Spine
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Randomized Controlled Trial Comparative Study Clinical Trial
Active therapy for chronic low back pain part 1. Effects on back muscle activation, fatigability, and strength.
Randomized prospective study of the effects of three types of active therapy on back muscle function in chronic low back pain patients. ⋯ Significant changes in muscle performance were observed in all three active therapy groups post-therapy, which appeared to be mainly due to changes in neural activation of the lumbar muscles and psychological changes concerning, for example, motivation or pain tolerance.
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Randomized Controlled Trial Clinical Trial
Active therapy for chronic low back pain: part 2. Effects on paraspinal muscle cross-sectional area, fiber type size, and distribution.
Randomized prospective study to compare the effects of three types of active therapy on the back muscle structure of chronic low back pain patients. ⋯ Three months active therapy is not sufficient to reverse the typical "glycolytic" profile of the muscles of cLBP patients or to effect major changes in backmuscle size. The alterations in muscle performance observed (increased strength and endurance; Part 1) werenot explainable on the basis of structural changes within the muscle.
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A biomechanical investigation using indentation tests in a human cadaveric model to seek variation in the structural properties across the lower lumbar and sacral endplates. ⋯ Highly significant regional strength and stiffness variations were identified in the lumbar and sacral endplates. The center of the bone, where implants are currently placed, is the weakest part of the lumbar endplates and is not the strongest region of the sacral endplate.
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Using human cadaver spines, the authors investigated mechanical properties of the interface between titanium mesh cage and vertebra in respect to vertebral bone mineral density. ⋯ A titanium mesh cage with larger diameter and/or augmentation of internal end ring produces a significant increase of the interface strength between the cage and the vertebra. A positive correlation between the interface strength and vertebral bone mineral density suggests that vertebral bone mineral density is an important parameter for successful spinal reconstruction, and also implies that in severe osteoporotic spine the stability of the cage is declined, and other instrumentation should be combined.
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An experimental study to clarify the effects of pentoxifylline, as an anti-tumor necrosis factor-alpha therapy on endoneurial fluid pressure in the dorsal root ganglion using an animal model of herniated nucleus pulposus. ⋯ Pentoxifylline, an anti-tumor necrosis factor-alpha drug, prevented the dorsal root ganglion compartment syndrome caused by topical application of nucleus pulposus. Anti-inflammatory cytokine therapy may become an effective treatment of sciatica due to disc herniation.