Spine
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Facet orientation in the thoracolumbar spine: three-dimensional anatomic and biomechanical analysis.
Thoracolumbar facet orientations were measured and analyzed. ⋯ Transverse and longitudinal facet angles were measured directly from 240 human vertebral columns (males/females, blacks/whites). The specimens' osteologic material is part of the Hamann-Todd Osteological Collection housed at the Cleveland Museum of Natural History (Cleveland, OH). A total of 4,080 vertebrae (T1-L5) from the vertebral columns of individuals 20 to 80 years of age were measured, using a Microscribe three-dimensional apparatus (Immersion Co., San Jose, CA). Data were recorded directly on computer software. Statistical analysis included paired t tests and analysis of variance. RESULTS.: Facet orientation is independent of gender, age, and ethnic group. Asymmetry in facet orientation is found in the thorax. All thoracolumbar facets are positioned in an oblique plane. In the transverse plane, all facets from T1 to T11 are positioned with an anterior inclination of approximately 25 degrees to 30 degrees from the frontal plane. The facets of T12-L2 are oriented closer to the midsagittal plane of the vertebral body (mean range, 25.89 degrees-33.87 degrees), while the facets of L3-L5 are oriented away from that plane (mean range, 40.40 degrees-56.30 degrees). Facet transverse orientation at the thoracolumbar junction is highly variable (approximately 80% with approximately 101 degrees and approximately 20% with 35 degrees). All facets are oriented more vertically from T1 (approximately 150 degrees) to L5 (approximately 170 degrees). The facet sagittal orientations of the lumbar zygoapophyseal joints are not equivalent. CONCLUSIONS.: Asymmetry in facet orientation is a normal characteristic in the thorax.
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A retrospective clinical follow-up study of patients who underwent intraspinal surgery with reconstruction of the laminar roof using titanium miniplates. ⋯ The reconstruction of the laminar roof using the technique described is safe, well suitable to serve as a standard posterior approach to intraspinal pathologies, and offers distinct advantages over laminectomy. However, some patients, particularly those with intramedullary cervical lesions, could develop spinal malalignment after surgery despite reconstruction of the laminar roof and sufficient bony healing of the laminae.
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In 2001, several myths of low back pain still were alive in the general population in Norway, myths that were not in concordance with current guidelines. ⋯ In Norwegian general practitioners and physiotherapists, Deyo's 7 myths mostly seem to be dead and buried. However, it does not seem that this has extended to the public yet, as many myths still are alive in the general population.
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To assess the report of low back pain (LBP) over 1 year and its predictors in individuals reporting symptoms during an initial cross-sectional survey. ⋯ In this community-based study, LBP symptoms after 1 year are common and symptoms of those experiencing LBP at follow up do not improve over time. Predictors of experiencing LBP and of LBP symptoms after 1 year included baseline pain characteristics and psychosocial factors.
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Comparison of occlusion of lumbar arteries in magnetic resonance angiography (MRA) with patient-reported sciatica symptoms during a 3-year follow-up. ⋯ Arterial stenosis is associated strongly and consistently with patient-estimated physical ability,but only slightly with subjective pain symptoms. Interestingly, new stenosis is preceded by pain symptoms. The evaluation of lumbar blood flow may thus be useful in clinical practice.