Spine
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A critical review of published literature from 2 decades. ⋯ The present data indicate that clinical outcomes and fusion rates statistically differ among the various subgroups of degenerative disc disease. Concerning the use of instrumentation, it appears that it may have greater clinical benefit in patients with DDDsp than DDDn. These findings underscore the importance of delineating specific clinical diagnoses when documenting results of lumbar fusion. This information might also be useful for both selecting surgical candidates and discussing anticipated operative outcomes.
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An in vitro study was conducted to determine the biomechanical properties of a new simple, percutaneous, posterior fixation technique for the lumbar spine involving a new implant, the so-called Lumbar Facet Interference Screw. ⋯ Results of this study indicate that the new Lumbar Facet Interference Screw fixation yields initial biomechanical stability similar to translaminar screw fixation, yet inferior biomechanical stability compared to pedicle screw fixation. Although these results are encouraging, additional biomechanical studies including cyclic loading tests have to evaluate the mid- and long-term stabilization capacity of this new minimally invasive fixation technique before human application.
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A retrospective comparison of postoperative continuous epidural analgesia and patient-controlled analgesia following surgical treatment for adolescent idiopathic scoliosis. ⋯ Although both continuous epidural analgesia and patient-controlled analgesia provide effective pain control following surgery for adolescent idiopathic scoliosis, patients with continuous epidural analgesia had significantly better pain scores for all time periods, less fluctuations in pain, and lower maximum pain levels during the postoperative period.
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A retrospective study on the correlation between preoperative pulmonary function tests, preoperative pulmonary symptoms, and postoperative pulmonary complications. ⋯ The incidence of postoperative pulmonary complications increased with the deterioration of pulmonary function tests. The posterior procedure had a very low incidence of postoperative pulmonary complications, but a transthoracic procedure increased the complications significantly. Preoperative pulmonary symptoms usually predicted abnormal results of pulmonary function tests but had no correlation with postoperative pulmonary complication.
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An in vivo study on the rabbit lumbar spine model. ⋯ The results of this study suggest that disc regeneration can be induced by axial dynamic distraction in the rabbit intervertebral disc. The decompressed rabbit intervertebral discs showed signs of tissue recovery on a biologic, cellular, and a biomechanical level after 28 days of distraction.