Spine
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A candidate gene association study in a longitudinal cohort. ⋯ Our results suggest a role for genes regulating inflammatory pathways in the radiographic progression of spine degeneration. This could prove a fruitful area for future therapeutics for the spine and other joints.
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Comparative Study
A comparison of pedicle and lateral mass screw construct stiffnesses at the cervicothoracic junction: a biomechanical study.
Biomechanical comparison of five different posterior cervicothoracic junction (C7-T1) fixation constructs in a cadaveric model. ⋯ C7 pedicle screw fixation provides the construct with the highest normalized stiffness for stabilizing the cervicothoracic junction. If C7 pedicle fixation is not possible, then performing two-level lateral mass fixation at C6 and C7 will achieve a construct with similar normalized stiffness except in axial compression. The addition of triple wiring to the spinous processes does not significantly increase lateral mass construct normalized stiffness.
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A retrospective review of 33 consecutive patients treated with posterior fusion and selective nerve root decompression for the treatment of pseudarthrosis following anterior cervical discectomy and fusion. ⋯ This is the first study to our knowledge to use standardized outcome measures to assess clinical outcome in patients treated with posterior fusion for pseudarthrosis after anterior cervical discectomy and fusion. Patients and surgeons need to understand the potential for success with this revision procedure but also be aware of the relatively high rate of continued moderate to severe pain observed in this patient population even after a solid fusion is achieved. All of the patients in this study fused with a single posterior fusion procedure, further supporting the relatively higher fusion rates observed in the literature using posterior fusion as a treatment for cervical pseudarthrosis. Our results also support the ability of surgeons to use local bone graft without iliac crest in a posterior fusion for cervical pseudarthrosis and therefore avoid the morbidity associated with iliac crest bone graft harvest.
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Retrospective observational study. ⋯ Osteoporotic vertebral fractures with no sign of vertebral collapse on initial radiographs do indeed exist. They are analogous to occult stress fractures well known in other skeletal sites. They must not be misdiagnosed as malignant lesions.
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Retrospective study. ⋯ The treatment of choice of spinal hydatidosis is surgical removal of the affected vertebrae combined with posterior stabilization, followed by postoperative adjuvant chemotherapy. Recurrence is very frequent.