Spine
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This study retrospectively reviewed the outcomes of 11 patients treated for a cervical spine injury with a tracheostomy placed before anterior cervical spine surgery. ⋯ The authors concluded that in patients with cervical cord damage resulting from nonpenetrating trauma, tracheostomy was not found to increase the risk of infection in subsequent anterior cervical surgery. Careful preparation of the skin and placement of the second surgical incision lateral to the tracheostomy site is recommended. Anterior cervical spine surgery remains a viable treatment option in this severely injured patient population.
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Seventy patients (average age, 13.8 years) with adolescent idiopathic right thoracic scoliosis had full assessment of pulmonary functions and radiographic evaluation of spinal and thoracic cage deformities and their flexibilities. ⋯ Deformities in coronal and transverse plane influence changes in pulmonary functions expressed as the percent of predicted values, whereas sagittal plane deformities influence mainly those absolute volumes in which residual volume is a component. It is suggested that rotational flexibility combined with other deformities could be evaluated in future studies on prediction of pulmonary function from the measurements of the deformity.
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Calf and human cadaveric spines were used to determine motion segment stiffness and laxity after implantation of threaded inserts (the Ray Threaded Fusion Cage, Surgical Dynamics, Inc., Concord, CA), comparing direction of placement, number of implants, shape of the device, and integrity of anterior spine structures. Stiffness and laxity of spines with inserts were compared with those with bone grafts, with and without posterior fixation plates. ⋯ Threaded inserts increase vertebral motion segment stiffness and decrease laxity by distracting intervertebral structures. They are not sensitive to placement, except if vertebral structures are injured during insertion and produce constructs with more consistent mechanical properties than bone grafts.
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Quantitative magnetic resonance imaging (relaxation time and proton density measurements) has gained increasing interest as a noninvasive way to study changes in water content and biochemical composition of lumbar intervertebral discs and vertebral bodies. This article reviews the current methodological problems and the feasibility of quantitative magnetic resonance imaging in the lumbar spine for investigations on water content and biological composition. This technique does not allow direct quantification of water content. Although biochemical variations may sensitively influence relaxation times and proton density under in vitro conditions, it is not feasible to obtain sufficiently reliable and specific information to monitor biochemical alterations associated with lumbar disc pathology in vivo.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effects of spinal flexion and extension exercises and their associated postures in patients with acute low back pain.
A prospective randomized clinical trial compared the effects of flexion and extension back exercises and postures among soldiers with acute low back pain. ⋯ There was no difference for any outcomes between the flexion or extension exercise groups. However, either exercise was slightly more effective than no exercise when patients with acute low back pain were treated.