Spine
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To determine the effect of cage/spacer stiffness on the stresses in the bone graft and cage subsidence. ⋯ Spacers less stiff than the graft will: (1) provide stability similar to titanium cages in the presence of posterior instrumentation, (2) reduce the stresses in endplates adjacent to the spacers, and (3) increase the load transfer through the graft, as evident from the increase in stresses in graft.
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Intraoperative neurophysiologic monitoring with transcranial electric motor-evoked potentials was performed on patients who underwent cervical laminoplasty at a university hospital in a prospective study. ⋯ No abnormalities were observed on transcranial electric motor-evoked potential monitoring, even in those patients who developed postoperative transient C5 palsy. These results suggest that the development of postoperative C5 palsy after cervical laminoplasty is not associated with intraoperative injury of the nerve root or the spinal cord, although the precise mechanism of its development is still unclear. Surgeons should be aware that C5 palsy is a possible complication of cervical laminoplasty, even in the absence of intraoperative nerve injury.
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A 5-year prospective cohort study was conducted of men and women seeking care for a new period of low back pain (LBP). ⋯ Over a 5-year period, both men and women who had sought care for LBP reported a decrease in pain and disability; however, only a few were fully restored. In this study, we found no effect of nonspecific physical exercise on recovery from LBP in men and women.
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Comparative Study
The impact of disability compensation on long-term treatment outcomes of patients with sciatica due to a lumbar disc herniation.
Prospective, observational study. ⋯ Long-term employment and disability outcomes were favorable for most patients with a disc herniation, regardless of initial workers' compensation status. However, individuals initially receiving workers' compensation had worse disability and quality of life outcomes compared to individuals not receiving workers' compensation. Despite these differences, long-term work outcomes were similarly favorable.
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The intraoperative findings of the local pressure of the intervertebral foramen and the electrophysiologic values of the spinal nerve roots were evaluated. ⋯ Our findings suggested that a double compression of the nerve root exists in lumbar spinal stenosis with lumbar spine extension, which includes the spinal canal and the vertebral foramen.