Spine
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The axonal growth potential of dorsal root ganglion (DRG) neurons in an organ culture system was investigated. ⋯ The results suggest that the cultured DRG neurons exhibit pathologic changes similar to those found in injured neurons. NGF-sensitive neurons, which include disc-innervating neurons, may have a greater potential to extend their axons in response to neuronal injury under pathologic conditions in the presence of TNF-alpha than GDNF-sensitive neurons.
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Retrospective case series with a control group. ⋯ Compared with conventional MRI, MRM affords more specific information for the presurgical diagnosis of symptomatic foraminal stenosis.
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Review Comparative Study
Systematic review of randomized trials comparing lumbar fusion surgery to nonoperative care for treatment of chronic back pain.
Systematic review of randomized trials comparing surgical to nonsurgical treatment of discogenic back pain. ⋯ Surgery may be more efficacious than unstructured nonsurgical care for chronic back pain but may not be more efficacious than structured cognitive-behavior therapy. Methodological limitations of the randomized trials prevent firm conclusions.
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Comparative Study
The influence of fracture mechanism and morphology on the reliability and validity of two novel thoracolumbar injury classification systems.
The Thoracolumbar Injury Severity Score (TLISS) and the Thoracolumbar Injury Classification and Severity Score (TLICS) were prospectively evaluated. ⋯ Although both schemes were noted to have substantial reproducibility and validity, our results indicate the TLISS is more reliable than the TLICS, suggesting that the mechanism of trauma may be a more valuable parameter than fracture morphology for the classification and treatment thoracolumbar injuries. Since these injury characteristics are interrelated and are critical to the maintenance of spinal stability, we think that both concepts should be considered during the assessment and management of these patients.
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Comparative Study Clinical Trial
Total lumbar disc replacement: different results for different levels.
Prospective study analyzing midterm clinical results of total lumbar disc replacement (TDR) with ProDisc II performed at different lumbar motion segments. ⋯ The level and the number of lumbar disc replacements influence postoperative outcome significantly. Satisfactory outcome was achieved for monosegmental L4-L5 and L5-S1 disc replacement procedures with best results achieved following TDR at L4-L5. For bisegmental TDR, complication rates are significantly higher and inferior postoperative results are to be expected. The incidence of postoperative pain originating from facet and/or iliosacral joints is currently underestimated and will require further investigation.