Spine
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Biomechanics of spinal hemiepiphysiodesis for fusionless scoliosis treatment using titanium implant.
In vitro study of the effect of hemiepiphyseal implant on biomechanical properties of porcine thoracic motion segments. ⋯ Implantation of a titanium clip-screw construct decreased range of motion by less than one-fifth, increased stiffness by one-third or less, and decreased the neutral zone by less than one-half. Range of axial translation decreased on the instrumented side and increased contralaterally. This study suggests that most of the flexibility of the spine is preserved in the immediate postoperative period after implantation of the spinal hemiepiphyseal construct.
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Randomized Controlled Trial Comparative Study
Early versus late initiation of rehabilitation after lumbar spinal fusion: economic evaluation alongside a randomized controlled trial.
Economic evaluation conducted alongside a randomized controlled trial with 1-year follow-up. ⋯ Initiating rehabilitation at 6 weeks as opposed to 12 weeks after surgery is on average more costly and less effective. The uncertainty of this result did not seem to be sensitive to methodological issues, and clinical managements who have already adapted fast-track rehabilitation strategies have reason to reconsider their choice. .
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A prospective cohort study. ⋯ This study demonstrated that more than half of the patients with cervical OPLL had coexisting OPLL in the thoracic and/or lumbar spine. We strongly recommend computed tomographic analysis of the whole spine for patients with radiographical evidence of OPLL in the cervical spine for the early detection of additional sites of ossification.
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A retrospective study. ⋯ 3.
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An in situ study using whole-organ culture system. ⋯ Trypsin-induced extracellular matrix damage resulted in a change of the disc's biomechanics. Cross-linker augmentation recovers the rheological and dynamic properties of moderately degenerated discs but not of the severely degenerated discs. The genipin cross-linker may be able to improve the proteoglycan depletion effect in the nucleus pulposus but may not be effective to restore the structural damage in the collagen molecule of the anulus fibrosus.