Spine
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The authors examined a case series of patients younger than 16 years who had sustained a traumatic spine injury. ⋯ In children and adolescents, conservative treatment is an available option for stable fractures without neurologic lesion. Early surgical treatment (instrumentation and fusion) is mandatory for unstable fractures and injuries associated with spinal cord lesion. In children, a traumatic spinal cord lesion may develop a deformity that is mainly scoliotic, kyphotic, or lordotic in >90% of the cases.
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The current study was undertaken to determine if the presence of titanium wear particulate deleteriously influences early osseointegration of posterolateral bone graft or disrupts an established posterolateral fusion mass. ⋯ Titanium particulate debris introduced at the level of a spinal arthrodesis elicits a cytokine-mediated particulate-induced response favoring pro-inflammatory infiltrates, increased expression of intracellular tumor necrosis factor-alpha, increased osteoclastic activity, and cellular apoptosis. The presence of titanium particulate debris, secondary to motion between spinal implants, may serve as the impetus for late-onset inflammatory-infectious complications and long-term osteolysis of an established posterolateral fusion mass in the clinical setting.
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Randomized Controlled Trial Multicenter Study Clinical Trial
A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache.
A multicenter, randomized controlled trial with unblinded treatment and blinded outcome assessment was conducted. The treatment period was 6 weeks with follow-up assessment after treatment, then at 3, 6, and 12 months. ⋯ Manipulative therapy and exercise can reduce the symptoms of cervicogenic headache, and the effects are maintained.