Spine
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Comparative Study
Biomechanical evaluation of translaminar facet joint fixation. A comparative study of poly-L-lactide pins, screws, and pedicle fixation.
Nine sheep cadaveric spines were used in this acute postoperative model. ⋯ The facet joint is the only true articulation in the lumbosacral spine. It is logical to fix this part directly to achieve spine fixation. Translaminar facet joint fixation with screws show similar biomechanical performance to pedicle screw fixation. Translaminar facet joint fixation with poly-L-lactide pins is significantly less stiff than either type of screw fixation, but it also restricts the facet joint and intervertebral motions significantly when compared with the intact spine.
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A nonrandomized descriptive case series. ⋯ To avoid late progression of trunk deformity in skeletally immature patients, anterior spinal release and fusion combined with posterior segmental spinal instrumentation and fusion from the upper thoracic spine to the pelvis are recommended. Skeletally mature patients with good curve flexibility can be treated with posterior instrumentation and fusion only. Skeletally mature patients with large fixed curves benefit from an anterior-posterior procedure for better correction of the scoliosis and pelvis obliquity. Despite the surgical complexity and expected complications, the overall good surgical results and high patient and caregiver satisfaction confirm that corrective spinal surgery is indicated and is beneficial for most patients with total-body-involvement cerebral palsy and scoliosis.
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Case Reports Multicenter Study Clinical Trial Historical Article
The Bagby and Kuslich method of lumbar interbody fusion. History, techniques, and 2-year follow-up results of a United States prospective, multicenter trial.
A prospective, multicenter trial of the Bagby and Kuslich method of lumbar interbody stabilization for chronic discogenic low back pain, with follow-up evaluation at 3 months, 6 months, and yearly thereafter, with independent radiographic analysis. ⋯ Carefully selected middle-aged patients with chronic low back pain secondary to degenerative disc disease can be treated effectively and safely by skilled surgeons using the Bagby and Kuslich device for one- and two-level interbody fusion.
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Comparative Study
A human cadaver model for determination of pathologic fracture threshold resulting from tumorous destruction of the vertebral body.
Thoracic vertebrae were subjected to compressive loads after drilling of the centrum to simulate destruction from metastatic tumorous involvement. ⋯ The vertebral strength index can be used to predict the strength of any thoracic vertebra. When compared with an idealized vertebral strength index based on the intact vertebral cross-sectional area and normal bone mineral density, a patient's actual vertebral strength index can be used as one of the criteria for prophylactic stabilization.
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Comparative Study
The role of steroids and their effects on phospholipase A2. An animal model of radiculopathy.
The possible role of phospholipase A2 in an animal model for lumbar radiculopathy and mechanisms of epidural steroid injections were studied. ⋯ These results suggest that the behavioral pattern changes observed in the irritated nerve root model are caused in part by a high level of phospholipase A2 activity initiated by inflammation, and that the mechanism of action of epidural steroid injection in this model is inhibition of phospholipase A2 activity.