Spine
-
We present an in vitro biomechanical comparison of adjacent segment motion at the cranial segment (L3-L4) for an L4-L5 versus an L4-S1 fusion model using cadaveric lumbosacral spines. ⋯ In this load-controlled model, extending fusion across L5-S1 did not consistently increase motion at L3-L4. While it may be difficult to translate this finding to a clinical setting, avoiding fusion to the sacrum in a lower lumbar fusion may not provide significant benefit from the standpoint of avoiding adjacent segment disease.
-
The influence of the pathologic state of the hip joint on the total sagittal alignment of the spine was investigated in patients with congenital hip dislocation retrospectively ⋯ The total sagittal alignment of the spine in patients with bilateral hip dislocation was compensated for by anterior angulation of the pelvis and by lumbar hyperlordosis. The main clinical symptoms were lower back pain, and not lower leg pain.
-
Comparative Study
Fas-ligand expression on nucleus pulposus begins in developing embryo.
The expression of Fas ligand in the notochord or nucleus pulposus was examined immunohistochemically using rat embryos. ⋯ The present results demonstrated that Fas ligand expression is not detected in the notochord, but at the time of intervertebral disc formation, Fas ligand expression develops in the nucleus pulposus. These results indicate that the immune privilege of the intervertebral disc may begin in the very early stages of disc formation. Moreover, Fas ligand may play an important role in the formation of the intervertebral disc.
-
: A new model of experimental spinal cord injury is detailed based on the application of tensile (distraction) force to the vertebral column of the rat. ⋯ : Distraction-induced spinal cord injury was uniformly mild in rats with intact facet capsular ligaments, regardless of distraction parameters. Cutting the facet joint ligaments consistently generated outcome measures associated with mild, moderate, and severe spinal cord injury at 3-, 5-, and 7-mm distraction lengths, respectively.
-
Retrospective chart review. ⋯ Repeated radiofrequency neurotomies are an effective long-term palliative management of lumbar facet pain. Each radiofrequency neurotomy had a mean duration of relief of 10.5 months and was successful more than 85% of the time.