Spine
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A radiographic analysis of the cervical spine of 70 patients diagnosed with fibrodysplasia ossificans progressiva (FOP) and 33 diagnosed with Klippel-Feil (KF) syndrome was conducted. ⋯ FOP patients exhibit a characteristic set of congenital spine malformations. While the noggin gene (NOG) is not mutated in patients who have FOP, these findings extend a growing body of evidence implicating overactivity of the BMP signaling pathway in the molecular pathogenesis of FOP.
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Comparative Study
Pedicle screw placement in the thoracic spine: a comparison of image-guided and manual techniques in cadavers.
A cadaveric study comparing image guidance technology to fluoroscopic guidance as a means of pedicle screw placement in the thoracic spine, using a unique starting point for screw placement. ⋯ Our study showed no significant differences in the overall exit rates between the two techniques. Image guidance may increase confidence of surgeons with limited experience in thoracic pedicle screw placement. Successful placement of screws within the pedicle varies with the anatomic diameter of the pedicle itself. Concerns regarding accuracy of screw placement should be greatest in the middle thoracic vertebrae (T4-T7), where pedicle diameters are smallest and proximity of the great vessels is nearest.
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Retrospective cohort study using national sample administrative data. ⋯ Lumbar fusion rates rose even more rapidly in the 90s than in the 80s. The most rapid increases followed the approval of new surgical implants and were much greater than increases in other major orthopedic procedures. The most rapid increases in fusion rates were among adults aged 60 and above. These increases were not associated with reports of clarified indications or improved efficacy, suggesting a need for better data on the efficacy of various fusion techniques for various indications.
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Comparative Study
Biomechanical comparison of lumbosacral fixation using Luque-Galveston and Colorado II sacropelvic fixation: advantage of using locked proximal fixation.
Biomechanical evaluation of sacropelvic fixation strategies as they apply to neuromuscular scoliosis. ⋯ The 2 methods of sacropelvic fixation provided similar construct stiffness, although the Colorado II method had less L5-S1 motion on flexion-extension testing, and the Galveston construct tended (although not statistically) to be stiffer in torsional loading. The addition of a pair of L1 pedicle screws increased the construct stiffness for both constructs by approximately 50%.
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Comparative Study Controlled Clinical Trial
Spinal cord stimulation for axial low back pain: a prospective, controlled trial comparing dual with single percutaneous electrodes.
A prospective, controlled, clinical trial comparing single and dual percutaneous electrodes in the treatment of axial low back pain from failed back surgery syndrome. ⋯ While we observed disadvantages for dual electrodes in treating axial low back pain, we achieved technical success with single or dual electrodes in most patients and maintained this success clinically with dual electrodes in 53%.