The spine journal : official journal of the North American Spine Society
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It is suggested that the shape of the vertebral end plates may play a role in the development of abnormalities in the intervertebral disc. On midsagittal magnetic resonance images of the spine in patients with lumbar intervertebral disc herniation, a notable disproportion frequently exists between the end plates of two vertebrae to which the disc is attached. There is apparently no study in the literature examining possible association of this disproportion with development of disc herniation. ⋯ Difference of end plate is a significant and probably independent risk factor for lumbar disc herniation.
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Randomized Controlled Trial Multicenter Study
Retrolisthesis and lumbar disc herniation: a postoperative assessment of patient function.
The presence of retrolisthesis has been associated with the degenerative changes of the lumbar spine. However, retrolisthesis in patients with L5-S1 disc herniation has not been shown to have a significant relationship with worse baseline pain or function. Whether it can affect the outcomes after discectomy, is yet to be established. ⋯ Although retrolisthesis in patients with L5-S1 disc herniation did not affect the baseline pain or function, postoperative outcomes appeared to be somewhat worse. It is possible that the contribution of pain or dysfunction related to retrolisthesis became more evident after removal of the disc herniation.
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Although the precise cause of heterotopic ossification (HO) remains unclear, it is certain that it increases with time. The reason why the reported occurrence rate has been given as a wider range is that there were no clinical reports that have addressed the occurrence rate based on the morphology and position. ⋯ Type 1 HO developed mostly in the posterior disc space. Type 2 HO was the dominant type in the anterior disc space. Type 3 HO developed only in the anterior disc space. It is certain that both Type 1 and Type 2 HOs are related to biomechanical stresses (compressive force for Type 1 HO and traction force for Type 2 HO). It is suggested that a cervical arthroplasty should be selected in terms of the implant level, hybrid conditions on the upper adjacent segment, disc design vulnerable to the pseudotranslation, the presence of preoperative ossification, and fitting implants to end plates to reduce the development of HO.
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Thoracic pedicle screw (TPS) constructs have improved curve correction measurements compared with hook and hybrid constructs in the treatment of adolescent idiopathic scoliosis (AIS), but the optimal implant density, or the number of screws per level, remains unknown in the treatment of flexible thoracic curves. ⋯ We identified no clinical, radiographic, perioperative, or complication-related advantage of constructs with higher TPS implant density in this patient cohort with flexible idiopathic scoliosis. Cost was significantly higher with HD constructs in comparison with LD constructs. Optimal implant density chosen by the surgeon should rely on a number of factors including curve magnitude and rigidity, bone density, and desired correction.
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Although numerous studies have reported on the loss of flexion-extension range of motion (ROM) associated with laminoplasty, few have reported on the time course of this loss of motion for a long-term follow-up period. ⋯ These results suggest that the loss of cervical ROM after laminoplasty is time-dependent, and patients with OPLL and laminar autofusion had less ROM. Postlaminoplasty ROM reduction can recover after several years, unless laminar autofusion occurs.