Spine
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A systematic review of the medical literature regarding current intradiscal therapeutic methods. ⋯ Low back pain is an extremely common and potentially debilitating problem. Adding biophysical methods to well-tested biomechanical and newly investigated biomolecular solutions allows for multiple avenues of therapeutic interventions. With future clinical and basic science studies regarding intradiscal therapies forthcoming, we may soon alter our current treatment algorithms for the management of discogenic back pain.
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Review article. ⋯ Cervical disc replacement is an innovative technology that preserves motion at the instrumented level/s and will potentially improve load transfer to the adjacent levels compared with fusion. Clinical reports of success of cervical total disc replacement are encouraging but are also quite preliminary. As the U.S. IDE studies are completed, a clearer role for the place of cervical disc replacement in the spine surgeon's armamentarium should emerge.
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Review article regarding the developing field of cellular therapies for symptomatic disc degeneration. ⋯ Continued research is warranted to further define the optimal cell type, scaffolds, and adjuvants that will allow successful disc repair in human patients.
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Prospective longitudinal study of patients attending a back pain triage clinic with night pain. ⋯ Although it is a significant and disruptive symptom for patients, these results challenge the specificity of the presence of night pain per se as a useful diagnostic indicator for serious spinal pathology in a back pain triage clinic.
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Prospective, single-center, nonblinded clinical and radiographic analysis of consecutive adult deformity patients treated with recombinant human bone morphogenetic protein-2 (rhBMP-2) without iliac or rib bone graft supplementation. ⋯ With the use of rhBMP-2, a high rate of apparent fusion was observed for anterior (96%) and posterior (93%) fusions in adult spinal deformity patients. Use of rhBMP-2 results in a promising early fusion rate without the graft harvest site morbidity.