Spine
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A prospective study was conducted in 37 patients with cervical spondylosis with incomplete cord injury to assess the role of decompression in these patients. ⋯ Although neurologic improvement after an incomplete spinal cord injury when no bony lesion was present was slow during the first few months after trauma, more than 60% of the patients showed neurologic recovery with a muscle grade higher than 3 at 2-year follow-up. Surgical decompression, however, was associated with immediate neurologic improvement, faster recovery of neurologic function, early mobilization, better long-term neurologic outcome, briefer hospital stays, and fewer complications related to long confinements in bed than was nonoperative treatment.
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The psychometric properties and clinical use of a battery of physical performance measures were tested on 44 patients with low back pain and 48 healthy, pain-free control subjects. ⋯ The results provide support for the use of these physical performance measures as a complement to patient self-report.
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The outcome of a herniated disc in patients with cervical myelopathy treated by laminoplasty without discectomy and in those treated conservatively was studied by magnetic resonance imaging. ⋯ The size of the herniated disc in cervical lesions regressed as it does in the lumbar lesions. Laminoplasty for patients with narrowed spinal canals showed favorable surgical results. Therefore, the therapeutic method for cervical disc herniation should be chosen after taking the natural history of the disc herniation into consideration.
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Comparative Study
Comparison of the strengths of lumbosacral fixation achieved with techniques using one and two triangulated sacral screws.
The strength of sacral screw fixation achieved with techniques using one sacral screw and two triangulated sacral screws with Chopin block was tested on 10 fresh human sacrum specimens. ⋯ This study showed that fixation with two divergent triangulated screws to the sacrum was significantly stronger than one-screw fixation for lumbosacral fusion. The strength of fixation seems to have a negative correlation with aging.
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The efficacy of a specially designed mineralized bovine collagen matrix as a carrier for bone marrow stem cells was studied in a rabbit posterolateral spinal fusion model. ⋯ These results show that Healos is an osteoconductive matrix that can be a useful carrier in the biologic and mechanical environment of a posterolateral intertransverse fusion site. In combination with bone marrow, it produces fusion rates that are comparable with those of autologous bone graft. However, it must be combined with an osteoinductive or osteogenic agent to ensure reliable fusion rates and alone cannot produce reliable osteogenesis. The Healos matrix was not compared with other commercially available matrices currently in use. Therefore, the efficacy of Healos relative to these other materials could not be determined.