Spine
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Immunohistochemistry for tumor necrosis factor (TNF) and protein gene product (PGP) 9.5 in vertebral endplates of patients with discogenic low back pain and Modic Type 1 or Type 2 endplate changes on MRI. ⋯ The results suggest that endplate abnormalities are related to inflammation and axon growth induced by TNF. TNF expression and PGP 9.5-positive nerve in-growth in abnormal endplates may be a cause of low back pain.
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Presented is a case series of 3 patients, all of whom developed neurologic deficits due to cord or cauda equina compression during elective extremity surgery. ⋯ Spontaneous neural injury is rare but can occur to the anesthetized patient. Neurologic examination should be routinely performed in the recovery room; and if significant neurologic deficits are seen, investigative workup should not be delayed. If an intraspinal lesion is identified, immediate decompression may offer favorable results. Neurologic deficits should not be dismissed as peripheral palsies without careful evaluation.
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Retrospective analysis of our experience with os odontoideum at the Children's Hospital of Philadelphia. ⋯ Our data supports two separate etiologies for the os odontoideum: post-traumatic and congenital. The data should raise awareness that some children with preexisting syndromes may develop os odontoideum without previous trauma.
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Biomechanical study, using human cadaveric spines, of two types of posterior fixation in the thoracolumbar spine. ⋯ This method offers a firm construct without sacrificing a normal motion segment.