Spine
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Comparative Study Clinical Trial
Healos and bone marrow aspirate used for lumbar spine fusion: a case controlled study comparing healos with autograft.
A prospective case controlled study to compare the clinical and radiographic performance of Healos soaked in bone marrow aspirate (BMA) to iliac crest autograft when used in lumbar spinal fusion. ⋯ The null hypothesis is only partially correct. Healos and BMA are not inferior to autologous iliac crest bone as a graft material in posterolateral lumbar spine fusions but are radiographically ineffective in lumbar interbody fusions.
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Review and reinterpretation of existing literature. ⋯ Structural defects such as endplate fracture, radial fissures, and herniation are easily detected, unambiguous markers of impaired disc function. They are not inevitable with age and are more closely related to pain than any other feature of aging discs. Structural failure is irreversible because adult discs have limited healing potential. It also progresses by physical and biologic mechanisms, and, therefore, is a suitable marker for a degenerative process. Biologic progression occurs because structural failure uncouples the local mechanical environment of disc cells from the overall loading of the disc, so that disc cell responses can be inappropriate or "aberrant." Animal models confirm that cell-mediated changes always follow structural failure caused by trauma. This definition of disc degeneration simplifies the issue of causality: excessive mechanical loading disrupts a disc's structure and precipitates a cascade of cell-mediated responses, leading to further disruption. Underlying causes of disc degeneration include genetic inheritance, age, inadequate metabolite transport, and loading history, all of which can weaken discs to such an extent that structural failure occurs during the activities of daily living. The other closely related definitions help to distinguish between degenerate and injured discs, and between discs that are and are not painful.
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A prospective, longitudinal single-cohort study of 32 patients treated with internal fixation for unstable sacral fractures. ⋯ Unstable fractures of the sacrum are frequently associated with additional injuries. These injuries have a significant effect on morbidity still 1 year after injury. The multifactor etiology of impairments after sacral fractures should be acknowledged in the assessment of these patients.
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We postulate that osteoplasty of osteolytic metastases of the pelvic region performed by computed tomography (CT)-guided insertion of Kirschner wires into the lesions is effective and more feasible. ⋯ This technique is safe and effective and requires fewer CT scans, thus reducing the patient's radiation exposure. The shorter procedure correlates to a better patient tolerance.
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Comparative Study
The comparative study of magnetic resonance angiography diagnosis and pathology of blunt vertebral artery injury.
Observational and comparative study of the vertebral artery injury detected by 2-dimensional (2-D) time-of-flight magnetic resonance angiography (MRA) for admitting patients. Construct a strike-induced flexion injury model of cervical spine with blunt vertebral artery injury in dogs. ⋯ The 2-D time-of-flight MRA is an effective diagnostic method for blunt vertebral artery injury. It may have difficulties differentiating spasm, small disruption of the intima from others under certain conditions.