Spine
-
Biomechanical. ⋯ This first reported technique of posterior element vertebroplasty may increase the indications and success for patients with decreased BMD who seek an interspinous implant such as the X STOP. A possible role may exist in increasing the effectiveness of such devices. However, clinical trials have yet been performed. These results demonstrate that PMMA injection in the spinous processes is effective in increasing resistance to compressive forces in an X STOP model.
-
This study was designed to verify the hypothesis of a constant, antidromic activation of fibers traveling along peripheral sensory nerves during spinal cord stimulation (SCS). ⋯ The authors hypothesize that this antidromic activation could represent a possible antalgic mechanism of SCS in patients with peripheral neuropathic pain, but further neurophysiological studies will be needed to elucidate this hypothesis.
-
A case report of late-onset paraplegia from an epidural abscess in a patient years after her instrumentation and fusion for scoliosis. ⋯ This case reports a delayed spinal epidural abscess years after removal of her implants for infection. This demonstrates that our patients remain at risk for reactivation of spinal infections even though they may be healthy hosts and may have had all foreign bodies removed as part of their treatment for deep postoperative infections. This case suggests that extensive unilateral decompression and debridement through a fusion mass is a viable treatment method in patients with fused spine.
-
Disc tissue was removed at surgery from 9 patients with discogenic pain and 9 deformity patients with scoliosis undergoing anterior and posterior spinal fusion. These samples were then analyzed using ex vivo proton high resolution magic angle spinning (HR-MAS) NMR spectroscopy to produce metabolic profiles for comparison between the 2 patient groups. ⋯ Our results suggest that spectroscopic markers of proteoglycan, collagen, and lactate may serve as metabolic markers of discogenic back pain. These results provide a further basis of the potential to develop in vivo MR spectroscopy for the investigation of discogenic back pain.
-
Interrupted time series. ⋯ Health status of people with whiplash improved after legislative change. Design of compensation schemes should be undertaken with the understanding that the scheme structure may have substantial effects on the long-term health of injured people.