Spine
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Occlusion of the infrarenal abdominal aorta was applied to adult rabbits, which induced spinal cord ischemia, followed by disocclusion and reperfusion. Cortical somatosensory- and motor-evoked potentials were monitored continuously up to 24 hours and correlated to hind limb motor and sensory status. ⋯ Reperfusion injuries to the spinal cord might occur in the rabbit model after disocclusion. Cortical somatosensory-evoked potentials seemed to be a very sensitive index for spinal cord ischemia, whereas motor-evoked potentials correlated well with the course of reperfusion injuries after disocclusion and reflected long-term follow-up hind limb motor function better than cortical somatosensory-evoked potentials.
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Appropriate application of an oncologic staging system is required to evaluate the relationship among histologic types, management, and outcome of primary bone tumors. A commonly accepted terminology for surgical procedures and for definition of tumor extent is needed for surgical planning and clinical reviews. The principles of the Enneking system for classifying stages of tumors are emphasized and applied to the spine using a practical approach for surgical staging.
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Clinical Trial
Prediction of success from a multidisciplinary treatment program for chronic low back pain.
The study included 90 disabled patients with chronic low back pain recruited from a pain clinic who were admitted to an 8-week program of functional restoration and behavioral support. Initial evaluations included a medical examination, rating of the physical impairment, a personal interview, a visual analogue scale to record pain intensity, an assessment of limitations for daily activities, a pain disability index, a depression and psychovegetative scale, and a scale to evaluate general living standards. The physical assessment included different flexibility measurements, measurement of power and endurance through standardized exercises, and measurements of isokinetic trunk and lifting strength and general endurance. The measurements were repeated at the end of the 8-week program and thereafter an intervals of 6 and 12 months. Final analyses were carried out on 82 patients. ⋯ This study has demonstrated that the most important variable in determining a successful treatment of chronic low back pain is the reduction of subjective feelings of disability in patients.
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Using human cadaver spines, the authors compared the effect of using a combination of pedicle screw and laminar hook on the same vertebra with that of using a pedicle screw alone in reference to bone mineral density of the vertebra under nondestructive cyclic loading. ⋯ Instrumentation stiffness obtained by the combination method was significantly greater than that obtained by the use of pedicle screw alone. There was no significant correlation between the improvement ratio by the combination method and bone mineral density. These results suggest that the combination method is valuable irrespective of the presence of spinal osteoporosis.