Spine
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Population-based, prospective cohort. ⋯ Most new and recurrent LBP episodes are mild. Less than one third of cases resolve annually, and more than 20% recur within 6 months. LBP episodes are more recurrent and persistent in older adults.
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Comparative Study
Does anterior plating of the cervical spine predispose to adjacent segment changes?
In a human cadaveric model, the effects of plate supplementation on the mechanical behaviors of adjacent segments were investigated. ⋯ Intradiscal pressures and intervertebral motion at the adjacent levels are not significantly affected by the instrumented anterior fusion. The clinically observed degenerative change at adjacent segments in the cervical spine is more likely to be attributed to natural progression of the spondylotic process as opposed to biomechanical effect of the instrumentation or fusion.
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Comparative Study
Biomechanical assessment of the pediatric cervical spine under bending and tensile loading.
Cadaveric head-neck complexes from pediatric donors aged 2-12 years were subjected to a test battery consisting of nondestructive flexion-extension bending, nondestructive tensile step-and-hold tests, and tensile distraction loading to failure. ⋯ The current study provides valuable new information on the response and tolerance of the pediatric cervical spine to quasi-static flexion-extension and tensile distraction loading.
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Computer modeling and parametric analysis were used to determine the effect of reflex contraction of the neck muscles in the unaware occupant in whiplash. ⋯ Because reflex contraction did not substantially alter spinal kinematics, muscle contraction likely does not initiate in sufficient time to mitigate whiplash injuries that may occur during the retraction phase.
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Randomized Controlled Trial Multicenter Study Comparative Study
Comparison of OP-1 Putty (rhBMP-7) to iliac crest autograft for posterolateral lumbar arthrodesis: a minimum 2-year follow-up pilot study.
A prospective, randomized, controlled, multicenter clinical study. ⋯ This study represents the first clinical trial to demonstrate the safety and similarity of OP-1 Putty as a replacement for autogenous bone graft in the posterolateral fusion environment with a minimum of 2-year follow-up. OP-1 Putty was able to achieve osteoinduction leading to a radiographically solid fusion in the absence of autogenous iliac crest bone graft in 55% of the patients at 24 and 36 months. These results compare favorably to the historical fusion rates reported for uninstrumented arthrodesis in this challenging clinical scenario.