Spine
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A prospective cohort study with 100% follow-up. ⋯ Positive PTSD symptoms occurred at least once in 19.2% of patients after elective lumbar arthrodesis, with 7.5% to 13.6% of patients experiencing these symptoms at any 1 time point postoperatively. In this patient cohort, preoperative psychiatric diagnosis was the strongest predictor among tested variables of occurrence of PTSD symptoms, although occurrence of a perioperative complication was also significantly correlated with PTSD symptoms. Spine surgeons should be aware of the potential impact of lumbar arthrodesis surgery on patients' psychological state. Further investigation focusing on the impact of PTSD symptoms on clinical outcomes as well as on potential means of reducing the postoperative incidence of this disorder seems warranted.
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Two experiments were conducted. Experiment 1 evaluated the effect of 3 kinds of decellularized extracellular matrices (DECMs) deposited by synovium-derived stem cells (SDSCs) and/or nucleus pulposus cells (NPCs) on SDSC expansion and NP lineage differentiation. Experiment 2 evaluated the effect of DECM deposited by SDSCs on NPC expansion and redifferentiation capacity. In both experiments, hypoxia was evaluated in DECM preparation and pellet culture. ⋯ The in vitro microenvironment can be modulated by low oxygen and tissue-specific cell-based DECM to facilitate NP tissue regeneration.
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A retrospective case series of surgically treated patients with adult scoliosis. ⋯ In a long-term review of minimum 5 years, 76% of PJK occurred within 3 months after surgery. Pre-existing low bone mineral density, PSF, fusion to the sacrum, inappropriate global spine alignment, and greater sagittal vertical axis change were significant risk factors for PJK. Careful long-term follow-up should be done for a patient with PJK.
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We report on all patients treated for giant thoracic disc herniation in the past 10 years. ⋯ Anterior exposure of the thoracic spine using a mini-open thoracotomy and retropleural approach coupled with a limited bony resection surrounding the giant disc, without corpectomy or instrumentation, represents an effective, safe, and appropriate surgical treatment for the resection of giant thoracic discs.