Spine
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Database study using the Nationwide Inpatient Sample administrative data from 1988 through 2004. ⋯ This nationally representative study of inpatients in the United States provides evidence that patients with DM who received cervical fusion secondary to myelopathy are associated with greater perioperative complications, nonroutine discharge, and increased total charges. Subanalyses suggest that uncontrolled DM is a significant associative factor in outcome.
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Whole human cadaver model to assess a common diagnostic test for cervical spine stability. ⋯ The results of this study suggest that clinicians should make sure patients can flex and extend their head/neck to a minimum range of 60 degrees before evaluating them for a dynamic motion study to assess cervical spine stability. Even with adequate motion, interverterbral rotation and translation can remain within normal limits in the presence of extensive soft tissue damage. The most sensitive measure for detecting soft tissue damage was center-of-rotation although it lacks specificity, particularly in the presence of underlying degenerative changes, and is not readily assessed in most clinical situations.
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This historical perspective traces the history of the development of pathoanatomically based spinal disease diagnosis and the subsequent use of these diagnoses for scientific and social purposes. Spinal diagnostic categories have been used positively to guide both clinical (including their use as the primary units of investigation in many epidemiological and evidence-based projects) and basic science (studying the pathoanatomic disease outside of the patient) research programs--the aim being the improvement of patient care and outcomes. They are also used socially to confer/reject acceptability to patient behavior; to justify health policy decisions; to structure medical relationships; to shape medical/institutional infrastructure; to direct patient care via guideline establishment; and to manage health care. The positive and negative implications of the use of spinal disease categories are discussed.
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A virtual simulation model of the subaxial cervical spine was used to study the biomechanical effects of various disc prosthesis designs. ⋯ The simulation model showed the impact simple design changes may have on cervical disc dynamics. The predicted facet loads calculated from computer model have to be validated in the experimental study.
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In vivo experiments using a rat model of painful facet joint distraction. ⋯ Results suggest ligament tension may be required to produce pain from facet joint loading. Further studies of other cellular responses are needed to define the mechanisms of painful facet joint injury.