Spine
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Open surgical procedures have been the mainstay of spinal surgery for decades, but minimally invasive spinal surgery (MIS) has recently gained traction. Translaterally placed cages permit insertion of large cages and promote skeletal realignment and fusion. ⋯ MIS and open surgical procedures are reported to have similar outcomes at 1 year; in the first 6 weeks, patients undergoing open surgery often need blood transfusion, develop infection, and use more narcotics. Spine surgery has been associated with modulus mismatch between osteoporotic bone and titanium and the need for multiple painful and traumatic surgical procedures, and spine surgeons continue the quest to find better ways to do things.
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A retrospective cohort study. ⋯ 2.
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Almost 20% of joint replacement implants fail at 15 to 20 years. Reports suggest that systemic effects of metal-on-metal implants and local effects of total joint arthroplasty implants contributing to implant failure are immune system based. Sometimes implant wear debris can cause implant failure resulting from bone fracture, infection, or implant fracture/failure; most often, aseptic osteolysis or loosening leads to wear debris. ⋯ Corrosion-chemical oxidation comprising reduction reactions involving electron transport-produces electrochemical degradation. Metallic implant degradation occurs when electrochemical dissolution and mechanical/physical wear are combined (i.e., tribocorrosion). With metal-on-metal implants, even with relatively low levels of wear and particle release, pathology caused by metal debris such as pseudotumor/fibrous tissue growth can lead to early implant failure.
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The Uppsala Cryoplaning Technique has been used for over 30 years to study normal spinal anatomy and pathologies such as trauma, degenerative conditions, tumors, and metastases (SDC Figure 1, http://links.lww.com/BRS/B105). A heavy-duty sledge cryomicrotome creates authentic anatomical images of slices from the surface of in situ fresh-frozen specimens at submillimeter intervals. This presentation is intended to improve understanding of anatomical structures of the spine among spine surgeons.