Spine
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The effect of an anti-tumor necrosis factor alpha (anti-TNFalpha) antibody on abnormal discharges caused by application of nucleus pulposus to the nerve root was investigated in an electrophysiologic study. ⋯ These data indicate that application of TNFalpha antibodies to the nerve root partially prevents the nucleus pulposus-induced abnormal nociresponses. Therefore, anti-TNFalpha treatment may have a therapeutic effect on sciatica after lumbar disc herniation.
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Case Reports
Full-thickness thoracic laminar erosion after posterior spinal fusion associated with late-presenting infection.
A case report describes unilateral complete laminar erosion of the caudal thoracic spine and late-presenting infection in a patient 10 years after anteroposterior reconstruction for scoliosis. ⋯ The exact role of late-presenting infection with regard to the laminar erosion and rod migration seen in this case remains to be elucidated. However, the authors believe the primary cause of bony erosion was mechanical in origin. Regardless, most spine surgeons will treat many patients who have had posterior spinal implants and will perform hardware removal on a significant number of these patients during their careers. A full-thickness laminar erosion exposes the spinal cord to traumatic injury during hardware removal and debridement. This case is presented as a cautionary note to help surgeons become cognizant of a potentially devastating complication.
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Biography Historical Article
Malcolm H. Pope: the Fourth ISSLS Wiltse Lifetime Achievement Award sponsored by Stryker recipient.
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A case of recurrent idiopathic transverse myelitis occurring after surgery is reported. ⋯ Acute transverse myelitis is an intramedullary spinal cord disorder that may present to the spine specialist during the postoperative period. This diagnosis requires swift and aggressive diagnostic and treatment intervention. Although sometimes difficult, establishment of causation may help to determine therapy and prognosis.
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Randomized Controlled Trial Clinical Trial
Efficacy and safety of rofecoxib in patients with chronic low back pain: results from two 4-week, randomized, placebo-controlled, parallel-group, double-blind trials.
Two replicate, 4-week, randomized, double-blind, placebo-controlled, trials of rofecoxib 25 and 50 mg versus placebo for chronic low back pain. ⋯ Rofecoxib significantly reduced chronic low back pain in adults and was well tolerated.