Spine
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A genetic association study of tryptophan hydroxylase 1 gene (TPH1) and arylalkylamine N-acetyltransferase gene(AANAT) with adolescent idiopathic scoliosis (AIS) in Han Chinese. ⋯ TPH1 polymorphisms were associated with AIS but not with gender and Cobb angle in AIS patients. AANAT polymorphisms were not associated with AIS. These results suggested that TPH1 was an AIS predisposition gene, and there was a close relationship between the dyssynthesis of melatonin and AIS.
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Meta analysis of randomized control trials. ⋯ Although the radiographic results appeared better in the group of BMPs, the exact role of type, dose and carrier of BMPs and the cost-effectiveness of their use need further clinical delineation.
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Case series. ⋯ Relapse of low back or buttock pain and leg pain after thoracolumbar fusion to the sacrum may be related to a sacral fracture, difficult to diagnose in conventional radiographs. Surgery should be considered in the presence of a concomitant L5-S1 pseudarthrosis and when symptoms do not improve with the nonoperative treatment.
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We evaluated 2 types of nerve growth factor (NGF) receptors on dorsal root ganglion (DRG) cells and nerve fibers innervating rat lumbar intervertebral discs. ⋯ Rat L5/6 intervertebral discs were innervated by multisegmental levels of DRG. Most DRG neurons innervating the discs were positive for 2 types of NGF receptors.
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Randomized Controlled Trial Comparative Study
The cost effectiveness of surgical versus nonoperative treatment for lumbar disc herniation over two years: evidence from the Spine Patient Outcomes Research Trial (SPORT).
Spine Patient Outcomes Research Trial observational and randomized cohort participants with a confirmed diagnosis of intervertebral disc herniation (IDH) who received either usual nonoperative care and/or standard open discectomy were followed from baseline at 6 weeks, 3, 6, 12, and 24 months at 13 spine clinics in 11 US states. ⋯ Surgery for IDH was moderately cost-effective when evaluated over 2 years. The estimated economic value of surgery varied considerably according to the method used for assigning surgical costs.