Spine
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Comparative Study
Can vertebroplasty restore normal load-bearing to fractured vertebrae?
Cadaver motion segments were used to evaluate the effects of vertebroplasty on spinal loading following vertebral fracture. ⋯ Vertebroplasty reduces stress concentrations in the anulus and neural arch resulting in a more even distribution of compressive stress on the intervertebral disc and adjacent vertebral bodies.
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Comparative Study
Beliefs about low back pain in the Norwegian general population: are they related to pain experiences and health professionals?
A baseline study of the general population and the health care providers in 3 Norwegian counties. ⋯ Belief in spontaneous recovery from LBP seems to be positively correlated to previous experience with LBP without current pain. Patients of the various health care providers seem to have a faith in spontaneous recovery similar to that of their health care provider. These differences may frustrate the public and patients who visit more than one provider, and hinder collaboration among professional groups.
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Comparative Study
Experimental spinal fusion with recombinant human bone morphogenetic protein-2 delivered by a synthetic polymer and beta-tricalcium phosphate in a rabbit model.
An experimental animal study to achieve posterolateral intertransverse process spine fusion with recombinant bone morphogenetic protein in combination with a new delivery system. ⋯ Consistent spinal fusion was obtained by implanting a biodegradable bone-inducing implant composed of beta-TCP, PLA-DX-PEG, and rhBMP-2 within a period of 6 weeks. The rhBMP-2 doses required for the spinal fusion were significantly lower than those reported previously.
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Comparative Study
Is autograft the gold standard in achieving radiographic fusion in one-level anterior cervical discectomy and fusion with rigid anterior plate fixation?
A review of 66 consecutive patients at a single institution who underwent one-level anterior cervical discectomy and fusion (ACDF) with rigid anterior plate fixation with allograft or autograft. ⋯ A 100% and 90.3% radiographic fusion rate was obtained for allograft and autograft in one-level ACDF procedures with rigid anterior plate fixation, respectively. Although autograft achieved a higher incidence of nonunion than allograft, this may be attributed to the use of autograft early in the experience of plate application and fixation in this series. The effects of smoking were not found to be a significant factor influencing fusion in these plated patients. In 90.9% of the patients, excellent and good clinical outcome results were reported. The use of allograft in one-level ACDF with rigid plate fixation yields similar and high fusion rates as autograft. The use of allograft bone eliminates complications and pitfalls associated with autologous donor site harvesting. However, the use of autograft is a viable alternative to avoid the risk of infection, disease transmission, and histocompatibility differences associated with allograft. The use of allograft or autograft bone in properly selected patients for one-level ACDF with rigid anterior plate fixation can result in high fusion rates with excellent and good clinical outcomes.
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A case report of acute quadriplegia resulting from closed traction reduction of traumatic bilateral cervical facet dislocation in a 54-year-old male with concomitant ossification of the posterior longitudinal ligament (OPLL). ⋯ This case report highlights the advantages and shows some safety concerns regarding immediate, closed traction reduction of cervical facet dislocation with real-time neural monitoring in an awake, alert, oriented, and appropriately select patient before MRI studies in the setting of preexisting central stenosis from OPLL.