Spine
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Cadaver study. ⋯ Novice resident surgeons placing thoracic pedicle screws in cadavers were able to significantly improve by the fourth cadaver to accuracy levels documented in the literature. Surgeons in training shouldpractice these skills in the laboratory before proceeding to the operating room.
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Review
Lumbar adjacent segment degeneration and disease after arthrodesis and total disc arthroplasty.
Systematic review of published incidence of radiographic adjacent segment degeneration (ASDeg) and symptomatic adjacent segment disease (ASDis) after arthrodesis or total disc replacement. ⋯ Analysis of the literature suggests a correlation between fusion and the development of ASDeg compared to arthroplasty, but this association is dampened by the influence of patient age. There is a stronger correlation between fusion and ASDis compared to arthroplasty. The data supports only a class C recommendation (lowest tier) for the use of arthroplasty to reduce ASDis and disc degeneration compared to arthrodesis.
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Review
A systematic review of the predictive ability of the Orebro Musculoskeletal Pain Questionnaire.
Systematic review. ⋯ The OMPQ has moderate predictive ability in identifying patients with spinal pain at risk of persisting pain and disability. This evidence supports clinical guidelines recommending its use as an assessment tool for identifying psychosocial risk factors. Further research is needed to confirm the predictive ability of individual items in different populations and settings, to enhance its usefulness.
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Comparative Study
Atlantoaxial transarticular screw fixation with posterior wiring using polyethylene cable: facet fusion despite posterior graft resorption in rheumatoid patients.
A comparative retrospective study on the posterior graft union and the facet fusion in atlantoaxial transarticular screw fixation. ⋯ In atlantoaxial transarticular screw fixation, the use of PE cable and rheumatoid background are 2 of the unfavorable factors for the posterior graft union. However, atlantoaxial transarticular screws can bring the facet fusion despite the posterior graft failure in such cases.
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An in vitro biomechanical cadaver study of long segment thoracic pedicle screw constructs with transverse connectors (TC). ⋯ For long thoracic pedicle screw constructs, the addition of 1 or 2 TCs significantly decreases construct axial rotation, which is the primary plane of motion for the thoracic spinal region. A single TC contributed to a significant reduction of T4-T10 ROM (an additional 20%) relative to TPS fixation alone (P < 0.05), while the location of the TC within the construct was irrelevant. A second TC had an additive effect (an additional 15% reduction) on axial stability. (P < 0.05) Flexion-extension and lateral bending are not affected. Single TC significantly improves axial rotation stability in long thoracic pedicle screw constructs. Two crosslinks, however, are better than one.