Spine
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We postulate that osteoplasty of osteolytic metastases of the pelvic region performed by computed tomography (CT)-guided insertion of Kirschner wires into the lesions is effective and more feasible. ⋯ This technique is safe and effective and requires fewer CT scans, thus reducing the patient's radiation exposure. The shorter procedure correlates to a better patient tolerance.
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Fifteen asymptomatic volunteers were externally rotated and CT scanned to determine lumbar segmental motion. ⋯ Complex coupled motions were measured due to external torsion and could be indicative of instability chronic patients with low back pain. The presented data provide baseline segmental motions for future comparisons to symptomatic subjects.
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Clinical Trial
A gold standard evaluation of the "discogenic pain" diagnosis as determined by provocative discography.
This is a prospective study of the validity of a positive test result in provocative lumbar discography for the diagnosis of "discogenic pain." ⋯ Positive discography was not highly predictive in identifying bona fide isolated intradiscal lesions primarily causing chronic serious LBP illness in this first study comparing discography results to a gold standard.
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Prospective analysis of a consecutive series in which multimodality intraoperative neurophysiologic monitoring was used as an adjunct to microneurosurgery for adult tethered cord syndrome. The results of multimodality intraoperative neurophysiologic monitoring were compared with the "gold standard" (neurologic outcomes). ⋯ To our knowledge, this is the largest series to date reporting the use of multimodality intraoperative neurophysiologic monitoring in the surgical management of adult tethered cord syndrome. Posterior tibial nerve SSEPs have high specificity, but low sensitivity, for predicting new neurologic deficits. In contrast, continuous EMG showed high sensitivity and low specificity. Evoked EMG accurately identified functional neural tissue. The combined recording of SSEPs in concert with continuous and evoked EMGs may provide a useful adjunct to complex microsurgery for adult tethered cord syndrome.
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Immunocytochemistry for acid-sensing ion channel 3 (ASIC3) in neurons of rat dorsal root ganglions (DRGs) from animals exposed to a model of lumbar disc herniation. ⋯ Our results suggest that ASIC3 in DRG neurons may play an important role in nerve root pain caused by lumbar disc herniation. Lidocaine decreased ASIC3 expression in DRG neurons and pain associated with the disc herniation model.