Spine
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This static, nondestructive, in vitro biomechanical study examines anterior solid rod construct stiffness following the addition of multilevel, threaded cortical bone dowels in a bovine model. A comparison is made with a clinically relevant posterior construct with and without an anterior release. ⋯ Disc space augmentation increased stiffness except in axial rotation, in which values were restored to the intact level. Stiffness was superior to a clinically relevant posterior instrumentation comparison group following anterior release, and was equivalent to a posterior construct without anterior release except in anterior flexion. In addition, the implants enhanced lordosis. Increased rigidity should improve rates of arthrodesis, while maintenance of sagittal alignment may prevent pathologic compensatory curves in adjacent spinal segments. Further research is required to determine the optimal method of achieving structural interspace support.
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An animal model of posterolateral intertransverse process spine fusion healing. ⋯ The results of this study confirm the detrimental effect of a commonly used nonsteroidal anti-inflammatory drug on spinal fusion during the immediate postoperation period in a established rabbit model of posterolateral lumbar spine fusion. The addition of recombinant bone morphogenetic protein-2 to the autograft bone was able to compensate for the inhibitory effect of ketorolac on bone formation. On the basis of these data, caution is urged in the routine use of nonsteroidal anti-inflammatory drugs for postoperation analgesia in patients undergoing spine arthrodesis.
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Three cases of a previously undescribed body fracture of the axis vertebra are presented. ⋯ The presumed mechanism of injury in the described fracture is one of asymmetrical axial compression. The fracture can be managed safely in a halo jacket.
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Data were collected prospectively on 38 patients who underwent anterior cervical discectomy and fusion for neck pain with no symptoms or signs of radiculopathy or myelopathy. ⋯ A significant decrease in pain, a significant increase in function, and a high degree of patient satisfaction were found with anterior cervical discectomy and fusion for neck pain. Improvements were not affected by worker's compensation status or gender.