Fibular flap reconstruction of the cervical spine for repair of osteoradionecrosis.

Background Context: Although cervical spine reconstruction with osteocutaneous fibular flap microvascular grafting has been described, simultaneous reconstruction of the cervical vertebral column and laryngectomy have not been described.

Purpose: To present a unique case of combined cervical spine and laryngectomy reconstruction.

Study Design: Case report.

Sagittal plane deformity in the adult patient.

Recent studies have demonstrated that sagittal balance is the most important and reliable radiographic predictor of clinical health status in the adult with a spinal deformity. Affected persons typically present with intractable pain, early fatigue, and a perception of being off-balance. Nonsurgical management with nonsteroidal and analgesic medications as well as physical therapy plays a limited role.

Cauda equina syndrome: a comprehensive review.

Cauda equina syndrome (CES) is a rare syndrome that has been described as a complex of symptoms and signs--low back pain, unilateral or bilateral sciatica, motor weakness of lower extremities, sensory disturbance in saddle area, and loss of visceral function--resulting from compression of the cauda equina. CES occurs in approximately 2% of cases of herniated lumbar discs and is one of the few spinal surgical emergencies. In this article, we review information that is critical in understanding, diagnosing, and treating CES.

Blood conservation techniques in spinal deformity surgery: a retrospective review of patients refusing blood transfusion.

Study Design: A retrospective review.

Objective: To review the effectiveness of blood conservation techniques in the spinal fusion of patients that refuse blood transfusion; specifically the Jehovah's witnesses population.

Summary Of Background: Spinal surgery can be challenging in patients refusing blood transfusion.

Efficacy of aprotinin as a blood conservation technique for adult deformity spinal surgery: a retrospective study.

Study Design: A retrospective study that involved a total of 82 adult deformity patients who underwent spinal fusion surgery with instrumentation of 6 or more levels.

Objective: The purpose of this study is to assess the efficacy and safety of aprotinin in reducing blood loss in adult spinal deformity patients.

Summary Of Background Data: Aprotinin is an antifibrinolytic agent, which has been proven to be effective as a blood-conserving agent in cardiac surgery.

Evidence-based review of the role of aprotinin in blood conservation during orthopaedic surgery.

Aprotinin is a serine protease inhibitor with antifibrinolytic properties that has been approved as a blood-conserving drug in cardiac surgery by the United States Food and Drug Administration. On the basis of the current evidence from Level-I trials, we make a grade-A recommendation for use of the high-dose aprotinin regimen in hip and spine surgery. Because of conflicting data, the low-dose aprotinin therapy as well as the use of aprotinin in patients with cancer cannot be recommended (grade-I recommendation).

The use of short and rigid anterior instrumentation in the treatment of idiopathic thoracolumbar scoliosis: a retrospective review of 24 cases.

Study Design: The results of short anterior rigid rod instrumentation used to treat thoracolumbar scoliosis in 24 patients were reviewed retrospectively.

Objective: To assess the safety and efficiency of anterior correction of thoracolumbar scoliosis using a single rigid rod with segmental fixation.

Summary Of Background Data: This method of treatment results from the historical difficulties noted in obtaining adequate correction in both planes for this particular type of curve while saving as many segments as possible.