Spine
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Using magnetic resonance imaging, this study analyzed the anatomic characteristics of the iliolumbar ligament insertion on humans. ⋯ The minor width of the area of insertion on the iliac crest of the posterior band (and therefore its lower resistance with the mechanical overloads) could explain the frequency of the painful syndromes related, by some authors, to an enthesopathy of this ligament.
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A 5-year longitudinal interview and questionnaire-based survey of back pain in adolescents. ⋯ Back pain in adolescents is common; it increases with age and is recurrent, but in general does not deteriorate with time. Much of the symptomatology may be considered a normal life experience, probably unrelated to adult disabling trouble.
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An anatomic study was performed to investigate the ligamentum flavum of the human lumbar spine. ⋯ There is an inferoventral slip of the ligamentum flavum that attaches to the anterosuperior surface of the caudal lamina. This slip is the inferior portion of the deep ligamentum flavum. When the ligamentum flavum's superficial layer is selectively released, the inferoventral slip of the ligamentum flavum's deep layer remains attached to the anterosuperior surface of the caudal lamina and remains between the surgeon and the dura.
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Comparative Study
Differences in sensitivity between magnetic motor-evoked potentials and somatosensory-evoked potentials in experimental spinal cord lesions.
Graded posterior spinal cord compression and partial sectioning of the spinal cord were performed, and magnetically induced descending spinal cord potentials were recorded. ⋯ Posterior compression injuries are diagnosed more easily with spinal somatosensory-evoked potentials. Motor-evoked potentials were slightly less sensitive, but they were significantly more useful in diagnosing posterior compression injuries than were cortical somatosensory-evoked potentials.
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This case report illustrates the development of a cerebrospinal fluid fistula and pseudomeningocele in a patient after lumbar discectomy and fusion with instrumentation. ⋯ Postoperative pseudomeningocele and cerebrospinal fluid fistula in patients with spinal instrumentation can be treated successfully with epidural blood patch and a brief course (4 days) of spinal drainage. This combined treatment protocol may have some advantages to treatment with 7 days of cerebrospinal fluid diversion or to percutaneous epidural blood patch alone.