The spine journal : official journal of the North American Spine Society
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Spinal cord injuries (SCIs) related to cervical spine (C-spine) fractures can cause significant morbidity and mortality. Aggressive treatment often required to manage instability associated with C-spine fractures is complicated and hazardous in the elderly population. ⋯ In this elderly population, neurological recovery was poor and the in-hospital mortality rate was high. The strongest risk factors for mortality were injury level and severity of SCI. Although each case of SCI related to C-spine fractures is different, physicians may be able to use these findings to help better determine the prognosis and guide subsequent treatment.
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Novel dual-threaded screws are configured with overlapping (doubled) threads only in the proximal shaft to improve proximal cortical fixation. ⋯ Although dual-threaded screws required higher insertion torque than standard screws in bone and low density foam, dual-threaded and standard pedicle screws exhibited equivalent axial pullout and cyclic fatigue endurance. Unlike single-threaded screws, the mechanical performance of dual-threaded screws in bone was relatively independent of BMD. In foam, the mechanical performance of both types of screws was highly dependent on porosity.
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Lateral distraction injuries represent a very rare pattern of injury with only five cases reported in the literature. Such injuries are a result of high-energy trauma and have a high association with severe concomitant injuries. All previous reports of this injury are in skeletally mature individuals, and this has not been previously described in young children. ⋯ In this case, we describe a lateral distraction injury in a young child secondary to improper seat belt use. This represents the first description of such an injury in this age group, and this case highlights the spectrum of injury caused by improper seat belt use in the pediatric population.
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There is limited literature comparing different functional outcome measures used for cervical spondylotic myelopathy (CSM). ⋯ Preference-based quality-of-life instruments, such as the EQ-5D, are important measures for studying spinal disorders. Among the various commonly used outcome instruments for CSM, the Oswestry NDI is the most predictive of preference-based QOL.
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Recently the financial relationships between industry and professional medical associations have come under increased scrutiny because of the concern that industry ties may create real or perceived conflicts of interest. Professional medical associations pursue public advocacy as well as promote medical education, develop clinical practice guidelines, fund research, and regulate professional conduct. Therefore, the conflicts of interest of a professional medical association and its leadership can have more far-reaching effects on patient care than those of an individual physician. ⋯ The NASS experience can provide a template for other professional medical associations to help manage their own possible conflicts of interest issues.