Spine
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A cross-sectional survey of senior neurosurgical and orthopedic residents. ⋯ Training in spine surgery constitutes a considerably larger proportion of neurosurgery residency than orthopedic residency. Neurosurgery residents graduate with significantly higher levels of confidence to perform spine surgery, while orthopedic residents report significantly higher need for additional training in spine surgery. The majority of neurosurgery graduates report that they will include spine in their clinical practice, while most orthopedic graduates will exclude it.
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Human lumbosacral cadaveric specimens were tested in an in vitro biomechanical flexibility experiment using physiologic loads in 5 sequential conditions. ⋯ The anterior screw-plate and pedicle screws-rods both substantially reduced ROM and increased stiffness compared to stand-alone interbody cages. There was no significant difference in the amount by which the supplementary fixation devices limited flexion, extension, axial rotation, or anteroposterior shear; pedicle screws-rods better restricted lateral bending.
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Analysis of outcome data collected prospectively from 250 patients recruited to the UK Spine Stabilization Trial. ⋯ Although shown to be responsive, including the SWT alongside disease-specific and generic instruments is unlikely to add additional information. All instruments appear responsive to patient deterioration, however, further research for the SF-36 is required.
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Retrospective review. ⋯ A large proportion of injuries was seen among older adults, predominantly as a result of falls. Prevention programs should expand their focus to include home safety and avoidance of falls in the elderly.
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Comparative Study
Osteogenic protein-1 injection into a degenerated disc induces the restoration of disc height and structural changes in the rabbit anular puncture model.
In vivo study of the effect of injection of osteogenic protein-1 (OP-1) on a rabbit anular needle puncture model of intervertebral disc (IVD) degeneration. ⋯ The results of this study show the feasibility of restoring degenerative rabbit discs by a single injection of OP-1 into the nucleus pulposus. Importantly, the effects of the OP-1 injection on disc height were sustained for up to 24 weeks. The metabolic changes in the cells, following a single injection, might be sustained and, thus, induce long-term changes in disc structure. An efficacy study in large animals is required to show further that the intradiscal injection of OP-1, or bone morphogenetic proteins or growth factors with similar properties would be useful for the structural restoration of the IVD in humans.