Spine
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A retrospective study of 43 consecutive patients who underwent percutaneous endoscopic lumbar discectomy for recurrent disc herniation. ⋯ Percutaneous endoscopic lumbar discectomy is effective for recurrent disc herniation in selected cases. The posterolateral approach through unscarred virgin tissue can prevent nerve injury and could preserve the spinal stability. Both foraminal and intracanalicular portions can be decompressed simultaneously.
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A biomechanical study of lumbar threaded interbody cage construct under varying compressive preloads of similar magnitudes to those experienced in vivo during daily activities. ⋯ In vivo during activities of daily living, interbody cage constructs are subject to varying compressive preloads due to external loads generated by paraspinal musculature, and our results suggest that the stability created by the cage (reduction in segmental angular motion) is not constant. The cage construct is likely to be least stable in extension during activities that impart low compressive preloads to the lumbar spine. Supplemental translaminar facet screw fixation will enhance stability of the motion segment treated with threaded cages, particularly during conditions of low compressive preloads, the very condition in which the cage alone is least effective in providing stability.
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Prospective, 2-factor design. The first factor was the group with 2 levels, spine surgery and control. The second factor was timing with 3 levels, baseline, 1-week follow-up, and 6-week follow-up. ⋯ Substrate utilization shifts to fat oxidation in adolescents following spinal surgery, indicating lipids would be the alimentation of choice immediately after surgery. Caloric requirements increase 9% above the baseline measurements. Anterior/posterior surgeries and single surgeries (anterior or posterior alone) have the same increase in kcal/kg/day. Because of the substrate utilization change by the body after surgery, a preponderance of these calories should initially be given as lipids. After approximately 6 weeks, both resting energy expenditure and respiratory quotient returned to preoperative levels following spinal surgery in adolescents, indicating special nutrition is not required beyond 6 weeks.
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The authors reviewed a series of nontraumatic spinal cord injuries associated with surfing lessons. ⋯ Surfer's myelopathy is a nontraumatic paraparesis/paraplegia that affects first-time surfers. Although most patients have a complete or near-complete recovery, complete paraplegia has occurred.
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A population cohort study to determine the 1-year persistence of neck pain. ⋯ Among the general population, neck pain persists at 12 months in around half of those who report neck pain at the start of the period. An increased risk of persistent neck pain was associated with age 45 to 59 years and low back pain, and also with cycling. The link with psychological distress and the absence of a link with occupational factors compares with other previous findings for common musculoskeletal syndromes in the community.