Spine
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Ten fresh, cadaveric, two-vertebrae, functional spinal units were used to study the pathoanatomy, intervertebral foraminal area, and flexibility changes after posterior and transforaminal decompression. ⋯ Transforaminal decompression produced a significantly larger increase in the intervertebral foraminal area than posterior decompression, without increasing the range of motion or neutral zone in any direction. Because there was no violation of the anatomic integrity of the spine in the transforaminal approach, the risk of surgically induced instability was minimized. Endoscopic transforaminal decompression is a feasible alternative to current approaches.
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Retrospective clinical and magnetic resonance imaging study of patients with groin pain associated with lower lumbar disc herniation. ⋯ Elderly patients with L4-L5 protruding herniation of the anulus fibrosus were most likely to experience groin pain. The sinuvertebral nerve that innervates the posterior anulus fibrosus, the posterior longitudinal ligament, and the dura was indicated as the afferent nerve of groin pain.
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This study developed and independently applied a spine tumor classification system, referred to as the Weinstein-Boriani-Biagini system, in a retrospective analysis of a series of patients with spinal giant cell tumors from three institutions. ⋯ These results indicate that the Weinstein-Boriani-Biagini system may prove useful in developing treatment algorithms and in assessing outcome for these rare and difficult lesions. At least in the case of giant cell tumors, the musculoskeletal tumor staging system as developed by Enneking for long bones suggests the ideal surgical margin and may provide information relevant to tumor recurrence rates. Additional aspects of tumor extent and location, however, may berelevant to primary tumor recurrence rates when the selesions occur in the spine.
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A cross-sectional study to assess the lumbar spinal and proximal femoral bone mineral density in girls aged 12, 13, or 14 years with adolescent idiopathic scoliosis and to compare them with bone mineral densities of an age-matched control group. ⋯ There is a persistently lower bone mineral density in patients between 12 years and 14 years of age with idiopathic scoliosis. The decreased bone mineral density occurred in patients with idiopathic scoliosis before the age of 12 years, with no further progression from the age 12 to age 14, and did not correlate with the scoliosis degree or pattern. These findings suggest that the osteopenia in idiopathic scoliosis may be related to the primary etiology of the disease rather than secondary to the asymmetrical mechanical forces associated with the back deformities.