Spine
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Study Design. Basic pain study using osteoporotic rodent models. Objective. ⋯ Sustained upregulation of CGRP in DRG neurons was observed following compression of the Co5 vertebra, and Co5 compression caused significant increase in CGRP production in DRG neurons, while a greater level of ATF-3 upregulation was observed in DRGs in OVX rats following dynamic vertebral compression 8 weeks after surgery, implying potential neuropathic pain. Conclusion: There was sustained upregulation of CGRP and ATF3 in DRGs in osteoporotic model rats compared with controls, and levels were further enhanced by dynamic vertebral compression. These findings imply that dynamic compression stress on vertebrae can exacerbate osteoporotic pain by inducing both inflammatory and neuropathic pain mediators.
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Review Case Reports
Fate of the adult revision spinal deformity patient: a single institution experience.
Retrospective case series. ⋯ The rate of revision after revision SD surgery was 21%, most commonly due to pseudarthrosis, adjacent segment disease, infection, and implant prominence/pain. However, significant improvements in SRS outcome scores were still observed in those patients requiring additional revision procedures.
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Multicenter, prospective, consecutive series. ⋯ 3.
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Randomized Controlled Trial Comparative Study Pragmatic Clinical Trial
Classification-guided versus generalized postural intervention in subgroups of nonspecific chronic low back pain: a pragmatic randomized controlled study.
Pragmatic randomized controlled single-blinded study. ⋯ Compared with minimal change in the GPI group, the CSPI produced statistically and clinically significant improvements in disability and pain outcomes and short-term improvements in some parameters of spinal repositioning sense in NSCLBP subgroups.
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Multicenter Study
Identification of decision criteria for revision surgery among patients with proximal junctional failure after surgical treatment of spinal deformity.
Multicenter, retrospective, consecutive case series. ⋯ The decision to perform revision surgery is complicated and varies by surgeon. Factors that seem to influence this decision include traumatic etiology of PJF, severity of proximal junctional kyphosis angulation, higher SVA, and female sex. Factors that were expected to influence revision but had no statistical effect included soft tissue versus bony mode of failure, age, levels fused, and upper thoracic versus thoracolumbar proximal junction.