Spine
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Retrospective analysis of magnetic resonance imaging (MRI) and clinical findings about chemical radiculitis-associated anular tear in patients with radiculopathy. ⋯ The perianular enhancement adjacent to anular tears on MRI may be relevant in the diagnosis of symptomatic chemical radiculitis.
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Randomized Controlled Trial
Therapeutic effect of intrathecal morphine after posterior lumbar interbody fusion surgery: a prospective, double-blind, randomized study.
Prospective, double-blind, randomized, placebo-controlled study. ⋯ We demonstrated the efficacy of 0.4 mg intrathecal morphine after PLIF-surgery as indicated by a significantly lower cumulative piritramide requirement without any serious increase of opioid associated side effects. Therefore, morphine in a dose of 0.4 mg administered intrathecally seems to be a viable alternative therapeutic option to provide postoperative analgesia with PLIF-surgery.
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A prospective cohort. ⋯ The PSAQ was highly responsive to change in patients who report improvement in back symptoms but unlike the ODI and RMDQ was unable to detect deterioration. Overall, the ODI was more responsive than either the PSAQ or the RMDQ.
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Case Reports
Unusual association of tethered cord, filum terminale lipoma, and myxopapillary ependymoma.
Case report. ⋯ The coexistence of filum terminale lipoma and ependymoma is rare. Patients with relevant symptoms may be referred for an MRI study; however, especially patients with known filar lipomas causing tethered cord may be missed. Therefore, including these patients, a contrast-enhanced lumbar MRI must be performed to exclude any coexistence of filum terminale lipoma and ependymoma in the early course of the disease which can also help the surgeon in guiding the appropriate treatment.
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Comparative Study
A biomechanical evaluation of three revision screw strategies for failed lateral mass fixation.
This is a biomechanical study evaluating 3 revision strategies for failed cervical lateral mass screw fixation. ⋯ Conversion of a stripped lateral mass screw to an alternate trajectory appears to offer no biomechanical advantage over placement of an increased diameter salvage screw using the same trajectory. Pedicle screw fixation provides superior biomechanical fixation but was associated with a significant breech rate.