Spine
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Tethered cord syndrome (TCS) occurs as a constellation of neurologic signs and symptoms resulting from longitudinal traction on the spinal cord between fixed points. This condition involves a tug-of-war between ascent and inhibition of ascent of intrathecal nervous tissue within the vertebral canal during growth. ⋯ Patients report low back, lower extremity, and perineal pain; lower extremity sensory and motor deficits; urinary and bowel incontinence; and sexual dysfunction. When not treated early or adequately, TCS can lead to neurologic devastation.
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Spine research has advanced substantially over the past 25 years through a highly multidisciplinary process. Through early work on fracture healing, osteosynthesis, tissue engineering, and joint biomechanics, researchers discerned 2 main areas of study: musculoskeletal biomechanics and musculoskeletal regeneration. Investigations of the spine continually move from the research bench-through endeavors that incorporate basic science, biology, biomaterials, mechanical testing, finite element analysis, and mathematical modeling-to the bedside-through treatments, devices, and procedures designed to improve patient health while safeguarding quality of life.
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In treating patients with idiopathic scoliosis and Lenke 1C curves, surgeons must choose between selective fusion of the thoracic spine (STF) and nonselective fusion of the thoracic and lumbar spines. Research shows mixed results. Demura et al reported that 40% of patients who had undergone selective fusion of the thoracic curve were decompensated 2 cm after 2 years, and 89% of those treated with nonselective fusion were balanced in the thoracic and lumbar planes, regardless of preoperative balance.
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A preclinical animal model of chronic ligation of the sciatic nerve was used to compare the effectiveness of a slow-release hydrogel carrying methylprednisolone to methylprednisolone injection alone, which simulates the current standard of care for chronic compressive radiculopathy (CR). ⋯ N/A.