Spine
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A retrospective, long-term follow-up study. ⋯ Our study revealed that incidental durotomy in lumbar disc surgery was associated with long-term clinical sequelae. We therefore conclude that dural tears bring about poor clinical outcome at the long-term follow-up.
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A new proposed classification system for thoracolumbar (TL) spine injuries, including injury severity assessment, designed to assist in clinical management. ⋯ Although there will always be limitations to any cataloging system, the TLICS reflects accepted features cited in the literature important in predicting spinal stability, future deformity, and progressive neurologic compromise. This classification system is intended to be easy to apply and to facilitate clinical decision-making as a practical alternative to cumbersome classification systems already in use. The TLICS may improve communication between spine trauma physicians and the education of residents and fellows. Further studies are underway to determine the reliability and validity of this tool.
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Spine loads associated with lifting a 9-kg weight were estimated at three torso flexion angles (0 degrees, 22.5 degrees, and 45 degrees), and lumbosacral motion segments were cyclically loaded using these loads until failure or to a maximum of 10,020 cycles. ⋯ Fatigue failure of spinal tissues can occur rapidly when the torso is fully flexed during occupational lifting tasks; however, many thousands of cycles can be tolerated in a neutral posture. Future lifting recommendations should be sensitive to rapid development of fatigue failure in torso flexion.
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Details of presentation and approach to the treatment of scoliosis in a case of a Rigid Spine Syndrome (RSS). ⋯ The chromosomal bases of CMD and characteristic features of RSS, including diagnostic tests, have been reviewed. Surgical intervention with spinal deformity fusion, correction, and instrumentation is indicated in RSS with progressive spinal imbalance not responding to conservative therapy is safe and can give promising results.
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An updated Cochrane review. ⋯ No conclusions are possible about the relative effectiveness of anterior, posterior, or circumferential fusion. The preliminary results of three small trials of intradiscal electrotherapy suggest it is ineffective, except possibly in highly selected patients. Preliminary data from three trials of disc arthroplasty do not permit firm conclusions.