Spine
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Comparative Study
Efficacy of aprotinin as a blood conservation technique for adult deformity spinal surgery: a retrospective study.
A retrospective study that involved a total of 82 adult deformity patients who underwent spinal fusion surgery with instrumentation of 6 or more levels. ⋯ The results of our study suggest that the administration of aprotinin is a safe and effective method to reduce blood loss and to decrease the need for transfusions without increasing risk of complication in the younger patients in relatively good general health undergoing spinal deformity surgery requiring 6 or more levels of fusion.
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Comparative Study
Clinical significance of ring apophysis fracture in adolescent lumbar disc herniation.
Retrospective review and post-test-only control group design. ⋯ Apophyseal fracture is not uncommon in adolescent lumbar disc herniation. The surgical decision must depend on clinical symptoms instead of radiologic findings, but disc herniation with apophyseal fracture may exhibit more severe symptoms. Patients with large apophyseal fragments must be informed of a greater chance of chronic back pain later on. Small apophyseal fragments had no clinical significance.
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Comparative Study
Cement distribution, volume, and compliance in vertebroplasty: some answers from an anatomy-based nonlinear finite element study.
The biomechanics of vertebral bodies augmented with real distributions of cement were investigated using nonlinear finite element (FE) analysis. ⋯ The developed FE approach, which accounts for real cement distributions and bone damage accumulation, provides a refined insight into the mechanics of augmented vertebral bodies. In particular, augmentation with compliant cement bridging both endplates would reduce stress transfer while providing sufficient strengthening.
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Retrospective review of sacral insufficiency fractures. ⋯ Sacral insufficiency fractures are an uncommon complication of segmental posterior lumbosacral fixation in osteoporotic patients. They are potentially unstable fractures and kyphosis and displacement may contribute to persistent problems of pain and postural malalignment. The diagnosis may be difficult and should be considered in the differential diagnosis in patients who do not improve during the postoperative course. Lumbopelvic fixation is a useful salvage treatment modality for patients who fail nonoperative treatment.
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A report on plenary presentations and discussions of an expert panel and workshop ("Exercise as a treatment for subacute low back pain") that was held at the Amsterdam Forum VIII on Low Back Pain Research in Primary Care. ⋯ By paying proper attention to issues concerning the design and reporting of exercise protocols when conducting future exercise trials, research may provide a stronger evidence basis for recommending or not recommending various exercise therapies for LBP.