Publications by authors named "Mehdian S"

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Study Design: A retrospective observational cohort study with a minimum follow-up of 10 years of patients who underwent surgery for Scheurmann Kyphosis (SK).

Objective: Evaluate the long-term clinical and radiological outcome of patients with SK who either underwent combined anterior-posterior surgery or posterior instrumented fusion alone. There is paucity of literature for long-term outcome studies on SK.

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Introduction: Giant herniated thoracic discs (GHTD) remain a surgical challenge. When combined with calcification, these discs require altered surgical strategies and have only been infrequently described. Our objective was to describe our surgical approaches in the management of calcified GHTD.

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Aim: Rett syndrome is a progressive neurodevelopmental disorder that predominantly affects females and is associated with a high incidence of scoliosis and epilepsy. There is scant published work about intraoperative spinal cord monitoring in these patients and little more regarding the rate of perioperative complications. We investigated our institutions' experience with both.

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Purpose: Patients with neuromuscular scoliosis are at increased risk of neurological deficit post-operatively, but are a difficult population on whom to perform neurophysiological monitoring. We look here at a 7-year sample of our practice in the monitoring of neuromuscular patients.

Methods: A retrospective chart review was performed for 109 patients who underwent correction of neuromuscular scoliosis within our institution between 2005 and 2011.

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Study Design: A retrospective matched cohort study.

Purpose: To compare the results of combined Luque rod-sublaminar wiring (thoracic) and pedicle (lower lumbar) instrumentation (SLW) versus those with pedicle screw fixation (PS) for scoliosis correction in Duchenne muscular dystrophy (DMD).

Overview Of Literature: PS fixation is gaining popularity.

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Study Design: A case series of eight consecutive patients with severe (Meyerding Grade ≥ 3) adolescent isthmic spondylolisthesis (SAIS) who underwent reduction and stabilization by using a new surgical technique.

Objective: To report the results of a safe three-stage spinal shortening procedure in a single operative session in eight patients with SAIS.

Summary Of Background Data: The treatment of SAIS is controversial and the opinion continues to remain divided between in situ fusion and reduction followed by stabilization.

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Study Design: A retrospective review of clinical and radiologic outcome in 13 consecutive patients with Ankylosing Spondylitis (AS) who underwent cervical osteotomy for correction of fixed cervicothoracic kyphotic deformity (CTKD) using an innovative technique.

Objective: To report further refinements to an existing technique for instrumented reduction of cervical osteotomy and assess the safety and efficacy of this procedure in 13 patients.

Summary Of Background Data: Cervical osteotomy in AS has been used for correction of CTKD, but is associated with significant risks.

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A non-randomised retrospective study to compare the results of surgical correction of scoliosis in Duchenne's muscular dystrophy (DMD) patients using three different instrumentation systems-Sublaminar instrumentation system (Group A), a hybrid of sublaminar and pedicle screw systems (Group B) and pedicle screw system alone (Group C). Between 1993 and 2003, 43 patients with DMD underwent posterior spinal fusion and instrumentation. Group A (n = 19) had sublaminar instrumentation system, Group B (n = 13) had a hybrid construct and Group C (n = 11) was treated with pedicle system.

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There is a high risk of cervical osteomyelitis in intravenous drug abusers due to the use of jugular veins for administration of drugs. Here described is a case of rapid vertebral body destruction at two levels leading to a progressive kyphotic deformity followed by autofusion, secondary to cervical osteomyelitis. The case report goes on to hypothesise about the unique manner of progression of untreated cervical osteomyelitis with a rapid onset of kyphotic deformity and associated severe bone destruction in an intravenous drug abuser.

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We report a case of multilevel vertebral osteomyelitis with facet joint infection after epidural catheterisation. Back pain relating to regional anaesthetic techniques is common and usually self-limiting. However, it is essential to consider infection in any differential diagnosis.

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The authors report a rare case of rotational dislocation of the thoracolumbar spine in a 12-year-old girl with neurofibromatosis Type 1. The patient had progressive spinal kyphoscoliosis with acute-onset paraplegia. She was treated with corrective traction preoperatively, followed by spinal decompression and circumferential spinal fusion without instrumentation.

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Background Context: Previous studies have analyzed the outcome following posterior correction and combined anterior-posterior correction for Scheuermann's kyphosis. Traditionally interbody fusion has been obtained using morselized rib graft. Recently the use of titanium anterior cages has been suggested for interbody use.

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Study Design: The case of a 14-year-old boy with a severe-grade isthmic spondylolisthesis who underwent reduction and stabilization using this technique is described.

Objective: To report a new sequential 3-stage procedure for reduction and stabilization of severe adolescent isthmic spondylolisthesis during 1 operative session.

Summary Of Background Data: Conventional reduction techniques do not address the important regional anatomic restraints on the L5 nerve root during the reduction maneuver, thereby leading to a high risk of neurologic deficit.

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The literature reports on the safety and efficacy of titanium cages (TCs) with additional posterior fixation for anterior lumbar interbody fusion. However, these papers are limited to prospective cohort studies. The introduction of TCs for spinal fusion has resulted in increased costs, without evidence of superiority over the established practice.

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We retrospectively analysed ten consecutive patients (age range 32-77 years) treated surgically from 1994 to 1999 for symptomatic thoracic disc herniation between the 6th and 12th thoracic discs. Clinically, eight patients had varying grades of back pain and eight patients had paraparesis. Radiography showed calcification in 50% of the herniated discs.

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Study Design: This retrospective study evaluates two groups of patients with scoliosis and Duchenne muscular dystrophy, treated with two different surgical stabilization methods.

Objective: To determine whether fixation to the sacropelvis is always necessary for adequate stabilization of scoliosis in Duchenne muscular dystrophy.

Summary Of Background Data: Pelvic fixation is generally recommended for scoliosis in Duchenne muscular dystrophy.

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Background: Recent cadaver studies show stability against axial rotation with a cylindrical cage is marginally superior to a rectangular cage. The purpose of this biomechanical study in cadaver spine was to evaluate the stability of a new rectangular titanium cage design, which has teeth similar to the threads of cylindrical cages to engage the endplates.

Methods: Ten motion segments (five L2-3, five L4-5) were tested.

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Objectives: To demonstrate possible advantages of combined (motor and sensory) versus single modality (either motor or sensory) intra-operative spinal cord monitoring and to investigate risk factors for post-operative neurological sequelae.

Methods: Recordings of lower limb motor evoked potentials (MEPs) to multi-pulse transcranial electrical stimulation (TES), and tibial nerve somatosensory evoked potentials (SEPs), were attempted during 126 operations in 97 patients (79 with spinal deformity and 18 with miscellaneous spinal disorders).

Results: Combined motor and sensory monitoring was successfully achieved in 104 of 126 (82%) operations.

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Sacral insufficiency fractures (SIF) usually occur in elderly women and are secondary to various conditions, mainly postmenopausal or steroid-induced osteoporosis and radiation therapy. They are often overlooked or confused clinically and radiographically with metastatic disease. We report a case of a 72-year-old woman who presented to our department with severe low-back pain.

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Gordon's Syndrome is described as an autosomal dominant condition with the characteristics of short stature, a stiff spine, camptodactyly (89%), cleft palate (27%) and club feet (73%). The authors present a case report of a patient with this rare entity complicated by an unusual complex spinal deformity. There are no prior reports in the literature concerning operative or nonoperative management of deformity in this patient population.

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The technique of posterior lumbar interbody fusion allows decompression of the spinal canal and interbody fusion through one posterior incision. A number of techniques exist to achieve additional posterior stability. The literature reports wide variation in outcomes for these different techniques.

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