Spine
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Pavlov's ratio from plain radiographs in patients with neck pain but no radicular symptoms was compared with the areas of the cervical spinal cord and cerebrospinal fluid column on magnetic resonance scans. ⋯ This study shows a poor correlation between Pavlov's ratio and the space available for the cord. Therefore, this ratio cannot be solely relied upon to predict the area changes in that plane of the cervical spinal canal.
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This retrospective study analyzed the effects of cervical alignment on surgical results of expansive laminoplasty (ELAP) for cervical spondylotic myelopathy (CSM). ⋯ The influence of cervical malalignment on neurologic recovery after ELAP for CSM was shown. When patients have local kyphosis exceeding 13 degrees, anterior decompression or posterior correction of kyphosis as well as ELAP should be considered. Expansive laminoplasty for CSM is best indicated for patients with local kyphosis less than 13 degrees.
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Randomized Controlled Trial Comparative Study Clinical Trial
A prospective, randomized, controlled cervical fusion study using recombinant human bone morphogenetic protein-2 with the CORNERSTONE-SR allograft ring and the ATLANTIS anterior cervical plate.
A prospective, randomized, pilot clinical trial compared recombinant human bone morphogenetic protein-2 (rhBMP-2) with iliac crest autograft bone for the treatment of human cervical disc disease. ⋯ This pilot study demonstrates the feasibility of using rhBMP-2 safely and effectively in the cervical spine.
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A case report of a patient with a congenital anomaly of the posterior arch of the atlas and review of the literature are reported. ⋯ This case illustrates a symptomatic congenital deformity of the posterior arch of the atlas due to a mobile, isolated fragment. These anomalies are exceedingly rare. To date, only 17 patients, including ours, have been described in the literature as having myelopathy related to an isolated posterior tubercle. Of these, only two patients had documented movement of this tubercle before our report. Recognizing the anomaly is crucial because treatment is relatively simple, produces resolution of symptoms, and prevents major neurologic deficits from occurring after trauma.
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Clinical Trial Controlled Clinical Trial
Proximal neuromuscular impairment in lumbar disc herniation: a prospective controlled study.
A prospective and controlled study investigated the relation of muscle dysfunction to residual pain and disability in patients with lumbar disc herniation. ⋯ Neuromuscular dysfunction frequently is present in patients with lumbar disc herniation. Sciatica resolves quickly after surgery, whereas disability improves gradually up to 4 months and muscular performance improves throughout the first year. Proximal muscular dysfunction in lumbar disc herniation has a prognostic value concerning residual pain and disability.