Spine
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Finite element analysis (FEA) and in vivo ovine spinal interbody fusion study. ⋯ Validating FEA estimates, cages with smaller diameter struts exhibited more rapid fusion consolidation and more aggressive osseointegration compared with cages with larger diameters struts.Level of Evidence: 4.
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Retrospective cohort study. ⋯ In patients undergoing elective PCLF, those instrumented to C2 had only longer operative times compared with those stopping at C3/4. No differences were seen in EBL, LOS, 1-year PROs, and complications. Type of C2 screw had no impact on outcomes. Besides increased operative time, instrumenting to C2 had no detectable difference on surgical outcomes or adverse event rates.Level of Evidence: 3.
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Multicenter Study
Assessment of Adult Spinal Deformity Complication Timing and Impact on Two-Year Outcomes Using a Comprehensive Adult Spinal Deformity Classification System.
Retrospective review of prospectively collected multicenter registry data. ⋯ Surgeons should recognize that long-term complications have a substantial negative impact on HRQoL, and should carefully monitor for implant-related and radiographic complications over long-term follow-up.Level of Evidence: 4.
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Observational Study
A Prospective, 3-year Longitudinal Study of Modic Changes of the Lumbar Spine in a Population-based Cohort: The Wakayama Spine Study.
Large-scale, prospective, population-based, longitudinal observational study. ⋯ This study revealed a high incidence of MCs at the upper lumbar levels and transformation at the lower lumbar levels. Reverse transformation of MCs occurs but are rare.Level of Evidence: 2.
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Retrospective cohort study. ⋯ Among ASD patients undergoing long-segment primary fusion to the pelvis, the risk of PJF was lower among patients with less than 1.8 screws per level. This finding may be related to construct rigidity. Residual confounding by other patient and surgeon-specific characteristics may exist. Further biomechanical and clinical studies exploring this relationship are warranted.Level of Evidence: 3.