Spine
-
A useful modification of the Kerrison rongeur is reported. ⋯ The design of the chip collector fully met the expectations for the modification: no clogging of resected bone material, easy clinical use, and shorter operating times. The modified rongeur, available in two lengths (190 and 290 mm) and three sizes of the chip collector (diameter of 4, 6, and 8 mm) proved to be useful in clinical applications.
-
A prospective cohort study was conducted on workers claiming earnings-related compensation for low back pain. Information obtained at the time of the initial claim was linked to compensation status (still claiming or not claiming) 3 months later. ⋯ Simple self-report measures of individual, psychosocial, and workplace factors administered when earnings-related compensation for back pain is claimed initially can identify individuals with increased odds for development of chronic occupational disability.
-
This study was designed to assess both lumbar sagittal balance and clinical outcomes of decompression and posterolateral fusion for degenerative lumbar spondylolisthesis. As an index for the radiologic evaluation of sagittal alignment, the L1 axis S1 distance was used (i.e., the horizontal distance from the plumbline of the center in the L1 to the back corner of the S1). ⋯ Both preoperative L1 axis S1 distance and lordosis at follow-up assessment affected surgical outcome. Reduction of slippage may improve clinical outcomes of posterolateral fusion for degenerative lumbar spondylolisthesis with an L1 axis S1 distance more than 35 mm.
-
To determine the osteogenicity of posterior longitudinal ligament ossification, the posterior longitudinal ligament obtained during anterior cervical surgery from patients with the disorder was analyzed with in vitro cultures. ⋯ Posterior longitudinal ligament cells from the three North American white patients with ossification of the posterior longitudinal ligament, when cultured in vitro, synthesized osteocalcin on vitamin D3 priming, confirming their osteoblastic phenotype, whereas posterior longitudinal ligament cells from four white patients with isolated spondylosis did not.
-
In vivo strain techniques were used in an animal radiculopathy model. ⋯ For the first time, in vivo biomechanical analysis of tissue deformations was used to investigate the role of mechanics in radicular pain. Overall mechanical allodynia was greater for more severe nerve root injuries (greater strains) in an animal model, suggesting that mechanical deformation plays an important role in the pain mechanism. Continued work is underway to understand the complex interplay between mechanics and the physiology of radicular pain.