Spine
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A technical report. ⋯ When used judiciously to treat axial back pain during intradiscal electrothermal therapy heating, ketamine is a safe and effective rescue medication.
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Review Case Reports Comparative Study
Risk factors for adjacent segment degeneration after PLIF.
A retrospective study of 87 patients who underwent posterior lumbar interbody fusion (PLIF) at L4-L5 for L4 degenerative spondylolisthesis. ⋯ 1) There was no correlation between radiologic degeneration of cranial adjacent segment and clinical results. 2) Risk factors for postoperative radiologic degeneration could not be detected in terms of each preoperative radiologic factor. 3) Coexistence of horizontalization of the lamina at L3 and facet tropism at L3-L4 may be one of the risk factors for neurologic deterioration resulting from accelerated L3-L4 degenerative change after L4-L5 PLIF.
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Comparative Study
Biomechanical comparison of expandable cages for vertebral body replacement in the thoracolumbar spine.
An in vitro biomechanical study of expandable cages for vertebral body replacement in the human thoracolumbar spine. ⋯ Biomechanical results indicate that design variations of expandable cages for vertebral body replacement are of little importance. Additionally, no significant difference could be determined between the biomechanical properties of expandable and nonexpandable cages. After corporectomy, isolated implantation of expandable cages plus anterior plating was not able to restore normal stability of the motion segment. Therefore, isolated anterior stabilization using cages plus Locking Compression Plate should not be used for vertebral body replacement in the thoracolumbar spine.
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Comparative Study
Patients with chronic neck pain demonstrate altered patterns of muscle activation during performance of a functional upper limb task.
Cross-sectional study. ⋯ Patients with neck pain demonstrated greater activation of accessory neck muscles during a repetitive upper limb task compared to asymptomatic controls. Greater activation of the cervical muscles in patients with neck pain may represent an altered pattern of motor control to compensate for reduced activation of painful muscles. Greater perceived disability among patients with neck pain accounted for the greater electromyographic amplitude of the superficial cervical muscles during performance of the functional task.
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A retrospective review with clinical and radiologic assessment was conducted. ⋯ Twenty-three patients with tuberculosis of the lower lumbar spine underwent posterior instrumentation with laminar hooks and anterior interbody arthrodesis by a single surgeon. The clinical outcomes were evaluated with preoperative and postoperative questionnaires, and the radiographs were independently analyzed with respect to fusion status and sagittal angle. RESULTS.: The mean follow-up period was 28.7 months (range, 24-39 months). The average preoperative, immediate postoperative, and final follow-up sagittal angles were 2.7 degrees, -14.1 degrees, and -11.5 degrees, respectively. There was a mean reduction of 16.7 degrees (range, 9 degrees-23 degrees) after surgery. Two patients had a correction loss more than 5 degrees during the follow-up period. Bony fusion was obtained in all patients. There was no recurrence of the disease. CONCLUSION.: This technique appears to be effective in stabilizing the vertebrae, restoring lordosis, achieving a solid fusion, and improving clinical outcome without sacrificing additional motion segments.