Spine
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Comparative Study
Biomechanical comparison of anterior versus posterior lumbar threaded interbody fusion cages.
Biomechanical flexibility tests were performed in specimens receiving anterior lumbar interbody fixation or posterior lumbar interbody fixation using dual threaded cages. ⋯ Both anterior lumbar interbody fixation and posterior lumbar interbody fixation provided inconsistent stability. Therefore, stand-alone anterior lumbar interbody fixation or posterior lumbar interbody fixation may often be ineffective clinically. During all modes of loading except axial rotation, posterior lumbar interbody fixation performed slightly better than anterior lumbar interbody fixation, perhaps due to deeper hole preparation and destruction of anterior stabilizers necessary for anterior lumbar interbody fixation. Avoiding resection of facets during posterior lumbar interbody fixation led to significantly better performance during axial rotation.
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The Load Sharing Classification of spinal fractures was evaluated by 5 observers on 2 occasions. ⋯ Kappa statistics showed high levels of agreement when the Load Sharing Classification was used to assess thoracolumbar burst fractures. This system can be applied with excellent reliability.
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Retrospective study on a consecutive series of patients. ⋯ The results of the present study indicate that both back and leg pain are, on average, still moderately high 2 years after instrumentation with the Dynesys system. Only half of the patients declared that the operation had helped and had improved their overall quality of life; less than half reported improvements in functional capacity. The reoperation rate after Dynesys was relatively high. The results provide no support for the notion that semirigid fixation of the lumbar spine results in better patient-oriented outcomes than those typical of fusion.
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A prospective clinical and radiologic investigation of two groups of patients presenting with either acute back pain only or acute leg pain only, yet similar restriction in straight leg raising (SLR). ⋯ Acute low back pain associated with significant restriction in SLR is likely to be caused by a disc prolapse compressing the anterior theca.
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Case report and literature review. ⋯ Right-to-left atrial shunts may predispose to cerebral emboli during scoliosis surgery. These emboli may be a cause of postoperative visual field defects.