = .037), and T4 group (P = .010). Furthermore, CL at follow-up was significantly correlated with the following parameters: preoperative (coronal plane balance [r = .349, P = .004], pelvic tilt [r = 0.347, P = .004), pelvic incidence [r = 0.261, P = .031], and CL [r = 0.471, P < .001]) immediately postoperative (CL [r = 0.946, P < .001], T1-slope [r = -0.646, P < .001], and thoracic kyphosis [TK] [r = -0.353, P = .003]), and at follow-up (TK [r = -0.342, P = .004], and T1-slope [r = -0.821, P < .001]). However, there was no significant correlation between a selection of UIV and CL at follow-up (r = 0.031, P = .802). Moreover, Scoliosis Research Society (SRS-22) scores between groups were similar preoperatively (P = .242), immediately after surgery (P = .828), and at follow-up (P = .219).In Lenke 1 AIS patients, the selection of UIV mainly affects the coronal plane, especially shoulder balance. Fusion to T2, T3, or T4 did not affect the alignment of the cervical spine, and the SRS-22 score. LEVEL OF EVIDENCE: Level IV.
[Mh] Termos MeSH primário: Vértebras Cervicais
Escoliose/cirurgia
Fusão Vertebral
Vértebras Torácicas
[Mh] Termos MeSH secundário: Adolescente
Criança
Feminino
Seres Humanos
Masculino
Radiografia
Estudos Retrospectivos
Escoliose/diagnóstico por imagem
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009764



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