The spine journal : official journal of the North American Spine Society
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Different animal models are used in disc degenerative disease research by now. To our knowledge, a functional animal model that mimics ischemic and slowly progressive disc degeneration of humans does not exist. ⋯ Percutaneous injection of PYM into the subchondral bone adjacent to the lumbar IVDs of rabbits, using bone marrow needle guided by CT scan, can result in ischemic and slowly progressive disc degeneration model, which mimics the onset of human disc degeneration.
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It is widely recognized that sagittal spinal alignment changes with age. However, there are presently no clear benchmarks for such values or those for the cervical spine in the general population. Quality epidemiological studies are needed to establish standards for spinal alignment deviation. ⋯ This first resident cohort of Japanese individuals determined average spinal alignment parameters by age and gender. Spinal balance generally shifts forward as age increases. A forward shift in the upper cervical spine occurs first in men, whereas lumbopelvic alignment shift occurs first in women.
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Surgery for adult spinal deformity (ASD) is increasingly common. Although outcomes of ASD surgery have been studied extensively, to our knowledge, no data exist regarding factors predicting nonroutine discharge in this population. Nonroutine discharge is defined as discharge to a health care facility after surgery rather than to home. ⋯ To our knowledge, this is the first study to evaluate pre- and perioperative factors associated with nonroutine discharge after ASD surgery. Elderly patients who undergo complex surgery and receive blood transfusions are at particularly high risk of nonroutine discharge. Surgeons should consider these factors during surgical planning and preoperative patient counseling.
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Observational Study
The Spine Functional Index: development and clinimetric validation of a new whole-spine functional outcome measure.
Most spine patient-reported outcome measures are divided into neck and back subregions. This prevents their use in the assessment of the whole spine. By contrast, whole-spine patient-reported outcome measures assess the spine from cervical to lumbar as a single kinetic chain. However, existing whole-spine patient-reported outcomes have been critiqued for clinimetric limitations, including concerns with practicality. ⋯ The SFI demonstrated sound clinimetric properties with lower response errors, efficient completion and scoring, and improved responsiveness and overall clinimetric performance compared with the FRI. These results indicated that the SFI was suitable for functional outcome measurement of the whole spine in both the research and clinical settings.
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Randomized Controlled Trial
Platelet-rich plasma enhances bone union in posterolateral lumbar fusion: A prospective randomized controlled trial.
Platelet-rich plasma (PRP) accelerates bone union in vivo in a rodent model of spinal fusion surgery. However, PRP's effect on bone union after spinal surgery remains unclear. ⋯ Patients treated with PRP showed a higher fusion rate, greater fusion mass, and more rapid bone union after spinal fusion surgery than patients not treated with PRP.