Spine
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Case report. ⋯ This unique case highlights the value of electrophysiology in the evaluation of a complex spinal disorder in a patient suffering from acquired TDH in the presence of extensive congenital spine and spinal cord abnormalities. Clinical symptoms and signs can be complemented by neurophysiological techniques to improve diagnostic accuracy and improve the basis for treatment recommendations. In cases involving multiple spinal abnormalities, a comprehensive neurophysiological assessment beyond paravertebral electromyography studies, including nerve conduction and somatosensory-evoked potential recordings, is recommended to assist in confirming the diagnosis.
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Variation in abundance and structure of chondroadherin (CHAD) were studied in the extracellular matrix (ECM) of scoliotic and normal human discs. ⋯ As CHAD can interact with both the ECM and the cells, it can provide a mechanism for regulating cell metabolism and ECM structure, and so play a role in promoting matrix homeostasis. Thus, changes in CHAD abundance or structure could be associated with the pathologic changes occurring in the scoliotic IVD.
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An anatomic study that describes the relationship of the pedicle center to the mid-lateral pars (MLP) in the lower lumbar spine as a guide to pedicle screw placement. ⋯ The MLP is a reliable anatomic reference point for the center of the pedicle in the lower lumbarspine. Consideration needs to be taken when inserting pedicle screws at L4 and L5 because of the degree of their coronal tilts and unique pedicle footprints. It is important to distinguish a type I from type II L5 pedicle as a type II pedicle is wider, has a more lateral pedicle center relative to the MLP, and has the potential for lateral screw placement while still remaining within the pedicle.
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Multicenter Study Clinical Trial
Nucleus replacement with the DASCOR disc arthroplasty device: interim two-year efficacy and safety results from two prospective, non-randomized multicenter European studies.
A prospective, nonrandomized multicenter study of lumbar disc nucleus replacement using the DASCOR Disc Arthroplasty Device. An interim analysis of clinical results is presented, obtained from European patients enrolled in 2 studies. ⋯ The interim outcomes showed significant improvements in mean ODI and VAS scores. The results of these European studies suggest that the DASCOR Device may be a safe and effective less-invasive surgical option for patients with DDD.
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Retrospective evaluation of perioperative complications with recombinant human bone morphogenetic protein-2 on an absorbable collagen sponge (rhBMP-2/ACS) versus iliac crest bone graft (ICBG) for instrumented posterior cervical fusion. ⋯ The higher incidence of posterior cervical wound complications in the rhBMP-2/ACS group, although not statistically significant, may be related to an inflammatory response to rhBMP-2. This potential risk must be weighed against the elimination of donor-site complications associated with ICBG harvesting, and considered in light of ultimate clinical outcome. Additional studies are needed to clarify this issue, as well as to determine optimal dosing and carrier for usage in the posterior cervical spine.