Background:Deep vein thrombosis (DVT) is a great postoperative challenge in all orthopaedic surgeries. To the authors' knowledge, this study is the first to evaluate the efficacy of aspirin administration in the prevention of DVT in patients undergoing lumbar spinal surgery. Methods:In this double-blind parallel randomized clinical trial, a total of 126 candidates (age 40 yr and older) were admitted between June 2021 to December 2021. Patients were randomly assigned to the intervention chemoprophylaxis group (41 patients receiving 325 mg aspirin) and controls. The DVT occurrence was recorded by clinical features (Well's criteria), Doppler lower limbs ultrasound, and D-dimer levels in all participants at baseline (24 hr before the time of surgery) and 2, 6, and 12 wk after surgery in postoperative visits. Results:The mean age of the participants was 63.72 ± 6.87 yr. Baseline demographic values were similar in both groups (P > 0.05). The mean follow-up duration was 6.11 ± 2.33 mo. No cases of DVT or abnormal findings on Doppler ultrasound were observed in either group. The mean duration of hospitalization or intensive care unit (ICU) admission was similar between the two groups. Mean baseline D-dimer levels were significantly higher in the intervention group compared with the controls (P = 0.047), while it was similar in both groups 3 mo after the operation (P = 0.13). Conclusions:In the current study, no case of DVT was observed in either study group. These data do not support the use of aspirin as an anticoagulant for DVT prophylaxis following regular lumbar spinal surgeries.
Background: Treatment of adolescent idiopathic scoliosis (AIS) is one of the most challenging problems for spine surgeons. Although it has been previously demonstrated that curve pattern in AIS is different between males and females, there are, however, limited studies specially focused on the differences of AIS characteristics between the two genders. Objectives: In current study, we compared the demographics and curve patterns in male and female patients with AIS. Patients and Methods: A total of 68 girls and 17 boys with AIS were included in this cross-sectional study. The magnitude of curvature, thoracic kyphosis, flexibility and pattern of the deformity were measured on x-rays and compared between the two genders. Results: Although girls were significantly younger (15.3 ± 2.5 versus 16.7 ± 2.1 years; P = 0.036), however, the Risser sign was the same. Most of the males were hypokyphotic (70.6%), while most of the girls had normal thoracic kyphosis (69.1%) (P = 0.001). The main scoliotic curve (77.2 ± 18.2 versus 59.6 ± 18.6 degrees) and flexibility (25.5% ± 18.2% versus 41.9% ± 18.6%) were significantly greater and lower in males, respectively (P < 0.05). The typical AIS pattern was present in 64.7% of boys and 95.6% of girls (P < 0.001). Conclusions: The radiographic characteristics of AIS are substantially different between genders. In male patients, AIS is more severe and rigid compared to females. Also, hypokyphosis and atypical pattern of AIS are common findings in males compared to females.
Background: Patients with idiopathic scoliosis are exposed to repetitive x-ray for angle measurement. Therefore, the discovery or development of alternative techniques with less radiation has continuously been a major concern. Objectives: In this study, we compared the Cobb angles on supine Magnetic Resonance Imaging (MRI) with those on standing plain radiographs to figure out how precisely the supine MRI can show the real curve. Consequently, the need for certain exposures throughout the management of idiopathic scoliosis might be eliminated. Methods: A total of 103 patients with idiopathic scoliosis were included in this prospective study. The standing radiographs and supine MRI were obtained with less than a 1-month time lag. One senior author assessed Cobb angles of the major curves were on both standing radiographs and MR images. All the eligible patients had already signed the consent for diagnostic imaging, including MRI. The individuals, who were not requested for x-ray and MRI, were excluded from this study. Results: The Mean±SD Cobb angle was 55.5±11.2° on the standing plain radiographs and 44.5±10° on MR images (P<0.001). The Mean±SD difference between the Cobb angles on the standing plain radiographs and MR images was 11±1.4°. A significant positive correlation was found between the Cobb angles calculated on plain radiographs and MRI (r=0.996, P<0.001). Accordingly, Cobb angles on MRI could be converted to Cobb angles on plain radiographs under the formula of MRI=0.9* XRAY-5.31 (absolute error of 5.31°). Conclusion: Cobb angles on supine MRI correlates with measured ones on standing radiographs with an acceptable range of error and could be used as a valuable alternative for radiographic Cobb angle measurement.
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