Spine
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Review
The effect of relative needle diameter in puncture and sham injection animal models of degeneration.
Biomechanical study and literature review. ⋯ A needle puncture may directly alter mechanical properties via nucleus pulposus depressurization and/or anulus fibrosus damage, depending on the relative needle size. As more basic science research is aimed at treating disc degeneration via injection of therapeutic factors, these findings provide guidance in design of animal studies. Such studies should consider the relative needle size and include sham control groups to account for the potential effects of the needle injection.
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Comparative Study
Minimal invasive short posterior instrumentation plus balloon kyphoplasty with calcium phosphate for burst and severe compression lumbar fractures.
Prospective consecutive series. ⋯ Balloon kyphoplasty with calcium phosphate cement combined with posterior segmental short minimal invasive fixation for fresh burst and severe compression lumbar fractures provided excellent immediate reduction of post-traumatic segmental kyphosis with simultaneous reduction of spinal canal encroachment and restoration of vertebral body height in the fracture level.
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Comparative Study
Repeat vertebroplasty for unrelieved pain at previously treated vertebral levels with osteoporotic vertebral compression fractures.
A retrospective study was performed in patients with a repeat percutaneous vertebroplasty (PV) at the vertebral levels previously undergoing vertebroplasty. ⋯ The outcomes of this series suggest that repeat PV is effective at the same vertebral levels in patients without pain-relief who underwent previous PV. Absent or inadequate filling of cement in the unstable fractured areas of the vertebral body may be responsible for the unrelieved pain after the initial PV.
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Thromboembolic disease (TED) after anterior/posterior spinal reconstructions was prospectively evaluated in 66 consecutive patients. ⋯ We report a high rate of TED after extensive anterior/posterior spinal reconstructions, for which a right-sided thoracoabdominal approach is an independent risk factor and screening ineffective at preventing PE. These patients should be considered at high risk for postoperative TED.
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Comparative Study
The effects of the degenerative changes in the functional spinal unit on the kinematics of the cervical spine.
The sagittal kinematics of the cervical spine was evaluated using kinematic magnetic resonance imaging (kMRI). ⋯ Our results suggest that cervical cord compression may cause deterioration of cervical cord function and kinematic changes in the cervical spine. We hypothesize that the spinal cord may potentially protect its functions from dynamic mechanical cord compression by restricting segmental motion, and these mechanisms may be closely related to the intervertebral discs.