Spine
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The influence of ketorolac on spinal fusion was studied in a retrospective review of 288 patients who underwent an instrumented spinal fusion. ⋯ These data suggest that nonsteroidal anti-inflammatory drugs significantly inhibit spinal fusion at doses typically used for postoperative pain control. The authors recommend that these drugs be avoided in the early postoperative period.
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The Alpine goat model for multilevel anterior cervical discectomy and fusion was used to analyze the use of an intervertebral fusion device to promote an arthrodesis after anterior cervical discectomy. Comparisons were drawn with biomechanical, histologic, and radiographic data. ⋯ The use of a threaded intervertebral fusion cage, with or without hydroxyapatite coating, filled with autogenous bone graft provides a fusion rate that is slightly better than those previously reported using autogenous interbody bone grafts with or without plate stabilization. Recombinant human bone morphogenetic protein-2-filled cages resulted in a much higher arthrodesis rate and accelerated bone formation compared with either autogenous bone-filled BAK devices, or autogenous interbody bone grafts with or without plate stabilization.
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Surface electromyographic activities were recorded from bilateral trunk muscles as test participants maintained a 50% maximum, voluntary, isometric, lateral bend contraction to volitional exhaustion. ⋯ The trunk responded to a prolonged, lateral bend contraction by increasing co-contraction as agonist trunk muscles fatigued. It was proposed that the fatigue compromised neural coordination and that the co-contraction served to maintain spine stability.