Spine
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The kinematic study of human lumbar spinal movements. ⋯ Our results support that facet joint degeneration is followed by disc degeneration according to age. Increased translational movements of the lumbar segments occurred in severe disc degeneration accompanied by facet joint degeneration or the presence of LFH even if the movements were stabilized in the advanced status. Therefore, the current status of the intervertebral discs, facet joints, and ligamentum flavum should be taken into consideration when evaluating stability within the lumbar spine.
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Randomized Controlled Trial Multicenter Study Comparative Study
Segmental contribution toward total lumbar range of motion in disc replacement and fusions: a comparison of operative and adjacent levels.
Radiographic results from a prospective, randomized, multicenter trial assessing patients who underwent lumbar total disc replacement (TDR) or circumferential arthrodesis for 1-level degenerative disc disease. ⋯ In conclusion, patients with TDR lost slight relative contribution to total lumbar motion from the operative level which was mostly compensated for by the caudal adjacent level (if operated at L4/5). In contrast, the significant loss of relative range of motion contribution from the operative level in fusions was redistributed among multiple cranial adjacent levels, most notably at the first cranial adjacent level.
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Retrospective clinical review and prospective report of postoperative delirium after cervical spine surgeries. ⋯ Early commencement of mobilization after cervical spine surgery would be crucial to the prevention of postoperative delirium in the elderly.
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Systematic review of clinical guidelines. ⋯ Compared to the quality assessment performed in 2004, the average quality of guidelines has improved. However, guideline developers should still improve the quality transparency of the development process. Especially the applicability of guidelines and the editorial independence need to be ensured in future guidelines.
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Prospective clinical study. ⋯ The prevalence of depression was notable among 1-year postoperative spinal stenosis patients. Depressive symptoms in the preoperative and early recovery phase were strong predictors of a poorer self-reported surgery outcome on 1-year follow-up. The results call for intervention strategies to detect and treat depression during both the preoperative and postoperative phase.