Spine
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Electrophysiologic recordings were obtained from low threshold primary afferent neurons innervating lumbar multifidus and longissimus muscles in the anesthetized cat. ⋯ This preliminary report suggests that abrupt changes in neural discharge (instantaneous frequency) of low threshold muscle mechanoreceptors of the lumbar spine occur as the duration of a biomechanical load approaches that typically used during spinal manipulation. These changes could comprise part of the mechanism contributing to this intervention's physiologic effects. Further studies are warranted to better understand the signaling properties of a wider range of sensory receptors as well as determine the central effects of these high frequency discharges.
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Cross-sectional. ⋯ Sagittal spinal alignment is found to be changing as a child grows. There is a statistically significant difference among different age groups, especially at cervicothoracic, thoracolumbar, and lumbosacral junctions. The position of the sacrum (inclination and translation), and spatial orientation, as well as the global magnitude of thoracic kyphosis, and lumbar lordosis changes with growth. These findings should be taken into consideration for the young patients who require spinal instrumentation. The question "whether sagittal alignment should be restored according to the normative data for the child's age or to the normative data for the adulthood" remains to be answered.
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The progression of intervertebral disc degeneration following anterolateral "stab" of adult rabbit lumbar discs by 16-gauge hypodermic needle to a limited (5-mm) depth was studied for up to 24 weeks using magnetic resonance imaging, radiograph, and histologic outcome measures. ⋯ Stabbing the anterolateral anulus fibrosus of adult rabbit lumbar discs with a 16-gauge hypodermic needle to a limited (5-mm) depth results in a number of slowly progressive and reproducible magnetic resonance imaging, radiograph, and histologic changes over 24 weeks that show a similarity to changes seen in human intervertebral disc degeneration. This model would appear suitable for studying pathogenesis and pathophysiology of intervertebral disc degeneration and testing safety and efficacy of novel treatments of intervertebral disc degeneration.
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Systematic review. ⋯ Despite an increase in the number of studies over the last 10 years, the level of evidence for the efficacy of spinal cord stimulation in chronic back and leg pain/failed back surgery syndrome remains "moderate." Prognostic factors found to be predictive of the level of pain relief following spinal cord stimulation were study quality, follow-up duration, study setting, and patient indication.
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Comparative Study
Comparison of multifidus muscle atrophy and trunk extension muscle strength: percutaneous versus open pedicle screw fixation.
This study was conducted by retrospective case selection and prospective observation of longitudinal changes of the multifidus muscle cross-sectional area and of trunk extension muscle strength in percutaneous and open pedicle screw fixations. ⋯ Percutaneous pedicle screw fixation caused less paraspinal muscle damage than open pediclescrew fixation and had positive effects on postoperative trunk muscle performance.