Journal of spinal disorders
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Thirty-five consecutive patients were evaluated at an average follow-up time of 20 months after circumferential lumbar spinal fusion. All patients had degenerative conditions of the lumbar spine and same-day anterior spinal fusion by using titanium cages packed with autograft bone and posterior instrumentation combined with a posterolateral autogenous bone graft. The purpose of this study was to determine whether anterior titanium cage placement and posterior instrumentation with autologous bone graft was a safe and efficacious procedure in patients with degenerative disease of the lumbar spine. ⋯ Thirteen (37%) patients had one or more surgical complications. Circumferential spinal fusion in patients with degenerative etiologies yields excellent radiographic fusion rates and good pain relief. The procedure is technically demanding and is associated with a high rate of complications.
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This study reviews the results of circumferential fusion in patients with degenerative disc disease who are at high risk for achieving spinal fusion. The fusion rate was 100% and the satisfactory clinical outcome slightly more than 50% in a patient population known to have high risk factors for a poor outcome.
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The histology of 69 human vertebral bodies from 23 individuals was studied by hematoxylin and eosin staining using a technique that allowed the creation of complete, large histologic sections of individual vertebral bodies. Particular attention was directed toward the documentation of intraosseous nerves. The vertebral bodies were dissected free of soft tissue, and then sectioned using a diamond wafering saw into 3-mm sagittal segments. ⋯ Although previous studies have documented nerves within long bones, and others have described the histology of the intervertebral disc and associated soft tissues, previous literature that documents the innervation of the human vertebral body has been very sparse. The documentation of nerve tissue within normal human vertebrae further supports the proposed role of neuronal factors in the regulation of bone physiology. Furthermore, it is possible that such intraosseous nerves may play a role in the clinical problem of back pain.