Spine
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This in vitro human cadaveric study tested the loss of thoracic motion segment flexion stiffness after sequential posterior upper instrumented vertebra anchor placement techniques and posterior column destabilization. ⋯ Posterior thoracic skeletal structures involved in upper instrumented vertebra exposure andanchor placement were found to contribute to adjacent segment flexion stiffness. Although stiffness loss was small after individual procedures, the effects were additive for routinely used combinations.
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Historical cohort study. ⋯ Prescriptions for opioid analgesia appear to be decreasing within workers' compensation claimants in Alberta, Canada. As expected, claimants with more severe injuries were more likely to receive opioids. An association was observed between early opioid prescription and delayed recovery, however, this is likely explained by pain severity or other unmeasured confounders.
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Comparative Study
Low profile pelvic fixation: anatomic parameters for sacral alar-iliac fixation versus traditional iliac fixation.
Three-dimensional computed tomography (CT) radiographic analysis. ⋯ Iliac fixation through the S2 ala provides a reproducibly chosen starting point in line with S1 pedicle anchors. Implant prominence is minimized because the starting point is 15 mm deeper than the PSIS entry. It is less likely to be affected in cases using iliac crest bone graft harvest because of the more anterior position of the anchor in the ilium.
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We collected the specimens of lumbar intervertebral discs from patients with discogenic low back pain, to study the histopathological features and connective tissue growth factor (CTGF) expressions. ⋯ The painful degenerative disc is significantly different from the asymptomatic degenerative disc with regard to histopathological findings. The strong CTGF expression in the painful disc may be related to disc fibrosis and degeneration.
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Questionnaire survey on leg cramps for patients with lumbar spinal canal stenosis (LCS). ⋯ LCS patients had significantly more frequent attacks of nocturnal leg cramps than the control population, and leg cramps disturbed the quality of the patients' life, and they rarely improved after decompression surgery. Leg cramps should be recognized as one of the symptoms of LCS, which disturb the patients' quality of life.