Spine
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A case report of a patient with a congenital anomaly of the posterior arch of the atlas and review of the literature are reported. ⋯ This case illustrates a symptomatic congenital deformity of the posterior arch of the atlas due to a mobile, isolated fragment. These anomalies are exceedingly rare. To date, only 17 patients, including ours, have been described in the literature as having myelopathy related to an isolated posterior tubercle. Of these, only two patients had documented movement of this tubercle before our report. Recognizing the anomaly is crucial because treatment is relatively simple, produces resolution of symptoms, and prevents major neurologic deficits from occurring after trauma.
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Randomized Controlled Trial Comparative Study Clinical Trial
A prospective, randomized, controlled cervical fusion study using recombinant human bone morphogenetic protein-2 with the CORNERSTONE-SR allograft ring and the ATLANTIS anterior cervical plate.
A prospective, randomized, pilot clinical trial compared recombinant human bone morphogenetic protein-2 (rhBMP-2) with iliac crest autograft bone for the treatment of human cervical disc disease. ⋯ This pilot study demonstrates the feasibility of using rhBMP-2 safely and effectively in the cervical spine.
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A retrospective investigation of the L5-S1 motion segment after an isolated L4-L5 posterior lumbar fusion. ⋯ There appears to be no need to routinely include the L5-S1 segment when performing a posterior lumbar fusion for patients with instability or stenosis at L4-L5 if no symptoms are attributed to the lumbosacral level. At an average of 7.3 years, there was neither increased symptomatic disc degeneration nor symptoms necessitating the need for an L5-S1 fusion.
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A case report of low back pain associated with a diagnosis of melorheostosis of the lumbosacral spine. ⋯ Melorheostosis rarely causes severe low back pain that can respond favorably to fusion surgery.
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Pavlov's ratio from plain radiographs in patients with neck pain but no radicular symptoms was compared with the areas of the cervical spinal cord and cerebrospinal fluid column on magnetic resonance scans. ⋯ This study shows a poor correlation between Pavlov's ratio and the space available for the cord. Therefore, this ratio cannot be solely relied upon to predict the area changes in that plane of the cervical spinal canal.