Spine
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Numerical modeling and simulations of scoliotic spine instrumentation using monoaxial, uniaxial, polyaxial, and multiple-degrees-of-freedom (6DOF) postloading pedicle screws. ⋯ The bone-screw loads of different screws were significantly different. The descending order of bone-screw loads was monoaxial, uniaxial, polyaxial, and 6DOF screws. For patients with large and stiff spinal deformities or for patients with compromised bone quality, screws with more degrees of freedom offer better perspective to reduce bone-screw connection failure.
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Cross-sectional study using T1ρ magnetic resonance imaging (MRI) of lumbar spine in healthy young adults. ⋯ The data of this study showed a significant difference in IDD onset between sexes. T1ρ values correlate with Pfirrmann degenerative grade in young adults. However, the wide distribution of T1ρ values in healthy intervertebral disc highlights the low sensitivity of Pfirrmann grade to detect the early IDD changes. T1ρ can be potentially used as a clinical tool to identify early IDD and to create a reliable quantitative scale.
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Case Reports
Epidural hematoma and intraoperative hemorrhage in a spine trauma patient on Pradaxa (dabigatran).
The authors present a case report of a 72-year-old man who presented with back pain and lower extremity weakness after a fall from his roof. ⋯ As dabigatran (Pradaxa) has recently been approved by the Food and Drug Administration, many spine specialists are not familiar with this agent. Many of the reversal agents (e.g., vitamin K and protamine), useful for other classes of anticoagulants, have no impact on Pradaxa. Similarly, prothrombin time and partial thromboplastin times have limited utility in estimating the patient's true clotting status. The purpose of this case report is to alert spine specialists to this drug and its implications on spine care. The drug's pharmacokinetics, clinical assessment of clotting status, and reversal options are discussed.
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A cross-sectional analysis of parents' and patients' perceptions of deformity- and brace-related stress regarding conservative treatment of adolescent idiopathic scoliosis. ⋯ Patients and parents perceive the emotional stress related to brace treatment in the same way; however, parents overestimate the assessment of stress levels related to body deformity. From the perspective of patients and parents, brace wearing increased the level of stress induced by the deformity alone. Complete assessment of conservative treatment should include evaluation of emotional stress from the perspective of patients and parents.
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Case report. ⋯ We used DTI to diagnose a symptomatic lesion as an extra-foraminal lumbosacral lesion caused by compression of the L5 spinal nerve at the foramina. Because DTI can quantitatively measure damage to nerve fibers, it may be advantageous for the diagnosis of far-out syndrome.