Spine
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Comparative Study
Herniated lumbar disc material as a source of free glutamate available to affect pain signals through the dorsal root ganglion.
Combined prospective human cohort and prospective controlled animal model. ⋯ Glutamate originating from degenerated disc proteoglycan may diffuse to the dorsal root ganglion and effect glutamate receptors. Consideration may be given to treating disc radiculopathy with epidural glutamate receptor antagonists.
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Sensory innervation of the lumbar dura mater passing through the sympathetic trunk was investigated by neuronal tracing and immunohistochemical methods. ⋯ Sensory fibers from the upper lumbar ganglia innervated the lower lumbar dura mater directly. These sensory nerves may mediate low back pain and possibly interact with sympathetic nerves.
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A retrospective review of 22 cases of chondrosarcoma arising from the mobile spine. ⋯ En bloc excision, with wide or marginal histologic margins, is the suggested management for chondrosarcomas of the spine. Early diagnosis and careful surgical staging and planning are necessary for conducting adequate management. However, tumor contamination of the specimen margins, even in a small area, or spreading of the tumor myxoid content can worsen the prognosis.
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A prospective evaluation of the outcome of a decompressive procedure for lumbar spinal stenosis designed to preserve spinal stability. ⋯ Degenerative spinal stenosis, even with nonlytic spondylolisthesis, can be decompressed effectively without violating the integrity of the posterior elements.
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A prospective assessment, performed using the Health Status Questionnaire, of the outcomes for 28 patients with cervical radiculopathy treated with one- or two-level anterior cervical discectomy and fusion. ⋯ Although this is a preliminary report involving 28 patients, it would appear, based on the results of the Health Status Questionnaire, that anterior cervical discectomy and fusion performed on appropriately selected patients is a highly reliable surgical procedure for the management of cervical radiculopathy. Additional disease-specific questions may provide more sensitivity in evaluating radiculopathy after surgical and nonsurgical intervention.