Spine
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An in vitro three-dimensional (3D) flexibility test of human C3-C7 cervical spine specimens. ⋯ Anterior cervical fusion with a wedged graft and a rigid constrained (locked) plate can effectively stabilize the nonosteoporotic cervical spine after complete posterior element injury when excessive ROM is prevented (for example, by the use of postoperative external immobilization). Even when the construct is subjected to higher moments, adequate stability can be achieved when physiologic preload is present. Osteoporosis and lack of sufficient preload due to poor neuromuscular control may affect long-term screw stability, and additional external immobilization may be needed until fusion matures.
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Comparative Study
Age-related changes in the extracellular matrix of nucleus pulposus and anulus fibrosus of human intervertebral disc.
To characterize age-related changes in the matrix of human intervertebral disc (IVD) specimens, human specimens from the third to the eighth decade of life were collected and analyzed for collagen and proteoglycan (PG) composition. ⋯ Collagen and PGs appeared to undergo specific age-related changes in the human IVD. Although the total contents of these 2 families of molecules decreased during aging, individual species of small nonaggregating PGs showed species-specific age-related changes. Interestingly, the level of biglycan rose and remained elevated in all 3 compartments of the disc with aging. The functional significance of these alterations is yet to be determined.
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Three-dimensional (3D) characterization of the thoracic scoliotic spine (cross-sectional study). ⋯ Two distinct subgroups within the surgical cases (major curves) of Lenke type-1 curves were found thus suggesting that thoracic curves are not always hypokyphotic. The ISOData cluster analysis technique helped to capture inherent 3D structural curve complexities that were not evident in a 2D radiographic plane. The daVinci representation is a new clinically relevant means to report 3D spinal deformities.
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A prospective study was performed. ⋯ This single-stage posterior approach for acute thoracic and lumbar burst fractures offers some advantages over the classic combined anterior-posterior approach. The results from this small series suggest that a single-stage posterior approach should be considered in select cases.
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A clinical and cohort study. ⋯ A 10 second step test is an easily performed, quantitative task, and useful in assessing the severity of CSM. Moreover, it can be used in determining the effects of decompressive surgical treatment.