Spine
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Randomized Controlled Trial Clinical Trial
Radiographic assessment of interbody fusion using recombinant human bone morphogenetic protein type 2.
A prospective randomized study investigated the radiographic progress of fusion at 6, 12, and 24 months in 42 patients who underwent a single-level anterior lumbar interbody fusion using cylindrical interbody fusion cages. ⋯ The use of rhBMP-2 is a promising method for facilitating anterior intervertebral spinal fusion in patients who have undergone anterior lumbar fusion surgery.
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A surgical simulation study in human cadaver spine specimens was conducted to evaluate the accuracy of thoracic vertebral body screw placement using four different intraoperative imaging techniques. ⋯ Fluoroscopy-based image guidance that uses only a single reference marker for the entire thoracic spine is highly inaccurate and unsafe. Systems with registration based on the instrumented vertebrae provide more accurate placement of thoracic vertebral body screws than standard fluoroscopy, but expose the patient to more radiation and require more time for screw insertion.
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Case Reports Comparative Study
Thoracic spinal cord injury without radiographic abnormality in a skeletally mature patient: a case report.
A case of thoracic spinal cord injury without radiographic abnormality in a skeletally mature patient is reported. ⋯ A rare case of thoracic spinal cord injury without radiographic abnormality manifested as a result of traction injury to the sciatic nerves caused by bilateral violent lower limb injuries in a skeletally mature patient is presented. To the best of the authors' knowledge, such a case has not been reported previously.
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A descriptive study was conducted to investigate the paraspinal muscle function in patients with lumbar spinal stenosis. ⋯ Abnormal findings in needle electromyography of the paraspinal muscles were observed in 18 of the 22 (81.8%) examined patients. Abnormal flexion-extension activation of the paraspinal muscles was observed in all the examined patients. The change in mean power frequency was significantly smaller than in previously evaluated healthy subjects and patients with nonspecific chronic low back pain (P < 0.001) who were not experiencing symptoms of lumbar spinal stenosis. Paraspinal muscle fatigability was not associated with the denervation of the muscles. CONCLUSIONS Denervation and abnormal activation of lumbar paraspinal muscles are frequent findings in patients with lumbar spinal stenosis who have not undergone surgery. The paraspinal muscle endurance of the patients was unexpectedly good.
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A case series of adults with surgical treatment for adult idiopathic thoracolumbar and/or lumbar scoliosis, low back pain, and spinal stenosis was studied. ⋯ Combined symptoms of back pain and spinal stenosis require complex reconstructive surgery in adults with idiopathic thoracolumbar and/or lumbar scoliosis. Significant pain relief, functional restoration, and satisfaction can be achieved and maintained over the long term in the properly selected patient.