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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Case Reports Multicenter Study
Complications and outcomes of posterior fusion in children with atlantoaxial instability.
Atlantoaxial instability (AAI) is an uncommon disease in children. Surgical treatment of pediatric patients with AAI poses a challenge to spine surgeons because of the patients' immature bone quality, extensive anatomical variability, and smaller osseous structures. In this study, the authors report complications and outcomes after posterior fusion in children with AAI. ⋯ A high complication rate should be anticipated after posterior fusion in children with AAI. Careful consideration should be paid to pediatric patients with AAI treated by screw and/or rod systems. After posterior fusion in pediatric patients, each vertebra continued to grow, in contrast the disc height decreased between fused levels.
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Randomized Controlled Trial
Can we predict response to the McKenzie method in patients with acute low back pain? A secondary analysis of a randomized controlled trial.
To evaluate whether patients' treatment preferences, characteristics, or symptomatic response to assessment moderated the effect of the McKenzie method for acute low back pain (LBP). ⋯ We were unable to find any clinically useful effect modifiers for patients with acute LBP receiving the McKenzie method.
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Anterior cervical decompression and fusion (ACDF) procedures are successful in treating multilevel cervical radiculopathy and cervical myelopathy. It was reported that this procedure would result in a loss of cervical range of motion. However, few studies have focused on the exact impact of multilevel (more than 3 levels) ACDF on cervical range of motion. ⋯ The patients of cervical spondylotic myelopathy had an obvious reduction in active cervical ROM following multilevel ACDF. However, patients might not experience great difficulties in performing daily activities with regard to the loss of neck motion after fusion.
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RhBMP-2 use in lumbar fusion surgery is associated with transient immediate post-operative leg pain.
Supra-physiological rhBMP loads during spinal fusion may trigger local inflammation and post-operative radiculitis. MRI is an effective tool to detect nerve root compression in severe post-operative leg pain. The aim of this study was to determine if recombinant bone morphogenic protein 2 (rhBMP-2) is associated with immediate post-operative leg pain without evidence of root compression using MRI. ⋯ III.
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To analyze the three-dimensional distribution of high-intensity zone (HIZ) in lumbar disks and to assess the correlation between low back pain (LBP) and spatial distribution of HIZs. ⋯ High-intensity zones occurred frequently at lower segments, inferior part of annulus fibrosus, and single disk.