Spine
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Multicenter Study Clinical Trial Controlled Clinical Trial
Predictors of bad and good outcome of lumbar spine surgery. A prospective clinical study with 2 years' follow up.
Based on prospective assessment, patients with lumbar disc surgery were examined to determine reliable predictors for clinical outcome. ⋯ Patients with a high risk of a bad operation outcome after lumbar discectomy could be identified preoperatively. It is suggested that those patients take part in a pain management approach instead of or in addition to surgical intervention.
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Lumbosacral nerve roots and dorsal root ganglia in relation to surrounding bony structures in normal subjects were investigated using magnetic resonance imaging. ⋯ The anatomy of the lumbar nerve roots and dorsal root ganglia and their relations to bony structures have been better defined in this study. Because of its more medial location, S1 radiculopathy may involve both the nerve root and dorsal root ganglion as a result of either disc herniation or degenerative L5-S1 facet changes. The relatively larger dorsal root ganglia and the greater dorsal root ganglion/foramen height ratios in the lower lumbar region may explain the higher incidence of L5 or S1 radiculopathy, particularly given the propensity to disc degeneration and intervertebral foraminal narrowing in the lower lumbar region.
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Clinical Trial Controlled Clinical Trial
Increased limb lengths in patients with shortened spines due to tuberculosis in early childhood.
The spine and limb lengths of 26 patients who had a severe spinal deformity due to tuberculosis in childhood were measured and compared with similar data from 79 normal adult volunteers. ⋯ Patients whose spinal growth was stunted due to disease in childhood have longer legs and upper limbs than healthy people. A compensatory stimulatory growth mechanism may be responsible for this. This has implications for the whole gamut of childhood spinal disorders that result in stunted spinal growth.
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Experimental axial pullout tests of a new type of pedicle screw were done on cadaveric lumbar vertebrae. The manner in which specimens were secured in the testing apparatus was varied to determined influence of specimen fixation method on the maximum pedicle screw pullout force. ⋯ Polymer resin intrusion can have a significant effect on the biomechanical characteristics of the bone-pedicle screw interface. When polymer resins are used to secure vertebral specimens for in vitro biomechanical tests of the bone-pedicle screw interface, it is important to either prevent intrusion (e.g., with a latex wrapping) or document post-test (e.g., through the methods described in this article) that intrusion did not occur for the specimens included in the analysis.
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This is a brief review of the life and contributions to neurologic science of Sir William Gowers. He was a neurologist in England in the late 19th century who, before the availability of modern diagnostic aids, established the importance of clinical examination, including history and physical signs, in the diagnosis of neurologic disorders. ⋯ He arranged for his colleague, Sir Victor Horsley, to remove it and the operation was completely successful. He invented the patella hammer and his book "Manual of Diseases of the Nervous System" (in two volumes) was the standard reference until early in the 20th century.