Spine
-
Retrospective study. ⋯ The overall prevalence of pseudarthrosis following long adult spinal deformity instrumentation and fusion to S1 was 24%. Thoracolumbar kyphosis, osteoarthritis of the hip joint, thoracoabdominal approach (vs. paramedian approach), positive sagittal balance > or = 5 cm at 8 weeks postoperatively, older age at surgery (older than 55 years), and incomplete sacropelvic fixation significantly increased the risks of pseudarthrosis to an extent that was statistically significant. Scoliosis Research Society 24 outcomes scores at ultimate follow-up were adversely affected when pseudarthrosis developed.
-
Retrospective clinical cohort study. ⋯ Researchers and clinicians should be aware of the potential for non-injury-related factors to delay recovery, and be aware of the interaction between the initial intensity of a patient's pain and other covariates when confirming these results.
-
Comparative Study
Comparison of Scheuermann kyphosis correction by posterior-only thoracic pedicle screw fixation versus combined anterior/posterior fusion.
Retrospective comparison review. ⋯ With less operating time and intraoperative blood loss, posterior-only Scheuermann kyphosis treatment with thoracic pedicle screws achieved and maintained better correction, and had significantly less complications than with circumferential fusion.
-
Comparative Study
Comparative effects of bone morphogenetic proteins and sox9 overexpression on extracellular matrix metabolism of bovine nucleus pulposus cells.
An in vitro biologic study of the effects of adenovirus expressing bone morphogenetic proteins (BMPs) and adenovirus expressing Sox9 on extracellular matrix metabolism by bovine nucleus pulposus cells. ⋯ To our knowledge, for the first time, we have shown the relative effectiveness of 12 different BMPs and Sox9 in stimulating proteoglycan and collagen production by nucleus pulposus cells. Adenoviruses expressing BMP-2 and 7 were the most effective in stimulating proteoglycan accumulation, while adenoviruses expressing BMP-4 and 14 were the most effective in stimulating collagen accumulation. To our knowledge, this study is the first to compare the relative effectiveness of various BMPs and Sox9 on extracellular matrix accumulation by nucleus pulposus cells, and could help to develop more efficacious approaches to the treatment of degenerating intervertebral discs.
-
Multicenter Study Comparative Study
Comparison of the lowest instrumented, stable, and lower end vertebrae in "single overhang" thoracic adolescent idiopathic scoliosis: anterior versus posterior spinal fusion.
A retrospective multicenter study. ⋯ These data confirm that anterior spinal fusion techniques result in a mean shorter fusion of 1.5 vertebral segments/patient when compared to posterior spinal fusion techniques with respect to the position of the lowest instrumented and stable vertebrae for "single overhang" thoracic (Lenke 1A/B) curves. However, because this is a retrospective multicenter study over 10 years, it represents various posterior spinal fusion techniques that do not include all pedicle screw constructs.