Spine
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Comparative Study
Comparison of segmental pedicle screw instrumentation versus anterior instrumentation in adolescent idiopathic thoracolumbar and lumbar scoliosis.
A retrospective study. ⋯ Surgical correction of both the frontal and sagittal plane deformity are comparable to anterior instrumentation. Shorter lengths of surgery and hospital stay are the potential benefits of posterior surgery. Posterior segmental pedicle screw instrumentation offer significant advantages and is a viable alternative to standard anterior instrumentation in idiopathic thoracolumbar and lumbar scoliosis.
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Cadaveric biomechanical study and retrospective chart review. ⋯ Segmental fixation of burst fractures with screws at the level of the fracture offers improved biomechanical stability. Theoretically, segmental fixation provides for additional fixation points that may aid in fracture reduction and kyphosis correction. This specific parameter is not evaluated in this study but will be an important outcome measure for a planned randomized controlled trial.
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Retrospective radiographic/imaging study. ⋯ There is a close linear association between the facet fluid index and the amount of radiographic instability at L4-L5. Facet fluid on MRI should raise high suspicion of lumbar instability.
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Retrospective study. ⋯ When combined with extensive posterior releases, posterior only approach is just as effective as combined anterior and posterior surgery for adult lumbar scoliosis measuring between 40 degrees and 70 degrees .
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Using a retrograde neurotracing method with Fluoro-Gold (FG), the level at which dorsal root ganglions (DRGs) innervate the L2 and L5 vertebral bodies and the innervation pathways were investigated in rats. ⋯ Sensory nerve fibers in the L2 and L5 vertebral bodies are derived from the T11-L3 and T13-L6 DRGs, respectively. Some sensory nerves from the L2 and L5 vertebral bodies enter the paravertebral sympathetic trunks and reach the DRGs at multisegmental levels. The present findings regarding multisegmental innervation to vertebral bodies may explain the diffuse pain that originates within osteoporotic vertebral fractures in elderly patients.