Spine
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Literature review. ⋯ Optimal inclusion criteria for future adolescent idiopathic scoliosis brace studies consist of: age is 10 years or older when brace is prescribed, Risser 0-2, primary curve angles 25 degrees -40 degrees , no prior treatment, and, if female, either premenarchal or less than 1 year postmenarchal. Assessment of brace effectiveness should include: (1) the percentage of patients who have < or =5 degrees curve progression and the percentage of patients who have > or =6 degrees progression at maturity, (2) the percentage of patients with curves exceeding 45 degrees at maturity and the percentage who have had surgery recommended/undertaken, and (3) 2-year follow-up beyond maturity to determine the percentage of patients who subsequently undergo surgery. All patients, regardless of subjective reports on compliance, should be included in the results (intent to treat). Every study should provide results stratified by curve type and size grouping.
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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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Review article of current knowledge of animal models used in the investigations of fusionless scoliosis surgery. ⋯ Fusionless scoliosis surgery offers theoretical advantages over brace treatment and surgery. Like bracing, fusionless treatments preserve growth, motion, and function of the spine. Like surgery, these treatments offer substantial correction of deformity. However, minimally invasive fusionless scoliosis surgery is less extensive than fusion surgery and may avoid adjacent segment degeneration and other complications related to fusion. Additional investigations are required to identify optimal implant strategies, to evaluate the effects of these implants of the spine and surrounding structures, and to define the appropriate patient population for these interventions.
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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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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.