Spine
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Localization and distribution of cartilage oligomeric matrix protein in the rat intervertebral disc.
Whole rat intervertebral disc (IVD), as well as the anulus fibrosus (AF) and the nucleus pulposus (NP) were studied using immunoblot, immunohistochemistry, and reverse-transcription followed by polymerase chain reaction (RT-PCR) methods to investigate the expression and distribution of cartilage oligomeric matrix protein (COMP). ⋯ Our results demonstrate the expression of COMP in both the AF and NP of the IVD. COMP is a component of the extracellular matrix of AF and NP, with a lamellar distribution pattern in the AF. Our data suggest that COMP may play a role in the normal structure of IVD.
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A prospective in vivo animal study. ⋯ HSV-mediated gene transfer provides a novel method for treating chronic neuropathic pain related to lumbar root injury in rodents.
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Randomized Controlled Trial
Natural course of disc morphology in patients with sciatica: an MRI study using a standardized qualitative classification system.
A prospective observational study of patients with sciatica. ⋯ This classification system could be used to identify the majority of symptomatic disc levels. At 14 months, the MRI outcome was generally good for disc herniations and nerve root compromise. Nerve root compromise had the best MRI prognosis if the disc was extruded at baseline. There were significant differences between men and women in relation to baseline findings as well as in relation to development of MRI findings over time.
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Randomized Controlled Trial
Contrast flow characteristics in the cervical epidural space: an analysis of cervical epidurograms.
A single-center prospective analysis of cervical epidurograms, using a crossover design. ⋯ In cervical epidural steroid injections performed in the midline at C6-C7 and C7-T1, the contrast consistently covers the dorsal cervical epidural space bilaterally, irrespective of the volume used or neck flexion angle used. This suggests that solutions introduced here would cover the dorsal cervical epidural space. This questions the utility of performing potentially more dangerous injections at higher cervical levels or more invasive procedures, such as the use of epidural catheters.