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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A computed tomography study. ⋯ In addition to the smaller preoperative CWA and higher apex location, lesser correction of vertebral rotation, if accompanied by great surgical correction of apical VT, could also largely result in a poor postoperative anterior chest wall contour.
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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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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.