Spine
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The Mississippi spinal cord injury surveillance system is both active and passive, designed to capture all cases of spinal cord injury through mandated reporting by multiple sources. Each case is confirmed by medical record review. ⋯ Mississippi's spinal cord injury incidence rates are substantially higher than rates reported for other states except Alaska. The surveillance system was found to be very complete. Prevention efforts should focus on increasing safety belt usage, increasing alcohol awareness, and reducing violence.
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A review of 141 consecutive patients who underwent instrumented circumferential lumbar fusions. Outcome was assessed by an independent third party after a minimum follow-up of 2 years. ⋯ Circumferential lumbar fusion is a useful procedure for a patient with difficult reconstructive disease. There is a very high fusion rate. Overall, 62% of patients are satisfied with the result, especially those with a diagnosis of pseudarthrosis or spondylolisthesis with stenosis. Patients who are working before surgery and patients who are not injured workers also tended to progress well.
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A comparison of electrical thresholds for biomechanical response in the ankle and for evoked electromyographic signals from specific leg muscles during intraoperative extradural direct stimulation of roots L4, L5, and S1. ⋯ The biomechanical response in the joint to root stimulation can be used to test all root-related muscles crossing that joint at their individual innervation pattern and their residual innervation and to detect electrical excitation of the root at electric thresholds lower than those for detecting CMAP from single standard root-specific muscle. However, this method does not provide sufficient root specificity. It will be valuable in conjunction with multimodality neurophysiologic monitoring of the roots for earlier and more reliable detection of pedicle bone breakthrough or integrity. Further clinical investigations are suggested.
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This in vivo study was performed to examine active lumbar motion without any support. ⋯ The greatest segmental flexibility induced by the moderate lumbar motion, usually seen with the activities of daily living, occurred more in the upper segments of the lumbar spine, especially in flexion. Further, the iliolumbar ligaments regulate lumbosacral motion especially flexion.
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Correlation between a lesion of the spinal cord that elicits increased signal intensity (ISI) on magnetic resonance images (MRIs) and the outcome of conservative treatment for cervical compressive myelopathy was retrospectively investigated. ⋯ Increased signal intensity was not related to a poor outcome of conservative treatment or severity of myelopathy in the patients with mild cervical myelopathy.