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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Seventy-eight patients were treated with closed reduction and transpedicular fixation for 82 spine fractures. The fractures were localised in the lower third of the spine and were all, according to the Denis classification, considered unstable. Eighteen patients had neurological deficiencies. ⋯ The complication rate of the transpedicular fixation method used reported by other authors could not be confirmed in our material. Iatrogenic neurological damage was not observed. A partial loss in the correction of the traumatic kyphosis was observed after removal of the implant in 11 patients.
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The evaluation of continued pain after a technically successful posterolateral lumbar spine fusion is often challenging. Although the intervertebral disc is often a source of low back pain, abnormal endplates may also be a focus of pain, and possibly a source of continued pain after a posterolateral fusion. MRI allows noninvasive evaluation for disc degeneration, as well as for abnormal endplates and adjacent vertebral body marrow. ⋯ We conclude that posterolateral lumber fusion has a less predictable result for the subset of degenerative disc patients with abnormal endplates and associated marrow inflammation. More research is needed to determine the biological and biomechanical effects of posterolateral fusion upon the endplate within the fused segments. If indeed further study supports the hypothesis that abnormal endplates associated with inflammation are a source of pain, then treating the endplates directly by anterior fusion may be a preferred treatment for this subset of degenerative patients.
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The authors analysed the clinical and radiological findings and the surgical management of 25 patients admitted for scoliosis classified as idiopathic at first presentation, but in fact associated with spinal cord and/or brain stem anomalies. Twenty patients had syringomyelia, 19 had Chiari malformation. ⋯ The diagnosis of syringomyelia and Chiari malformation was established by MRI, which is the best form of neuroradiological examination for discovering spinal abnormalities. Neurosurgical treatment is strongly recommended as the first step in the management of "pseudo" idiopathic scoliosis.
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The type and frequency of spinal therapeutic work being undertaken in the United Kingdom (UK) by clinicians with an interest in the surgical treatment of disorders of the spine (primary and secondary subspecialty interest) were evaluated by means of a postal questionnaire. The willingness of respondents to take part in postgraduate spinal training was determined along with issues regarding accessibility of spinal services to non-specialist physicians in the health service in the UK. The results of 450 respondents provided insight into the types of procedures taking place, for example: primary spinal decompression was regularly carried out by 76% of surgeons, while at least 20% of respondents regularly carried out 66% of the procedures surveyed. We found that 10% of surgeons indicated that they were prepared to participate actively in postgraduate spinal surgical training.