Spine
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An in vitro biomechanical comparison of four posterior fixation techniques in the setting of an anterior lumbar interbody fusion (ALIF). ⋯ In the ALIF setting, facet screw and translaminar screw techniques, which may be associated with less morbidity than pedicle screws clinically, provided initial posterior stabilization similar to pedicular fixation in this in vitro study.
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Comparative Study
Biomechanical analysis of anterior poly-methyl-methacrylate reconstruction following total spondylectomy for metastatic disease.
Three reconstruction options were evaluated biomechanically following total spondylectomy using human cadaveric spine specimens. OBJECTIVES.: To evaluate and compare the stability of combined anterior and posterior fixation incorporating poly-methyl-methacrylate with alternative accepted reconstruction techniques. ⋯ Combined anterior and posterior reconstruction using a cement construct provides equal to or more stability than the intact spine in all testing modes. Posterior stabilization alone is an inferior method of reconstruction following total spondylectomy. Poly-methyl-methacrylate has the advantage over traditional anterior reconstruction techniques in that it can be inserted using a posterior approach.
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Retrospective review of prospective database. ⋯ Steroid-induced compression fractures appear to have an increased incidence of subsequent fractures after the kyphoplasty procedure. The kyphoplasty protocol with concurrent medical osteoporotic regimen does not appear to increase, and may serve to reduce, the incidence of remote and adjacent fractures for primary osteoporotic fractures.
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We document a giant spinal extradural arachnoid cyst treated by selective closure of the dural defect. It was diagnosed using cinematic magnetic resonance imaging (cine-MRI). ⋯ Selective closure of the dural defect based on cine-MRI will be useful for treating extradural arachnoid cysts.
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Comparative Study
Value of magnetic resonance imaging and discography in determining the level of cervical discectomy and fusion.
The correlation between magnetic resonance imaging and discography of the cervical spine in degenerative disc disease was studied. In addition, the results of cervical discectomy and fusion were evaluated. ⋯ Magnetic resonance imaging can identify most of the painful discs but still has relatively high false-negative and false-positive rates. There is a high chance that hypointense signal and small herniated discs are the pain generators, but they are not always symptomatic. Discography can save the levels from being unnecessarily fused. The combination of clinical symptoms, magnetic resonance imaging, and discography provides the most information for decision making and can improve the management of cervical discogenic pain.