Spine
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Cross-sectional magnetic-resonance imaging (MRI) study. OBJECTIVE To investigate the relation of the lumbosacral transitional vertebra to signs of disc degeneration in MRI and to low back pain (LBP). ⋯ Lumbosacral transitional vertebra increases the risk of early degeneration in the upper disc. This effect seems to be obscured by age-related changes in the middle age. The degenerative process is slowed down in the lower disc. For these effects, the presence of a transitional vertebra should be noticed when morphologic methods are used in research on lumbosacral spine. Transitional vertebra is not associated with any type of LBP.
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A retrospective outcomes study. ⋯ Two-level discectomy is an effective treatment with clinical outcome comparable with single-level discectomy. Patients with posterolateral disc herniations and definitive radiculopathy without osseous degenerative changes at the same levels have better clinical outcome and quality of life scores compared with those patients having concomitant degenerative arthritis at the same levels. Patients having two-level discectomy may be at increased risk of requiring subsequent lumbar fusion compared with those with single-level discectomy.
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Case Reports
Bilateral pedicle stress fractures in a female athlete: case report and review of the literature.
Clinical case report of bilateral stress fractures of the pedicle in a female athlete presenting with back pain. ⋯ In this uncommon case of bilateral stress fractures of the pedicle, circumferential fusion assures full immobilization of the injured motion segment and assures a high probability of successful healing.
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Comparative Study
Morphometric comparison of the pedicle rib unit to pedicles in the thoracic spine.
A radiographic study of the pedicle rib unit morphology as compared with measurements of the pedicle in cadaveric thoracic spines. ⋯ This study confirms the marked difference in size of the pedicle rib unit as compared with the pediclein both transverse width and chord length. This allows for a space that accommodates much larger major screw diameters, longer screw lengths, and because of the nature of screw placement, a greater screw convergence. Thus, there is anatomic potential for extrapedicular vertebral body fixation in the thoracic spine. However, care must be taken in placement of screws following precisely our previously described method of extrapedicular screw insertion. Penetration of surrounding structures, most notably the aorta on the left, is a potential risk when deviating from the method. Biomechanical evaluations are presently being conducted to evaluate the use of extrapedicular thoracic screw fixation.
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Comparative Study Clinical Trial Controlled Clinical Trial
Characterization of acute whiplash-associated disorders.
An experimental study of motor and sensory function and psychological distress in subjects with acute whiplash injury. ⋯ Acute whiplash subjects with higher levels of pain and disability were distinguished by sensory hypersensitivity to a variety of stimuli, suggestive of central nervous system sensitization occurring soon after injury. These responses occurred independently of psychological distress. These findings may be important for the differential diagnosis of acute whiplash injury and could be one reason why those with higher initial pain and disability demonstrate a poorer outcome.