Spine
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An in vitro biomechanical study of adjacent segment motion (at L3-L4 and L5-S1) after a simulated lumbar interbody fusion of L4-L5 in different sagittal alignments was carried out. ⋯ Hypolordotic alignment at L4-L5 caused the greatest amount of flexion-extension motion at L3-L4, and the differences were statistically significant in comparison with intact specimen, in situ fixation, and hyperlordotic fixation. Hyperlordotic alignment at L4-L5 caused the greatest amount of flexion-extension motion at L5-S1, and the difference was statistically significant in comparison with intact specimen but not in situ fixation or hypolordotic fixation.
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A rare case of Baastrup's disease as a cause of spinal canal stenosis in a patient with double-level spondylolisthesis is reported. ⋯ Baastrup's disease leading to neoarthrosis formation with synovial cavity and causing low back pain has been reported previously. The cyst can enter into the epidural space through the midline cleft of the ligamentum flavum to result in extradural compression.
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Comparative Study
Association of the Japanese Orthopaedic Association score with the Oswestry Disability Index, Roland-Morris Disability Questionnaire, and short-form 36.
Cross-cultural translation and cross-sectional psychometric testing were performed. ⋯ The Japanese versions of the ODI and the RMDQ were reliable and valid. The use of these translated instruments can be recommended for future clinical trials in Japan. The results also showed the JOA score had acceptable psychometric properties of reliability and construct validity, suggesting that this score is reliable and valid. Further studies are needed to verify the validity and responsiveness of the JOA score.
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To assess the biomechanical effects of unipedicular vertebroplasty on nonfractured vertebrae. ⋯ The introduction of 20% bone cement by volume results in a significant increase in the compressive strength of intact lumbar vertebrae, however upper thoracic vertebrae do not demonstrate a similar strength improvement. There was no difference in the stiffness of the vertebrae injected with cement regardless of location. Bone mineral density (BMD) may play a role in the magnitude of the strength increase, with lower BMD specimens realizing a relatively greater strength improvement. Cement leakage was frequently noted with 20% cement injection, especially in the specimens with higher BMD. The location of the cement did not appear to have an effect on the loading behavior of the bone but should be controlled to minimize the chance of cement escaping into the spinal canal.
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This is a case report of a young patient who experienced an acute epidural compression of cauda equina revealing Stage IV Hodgkin's disease. ⋯ Although a rare situation, Hodgkin's disease may involve the spinal epidural space at presentation. The management is complex, but surgery provides the most rapid means of diagnosis and neurologic tissue decompression in severely affected patients.