Spine
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Cadaveric motion segment experiment. ⋯ Two physical aspects of disc degeneration (dehydration and endplate disruption) cause marked segmental instability. Back pain associated with instability may be attributable to stress concentrations in degenerated discs.
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Comparative Study
The positional magnetic resonance imaging changes in the lumbar spine following insertion of a novel interspinous process distraction device.
Patients with symptomatic lumbar spinal stenosis underwent magnetic resonance imaging to study changes in the lumbar spine in various postures before and after implantation of the X STOP Interspinous Process Distraction Device (St. Francis Medical Technologies, Concord, CA). ⋯ This study shows that the X STOP device increases the cross-sectional area of the dural sac and exit foramens without causing changes in posture.
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Comparative Study
The sensitivity and specificity of electrodiagnostic testing for the clinical syndrome of lumbar spinal stenosis.
Prospective, masked, double controlled diagnostic trial. ⋯ This first masked study in the 60-year history of needle electromyography also introduces anatomically validated needle placement, quantified and reproducible examination of the paraspinal muscles, and dual control populations to EDX research in spinal disorders. EDX has statistically significant, clinically meaningful specificity for spinal stenosis and detects neuromuscular diseases that may masquerade as stenosis.
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Comparative Study
Correlation of HR-MAS spectroscopy derived metabolite concentrations with collagen and proteoglycan levels and Thompson grade in the degenerative disc.
A quantitative high-resolution magic angle spinning (HR-MAS) NMR study of human lumbar discs was conducted to determine biomarkers of disc degeneration. ⋯ Changes in disc chemical composition can be accurately quantified using quantitative HR-MAS NMR spectroscopy ex vivo. This noninvasive method of qualitatively and quantitatively assessing disc degeneration supports the utility of these biomarkers and underlines the need for developing in vivo magnetic resonance spectroscopic imaging (MRSI) for characterizing intervertebral disc degeneration.
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Lower lumbar vertebral endplates from young and old sand rats were assessed in an Institutional Animal Care and Use Committee approved study for architectural endplate features using micro-computerized tomography (CT) 3-dimensional (3D) models and vascularization studies by an in vivo vascular tracer or immunocytochemical identification of blood vessels. ⋯ Findings show that disc degeneration in the sand rat occurs concomitantly with marked architectural bony changes on the endplate face, including loss of smoothness and development of irregular bony margins. Vascular connections were not present between the endplate and disc; this was verified with microCT studies, in vivo vascular tracers, and traditional immunocytochemistry. The canal system within the imaged endplate was revealed to consist of a complex 3D interconnected network.