The spine journal : official journal of the North American Spine Society
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Previous studies on the risk and prevalence of diabetes among spinal cord injury (SCI) patients are limited and controversial. ⋯ Our findings may facilitate the prioritizing of preventive health strategies and planning of long-term care for SCI patients.
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In vivo three-dimensional kinematics of the thoracic spine in trunk lateral bending with an intact rib cage and soft tissues has not been well documented. There is no quantitative data in the literature for lateral bending in consecutive thoracic spinal segments, and there has not been consensus on the patterns of coupled motion with lateral bending. ⋯ This study revealed in vivo three-dimensional motions of consecutive thoracic spinal segments in trunk lateral bending. The thoracolumbar segments significantly contributed to lateral bending. Coupled axial rotation generally occurred in the same direction with lateral bending. However, more variability was observed in the direction of coupled axial rotation at T2-T3 to T5-T6 segments in the supine position. These results are useful for understanding normal kinematics of the thoracic spine.
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Prior studies on the impact of obesity on spine surgery outcomes have focused mostly on lumbar fusions, do not examine lumbar discectomies or decompressions, and have shown mixed results regarding complications. Differences in sample sizes and body mass index (BMI) thresholds for the definition of the obese versus comparison cohorts could account for the inconsistencies in the literature. ⋯ Patients with high BMI appear to have higher complication rates after lumbar surgery than patients who are nonobese. However, the complication rates seem to increase substantially for Obese III patients. These patients have longer times spent in the operating room, extended hospitals stays, and an increased risk for wound, urinary, and pulmonary complications and for having at least one or more complications overall. Surgeons should be aware of the increased risk of multiple complications for patients with BMI greater than or equal to 40 kg/m(2).
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Achieving a posterolateral fusion in conjunction with performing decompressive laminectomies can prevent recurrence of stenosis or worsening of spondylolisthesis. Facet bone dowels have been introduced and marketed as a less invasive alternative to pedicle screws. Surgeons have been placing them during lumbar laminectomy surgery and coding for intervertebral biomechanical device and posterolateral fusion. These bone dowels have also been placed percutaneously in outpatient surgery centers and pain clinics for facet-mediated back pain. ⋯ This article is mainly intended to question whether the implantation of facet bone dowels can produce a solid fusion radiographically. In our experience, the placement of facet bone dowels does not equal the time, skill, or attention to detail that is necessary for a posterolateral lumbar arthrodesis, and our follow-up radiographic studies clearly demonstrate an inadequate fusion rate.
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Traditionally, the "dynamic" and "static" types of spondylolisthesis have been lumped into a single group in the literature. The goal of this study was to define the radiographic characteristics of "dynamic" and "static" spondylolisthesis with the use of magnetic resonance imaging (MRI) and flexion/extension radiographs. ⋯ The presence of FF and/or ISF is associated with instability greater than 3 mm in flexion/extension radiographs.