Spine
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Comparative Study
Augmentation of pedicle screw fixation strength using an injectable calcium phosphate cement as a function of injection timing and method.
Axial pullout tests using fresh cadaveric thoracolumbar vertebral bodies. ⋯ Results of this study demonstrate that the new calcium phosphate cement can improve the axial pullout strength of revised and augmented pedicle screws when injected along the entire length of the screw. This suggests that the injection method may be crucial for revision of failed pedicle screws. Considering inherent properties more favorable for in vivo application, such as nonexothermal polymerization and longer working time, and significant improvement in pullout strength, the new calcium phosphate cement may be a good alternative to polymethyl methacrylate for the augmentation of pedicle screw fixation.
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Prospective cohort with age- and gender-matched controls. ⋯ A history of psychiatric disease was more common in patients with chronic symptoms (chronic WAD). The dominating, retrospectively reported psychiatric diagnosis both before and after the accident was depression. Psychiatric morbidity may be a patient-related risk factor for chronic symptoms after a whiplash injury. The development of chronic symptoms after awhiplash injury seems to be associated with psychiatric vulnerability.
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We conducted a cross-sectional, genotyping study of intervertebral disc disease patients and controls. ⋯ The differences in Trp allele frequency we found between Greek and Finnish patients with intervertebral disc disease most likely represent true differences in polymorphism prevalence between the respective populations. The 2 previously described Trp alleles in COL9A2 and COL9A3 are likely to be less significant susceptibility factors for intervertebral disc disease development in Southern European populations.
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Morphometric study of the thoracic vertebral pedicular parameters and comparison with the previous studies in the literature. ⋯ These results suggest that even a 4-mm screw should be used carefully at the midthoracic level; 5-mm screw seems to be safe at upper and lower thoracic spine. Because of very small sagittal and transverse angle at mid and lower thoracic levels, the pedicular screw should be inserted along almost perpendicular line in these planes; 25-mm and 30-mm screw length appears to be safe at upper thoracic and lower thoracic levels, respectively. Pedicle entrance point lies along the midtrans-verse line at upper thoracic levels and along the upper border of transverse process at lower thoracic levels.
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We retrospectively review 32 patients who underwent posterior fixation for cervicothoracic junctional tumors. All patients possessed unstable or potential after surgery unstable spines as a result of either their tumors or the surgery performed. We examined cervicothoracic spine stability, maintenance of alignment, and associated complications. ⋯ Posterior plate or rod and screw fixation is a good method of treatment for cervicothoracic instability in spine tumors. Facet screw fixation in the cervical spine with Roy-Camille drilling technique and transpedicular screw fixation in the thoracic spine provides an efficacious means by which to stabilize the cervicothoracic junction. This stabilization technique was effective even in cases of high postoperative instability, such as with partial or total vertebrectomy. This screw-type stabilization is clinically effective and well documented. The evolution through 3 different systems reflects our attempts to improve accuracy in light of variable facet and pedicle interspaces. Importantly, posterior instrumentation will not interfere with subsequent laminectomy or more extreme surgical procedures.