Spine
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This study investigated the outcome of anterior decompression and stabilization for "unstable" burst fractures without initial neurologic deficits in the thoracolumbar spine. ⋯ Anterior decompression and stabilization for unstable burst fracture without initial neurologic deficits in the thoracolumbar spine has some advantages in the view of anatomical reduction and rigid stability that allows patients an early rehabilitation, return to work, and gainful employment.
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Segmental mobility and intradiscal pressure were measured and the data compared in six cadaveric lumbar spine specimens before and after in vitro simulated single level L4-5 and double level L4-5-S1 anterior interbody fusions. ⋯ There is no evidence that the neighboring unfused segments are loaded beyond their physiological limits due to the fusion. However, the neighboring unfused segments have to work more frequently toward the extremes of their functional ranges of motion after fusion and these effects will be more marked after a double level L4-5-S1 fusion.
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The diagnostic information achieved by a combination of ultrasonographic imaging of discs and local bony vibration of lumbar vertebrae was compared to that obtained by discographic imaging and pain provocation. ⋯ The combination of the two noninvasive methods provides a useful screening test for the evaluation of low back pain. The combination test can accurately depict painful disc degeneration with internal disc rupture and the use of discography can be limited to the cases suggesting total anular rupture in ultrasound examination.
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Retrospective review of all patients who underwent surgical treatment of cervical spondylitic myelopathy and were monitored by somatosensory evoked potentials. ⋯ 1) Multilevel anterior cervical decompression and fusion produced a significant improvement in the motor function of patients with cervical spondylitic myelopathy. 2) Patients with intraoperative increase in amplitude or shortening of latency had a more rapid clinical improvement than patients with stable recordings. 3) Long-term reassessment did not show any difference between patients with intraoperative somatosensory evoked potential improvement and those with stable somatosensory evoked potential recordings. Therefore, somatosensory evoked potential improvements cannot be used to determine prognosis at the present time. 4) A greater number of patients should be studied using more objective methods for quantifying gait patterns and motor function.