Spine
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Comparative Study
Region-dependent aggrecan degradation patterns in the rat intervertebral disc are affected by mechanical loading in vivo.
Immunoblotting study to evaluate aggrecan degradation patterns in rat intervertebral discs (IVDs) subjected to mechanical overload. ⋯ Aggrecan G1 regions resulting from proteolysis were found to have a strong regionally specific pattern in the rat IVD, which was altered under excessive loading. The shift from aggrecanase to MMP-induced degradation products with dynamic compression overloading suggests that protein degradation and loss can precede major structural disruption in the IVD, and that MMP-induced aggrecan degradation may be a marker of mechanically induced disc degeneration.
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Case Reports
Inadvertent injection of a cervical radicular artery using an atraumatic pencil-point needle.
Case report and review of the literature. ⋯ This case demonstrates that the use of pencil-point (Whitacre) needles does not eliminate the risk of inadvertent arterial injection during cervical transforaminal epidurals. Further investigation is required to determine whether the incidence of inadvertent vascular injection is reduced with pencil-point needles compared with sharp-beveled needles.
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Review Comparative Study
A Cochrane review of combined chiropractic interventions for low-back pain.
Cochrane systematic review of randomized controlled trials. ⋯ Combined chiropractic interventions slightly improved pain and disability in the short term and pain in the medium term for acute/subacute LBP. However, there is currently no evidence that supports or refutes that these interventions provide a clinically meaningful difference for pain or disability in people with LBP when compared to other interventions.
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Randomized Controlled Trial Comparative Study
Sagittal spinal balance after lumbar spinal fusion: the impact of anterior column support results from a randomized clinical trial with an eight- to thirteen-year radiographic follow-up.
Randomized clinical trial. ⋯ No difference in the investigated sagittal balance parameters was seen between patients treated with PLF + ALIF or posterolateral fusion alone. Lumbar lordosis and type of lordosis correlated with outcome but could not explain the superior outcome in the group with anterior support. Whether sagittal balance and anterior support during fusion provide a protective effect on adjacent motion segments remains unclear.