The spine journal : official journal of the North American Spine Society
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Fulfillment of expectations is an important outcome of spine surgery. ⋯ Fulfillment of expectations after spine surgery is associated with multiple pre- and postoperative variables, including the amount of improvement expected preoperatively.
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Over half the population of the world will suffer from moderate or severe low back pain (LBP) during their life span. Studies have shown that naringin, a major flavonoid in grapefruit and an active compound extracted from a Chinese herbal medicine (Rhizoma Drynariae) possesses many pharmacological effects. ⋯ Naringin effectively promotes the proliferation of degenerative human NP cells and improves the recuperation of the cells from degeneration by increasing expression of aggrecan, BMP-2, and Sox6 while inhibiting the expression of TNF-α and MMP3. This study suggests that naringin may represent an alternative therapeutic agent for disc degeneration.
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Obesity is a growing problem in health care. Studies have demonstrated similar functional outcomes but higher complication rates after spine surgery in obese patients. ⋯ When considering a subset of patient-reported outcomes and revision surgery after 5 years, patients with an elevated BMI >25 at baseline did not appear to have worse outcomes than those with a normal BMI of 20-25 when undergoing posterior lumbar fusion surgery. Obesity should not be considered a contraindication to surgery in patients with appropriate surgical indications.
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Cervical interlaminar and transforaminal epidural steroid injections have been increasingly performed as a medical interventional treatment for pain. ⋯ Although there is an increased use of interventional spine procedures to treat pain, this did not increase the proportion of cervical epidural-related SCI admissions. Additional research is needed to advocate reporting complications in all clinical settings.
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Basilar invagination (BI) is a malformation of craniovertebral junction. However, surgical procedures on BI with atlantoaxial dislocation (AAD) remain controversial. ⋯ Under traction, simple posterior fixation and fusion were effective for Type A patients suffering from BI with AAD; anterior atlantoaxial release and posterior fixation and fusion were effective for Type B patients with BI and AAD.