Spine
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Randomized Controlled Trial
The Influence of Simulated Low Speed Vehicle Impacts and Posture on Passive Intervertebral Mechanics.
An in vitro biomechanics investigation exposing porcine functional spinal units (FSUs) to sudden impact loading although in a flexed, neutral, or extended posture. ⋯ Functional spinal units exposed to the highest severity impact (11 g) had significant neutral zone changes, with increases in joint laxity in flexion-extension and anterior-posterior shear and decreased stiffness, suggesting that soft tissue injury may have occurred. Despite observed main effects of impact severity, no influence of posture was observed.Level of Evidence: N/A.
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Fourteen cadaveric specimens were separated into two groups: (1) L3 pedicle subtraction osteotomy (PSO) with transforaminal lumbar interbody fusion (TLIF) or (2) lateral lumbar interbody fusion (LLIF). A 2-rod configuration (2R) was compared with two supplemental rod configurations: 4-rod (4R) with accessory rods (ARs) using connectors or 4R with satellite rods (SRs) without connectors. ⋯ Both supplemental rod configurations reduced motion in both groups. Constructs with the SR configuration increased the primary rod strain and the sacral screw bending moment compared with AR constructs, which can share strain. Deep-seated SRs, which have become increasingly popular, may be more vulnerable to failure than ARs. LLIF provided more stability in sagittal plane. Protective effect of supplemental rods on rod strain was more effective with TLIF.Level of Evidence: NA.
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Retrospective study of magnetic resonance imaging (MRI). ⋯ We successfully differentiated OVFs and MVFs based on MRI with high accuracy using the CNN model, which was statistically equal or superior to that of the spine surgeons.Level of Evidence: 4.
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Delphi expert panel consensus. ⋯ Although telemedicine was initially introduced out of necessity, this technology most likely will remain due to evidence of high patient satisfaction and significant cost savings. This study was able to provide a framework for appropriate telemedicine utilization in spine surgery from a panel of experts. However, several questions remain for future research, such as whether or not an in-person consultation is necessary prior to surgery and which physical exam maneuvers are appropriate for telemedicine.Level of Evidence: 4.
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A retrospective study. ⋯ Skeletally immature patients with long thoracic curve, preoperative coronal imbalance, large rotation, and deviation of LSTV-1 are at increased risk of distal adding-on when selecting LSTV-1 as LIV. Under this condition, distal fusion level should extend to LSTV; while in other case, LSTV-1 could be a valid LIV.Level of Evidence: 4.