Spine
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Twenty-four pigs were randomized into three groups of eight pigs; a control group with 0% stenosis, a 25% stenosis group, and a 50% stenosis group. A fourth 75% stenosis group was added when results of the randomized experiment had been analyzed. Blood flow of the spinal cord and nerve roots and spinal evoked potentials were determined before and 1 hour after induction of the spinal stenoses. ⋯ Blood supply of the spinal cord and nerve roots in the segments between two central stenoses is preserved immediately after stenosis introduction by way of the segmental nerve pathway, even if nerve conduction is impaired.
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The authors performed a correlative macroscopic, histologic, and immunohistochemical investigation on human lumbar intervertebral discs using complete motion segment slices, including all age groups and stages of degeneration. ⋯ The authors present the first study in which age-related changes are correlated on a macroscopic, histologic, and molecular level using complete sections of lumbar motion segments. They reconfirm the notion that disc degeneration starts as early as in the second decade of life. Therefore, only early prevention of disc damage may inhibit disc degeneration and its sequelae. Phenotypic alterations of nuclear chondrocytes as monitored by collagen Type IV in young adults with minor lesions and collagen Type X in advanced lesions indicate distinct cellular reactions, possibly as a reaction to enhanced oxidative stress. The degree of this oxidative stress is reflected by the CML-staining pattern which, in turn, indicates that the disc undergoes an accumulative stress, possibly leading to altered properties of the collagen fibrils and, thereby, tissue destruction. The deposition of CML proved to be the best marker for ongoing age-related changes in the intervertebral disc.
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A prospective study of consecutive patients undergoing surgery for central lumbar spinal stenosis. ⋯ Pain was more intense and positive straight leg raising test results were more common in younger patients, whereas reflex disturbances were more common in the elderly. The vertebral site for the lowest anteroposterior value was higher with higher age. Preoperative duration did not affect the severity of symptoms or signs. Patients with more pronounced stenosis tended to have a more severe reduction of walking ability. There was no correlation between symptoms and signs and radiographically detected constriction.
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A biomechanical study of the compressive creep behavior of the porcine intervertebral disc before and after frozen storage. ⋯ In vitro tests of frozen porcine intervertebral discs do not represent fresh behavior. Frozen storage appears to permanently alter disc behavior. The precise nature of any freezing-induced damage, and whether frozen storage similarly affects human discs, remains to be seen.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Efficacy of traction for nonspecific low back pain. 12-week and 6-month results of a randomized clinical trial.
A randomized clinical trial. ⋯ Most common flaws of earlier studies on traction therapy could be overcome. This trial did not support the claim that traction is efficacious for patients with low back pain.