Spine
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Immunohistochemical study of elastic fibers in human intervertebral discs (IVD) collected at surgery from patients with scoliosis. ⋯ Our results reveal an abundant and organized network of elastic fibers in the adolescent (12 and 17-year-olds) human IVD, and suggest that elastic fiber network plays a significant biomechanical role. This network is sparse and disrupted in scoliotic discs, and could be involved in the progression of the spinal deformity.
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Prospective cohort study. ⋯ Principles of wide surgical resection, commonly applied in appendicular oncology, can and should be used for the treatment of primary bone tumors of the spine with anticipated acceptable morbidity and satisfactory survival.
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Study of interrater reliability. ⋯ This study shows that multiple raters, with training and guidelines, can reliably score pain drawings, and high consistency in the subsequent classification of cases of widespread pain can be obtained from such data.
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Sequential study of magnetic resonance imaging (MRI) of the spine for assessing the level of termination of the conus medullaris (CMT) and thecal sac (TST). ⋯ The CMT and TST displayed a wide range of values in our study. We detected small but systematic influences of gender and age on CMT and of age on TST, as well as a positive correlation between CMT and TST. These effects are small in amplitude, but they met all the criteria for statistical significance and have practical value for clinicians, as well as theoretical value for the medical and biologic community.
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Case Reports
Cord monitoring changes and segmental vessel ligation in the "at risk" cord during anterior spinal deformity surgery.
Retrospective analysis of all cases of anterior spinal deformity surgery that had intraoperative spinal cord monitoring (somatosensory-evoked potentials, SSEPs). ⋯ Patients with identified cords at risk should undergo spinal cord monitoring (SSEP) if they undergo anterior spinal deformity surgery. Soft clamping of segmental vessels is indicated with cord monitoring to prevent the risk of postoperative neurological sequelae.