Spine
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Biography Historical Article
The education, training, and evaluation of a spine surgeon.
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A retrospective study to review the results of unstable thoracolumbar burst fractures managed with casting or bracing and early ambulation in neurologically healthy patients. ⋯ Nonoperative management of thoracolumbar burst fractures with hyperextension casting or bracing was proven to be a safe and effective method of treatment in selected patients. Clinical results were favorable; no neurologic deterioration was observed; hospitalization times were minimized, and patient satisfaction was high. The authors do not believe that ligamentous injury of the posterior column is a contraindication to nonoperative management of thoracolumbar burst fractures.
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Comparative Study
In vitro biomechanical comparison of multistrand cables with conventional cervical stabilization.
The biomechanical stability of six different methods of cervical spine stabilization, three using multistrand cables, were evaluated in a bovine model. ⋯ Multistrand cables were superior to monofilament wire with fatigue testing using an in vitro calf cervical spine model. There were no failures or detectable differences in elongation after fatigue testing between the stainless steel, titanium, and polyethylene cables, as shown by the flexion-extension range of motion. The posterior cervical plate construct offered the greatest stability compared with all other constructs.
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Laminectomy was performed on cats to destroy the posterior epidural ligament. Evoked potentials and spinal cord blood flows quantified the spinal cord function before and after cervical flexion. ⋯ The role of the posterior cervical epidural ligaments is to anchor the posterior dura mater to the ligamentum flavum. Loss of the ligaments allows anterior displacement of the posterior dura mater in flexion. Abnormal distribution of or lack of the cervical posterior epidural ligaments may lead to flexion myelopathy.