Spine
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The first clinical implementation of a microsurgical endoscopic technique for removal of thoracic disc herniation is described. ⋯ The microsurgical endoscopic technique allows spinal cord decompression with a substantial reduction in surgical trauma. It may shorten bed confinement and allow early return to active life. Application of this technique in other areas is being studied.
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The applicability of using video assisted thoracoscopic surgery (VATS) to resect thoracic discs was investigated. A laboratory study was conducted using two human cadavers and three live pigs as surgical specimens. A total of nine thoracic levels were decompressed. ⋯ VATS provides a useful means of performing thoracic discectomies using a small thoracotomy incision. The decrease in invasiveness provided by this new technology may reduce operative morbidity, hospitalization time, and costs. More work is needed, especially in the design of instrumentation, before this becomes a viable alternative to current surgical procedures.
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Three-dimensional reconstructions of MRI scans measured volume, height, and diameter of intervertebral discs. These measurements were made in vivo. ⋯ The mean simulated diurnal volume decrease in the lower three lumbar discs is 16.2%. Most of the diurnal loss in disc height is due to volume loss. The effect of radial bulging is minimal.
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The authors hypothesized that the source of coccygodynia was a lesion of the coccygeal disc. ⋯ Common coccygeal pain could come from the coccygeal disc in approximately 70% of cases.
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The ability of hydroxyapatite (HA) materials to enhance the fixation strength of posterior spinal instrumentation was examined in 19 adult mongrel dogs. ⋯ The strength of poorly inserted transpedicular screws was significantly enhanced in vivo by the resorbable HA-grout material. The lower strength of HA-coated screws was attributed to screw geometry changes resulting from the coating process, and modifications of screw coating are recommended.