Spine
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Several attempts have been made to measure the segmental range of motion in the lumbar spine during flexion-extension with the purpose of gathering additional data for the diagnosis of instability. The previous studies were performed in vitro or in vivo during active motion. The aim of this study was to obtain normal values of passively performed segmental motions. ⋯ It is proposed that passive motion be applied during functional examination of patients with suspected instabilities. However, the large variation of rotational values between individuals in the normal population may limit the clinical usefulness of functional lumbar analysis using this parameter. Future studies should explore the clinical relevance of determining altered segmental mobility in low-back pain patients.
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Case Reports
Influence of the ultrasonic surgical aspirator on the dura and spinal cord. An electrohistologic study.
The influence of the ultrasonic surgical aspirator on the dura and underlying spinal cord was examined. Spinal-cord-evoked potential was simultaneously recorded. ⋯ With 60% energy at 20 seconds and 80% energy at both 10 and 20 seconds, spinal-cord-evoked potential showed wave changes. In light of these results, it is suggested that in using the ultrasonic surgical aspirator on the dura, the electrohistologic safety limit be set at 60% energy and the maximum time duration at one point less than 10 seconds.
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Comparative Study
Disc degeneration and associated abnormalities of the spine in elite gymnasts. A magnetic resonance imaging study.
The thoracolumbar spine was examined by magnetic resonance imaging (MRI) and the history of back pain was analyzed in 24 male elite gymnasts (age range, 19-29 years) and in 16 male nonathletes (age range, 23-36 years). Disc degeneration, defined as reduced disc signal intensity, was significantly more common in athletes (75%) than in nonathletes (31%). The gymnasts also had a higher incidence of other abnormalities of the thoracolumbar spine, and there was a significant correlation between reduced disc signal intensity and the other abnormalities among the gymnasts. There were also significant correlations between back pain and reduced disc signal intensity and abnormal vertebral configuration when the gymnasts run a high risk of developing severe abnormalities of the thoracolumbar spine, and they often have a history of back pain.
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Comparative Study
Posterior fixation of thoracic and lumbar spine fractures using DC plates and pedicle screws.
A prospective investigation of internal fixation of acute thoracic and lumbar spine fractures using pedicle screws and dynamic compression plates was performed. This article details the results of 23 patients who were followed for an average of 20 months. The indications for the procedure were an unstable fracture--dislocation below the eighth thoracic vertebra or low lumbar fractures that would be difficult to treat with conventional spinal implants. ⋯ There was no increase in neurologic deficit. One patient developed an asymptomatic pseudarthrosis demonstrated by breakage of both plates through unfilled screw holes at the motion segment. Other complications included one wound infection, one case of arachnoiditis after an intradural bone fragment was excised, and one dural tear created by a Kirschner wire, which did not result in a neurologic deficit or a cerebrospinal fluid leak.(ABSTRACT TRUNCATED AT 250 WORDS)
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A multicentered prospective trial to investigate the usefulness of the AO spinal internal fixator for the treatment of thoracolumbar fractures and fracture-dislocations was undertaken. This pedicle screw-rod system was effective in stabilizing a variety of unstable fracture patterns. It was effective in decompressing the canal of retropulsed bony fragments associated with burst fractures. By the use of this implant, sagittal plane deformity was easily corrected.