European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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The availability of human cadaveric spine specimens for in vitro tests is limited and the risk of infection is now of vital concern. As an alternative or supplement, calf spines have been used as models for human spines, in particular to evaluate spinal implants. However, neither qualitative nor quantitative biomechanical data on calf spines are available for comparison with data on human specimens. ⋯ Biomechanical similarities were observed between the calf and reported human data, most notably in axial rotation and lateral bending. Range of motion in the lumbar spine in flexion and extension was somewhat less in the calf than that typically reported for the human, though still within the range. These results suggest that the calf spine can be considered on a limited basis as a model for the human spine in certain in vitro tests.
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Randomized Controlled Trial Comparative Study Clinical Trial
Lumbar epidural perineural injection: a new technique.
Two controlled studies for a new epidural, perineural, single-shot, selective nerve root injection with a double-needle approach to the anterior epidural space of the lumbar spinal canal are presented. The results were analysed to determine the effectiveness of the new epidural perineural injection technique. The trial comprised two controlled studies on 182 patients. ⋯ There were no severe complications or side effects in any of the three groups. The studies concluded that single-shot epidural perineural injection is effective in the treatment of lumbar radicular pain. It is a "one drop only" therapy to the source of pain.
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Thirty-three patients with low back pain underwent spinal fusion following a positively predicting external fixation test. Thirty-two spinal fusions and one sacroiliac joint fusion were performed. ⋯ Multiple variables affect the results of spinal fusion. We feel that the external fixator test in low back pain management is very invasive, and its use cannot be justified.
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We report a case of a hernia through the thoracolumbar fascia in a young adult male who presented with pain and swelling in the thoracolumbar region. Surgical repair of the defect was performed in the superficial layer of the thoracolumbar fascia and, 18 months following surgery, he remained asymptomatic. The purpose of this report is to make clinicians aware of a thoracolumbar hernia as a rare cause of back pain.
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A 17-year-old young man presented with a highly unstable fracture dislocation of the third and fourth thoracic vertebrae with neurological deficit, in which the fractured spine had perforated the thoracic esophagus. Open reduction and internal fixation of the spinal fractures in combination with aggressive treatment of the mediastinitis caused by esophageal perforation, consisting of two re-thoracotomies, was performed. Two years after the accident, the patient had recovered well. The neurological deficit had recovered, and there were no difficulties with swallowing.