The spine journal : official journal of the North American Spine Society
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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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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.
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The adverse impact of chronic liver diseases, including chronic hepatitis and cirrhosis, on outcomes following orthopedic surgery has been increasingly recognized in recent years. The impact of these conditions on acute outcomes following spinal trauma remains unknown. ⋯ Our novel findings indicate that patients with chronic liver disease may be at elevated risk of posttreatment morbidity and mortality following cervical spine trauma. Medical comanagement in the acute period following injury and optimization before surgery may diminish the potential for adverse events.
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The achievement of a given change score on a valid outcome instrument is commonly used to indicate whether a clinically relevant change has occurred after spine surgery. However, the achievement of such a change score can be dependent on baseline values and does not necessarily indicate whether the patient is satisfied with the current state. The achievement of an absolute score equivalent to a patient acceptable symptom state (PASS) may be a more stringent measure to indicate treatment success. ⋯ An ODI score ≤22 indicates the achievement of an acceptable symptom state and can hence be used as a criterion of treatment success alongside the commonly used change score measures. At the individual level, the threshold could be used to indicate whether or not a patient with a lumbar spine disorder is a "responder" after elective surgery.