Spine
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Comparative Study
Volumetric changes of iliac crest autografts used to reconstruct the anterior column in thoracolumbar fractures: a follow-up using CT scans.
Patients with a thoracolumbar injury had a reconstruction of the anterior column using an tricortical iliac crest autograft. The volume and the length of the autograft were measured after 9 and 21 months using computed tomography. ⋯ The results show that more than a third of the initial graft volume is absorbed during the consolidation process. The loss was greater, the larger the volume of the initial graft was. The efficiency, however, was not dependent on the initial graft size.
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Comparative Study
Stage-specific sagittal spinopelvic alignment changes in osteoarthritis of the hip secondary to developmental hip dysplasia.
A retrospective, age- and sex-matched radiographic study. ⋯ Pelvic inclination tended to increase in pre/early-stage OA patients. In healthy subjects, aging is associated with reduction of lumbar lordotic angle and tendency for posterior inclination of the sacrum. With aging, patients with OA maintained the lumbar lordotic angle and did not develop a posterior sacral slope angle.
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Case report. ⋯ The early fusion prevented the customary severe progression of this condition and early death due to cor pulmonale. He is a fully functioning member of society. Will more modern treatments with lengthening of the hemithorax provide a better outcome? Only time will tell.
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Randomized Controlled Trial
ISSLS prize winner: cost-effectiveness of two forms of circumferential lumbar fusion: a prospective randomized controlled trial.
Economic evaluation alongside a prospective, randomized controlled trial from a secondary care National Health Service (NHS) perspective. ⋯ From an NHS perspective, the trial data show that TC is not cost-effective in circumferential lumbar fusion. The use of FRA was both cheaper and generated greater QALY gains. In addition, FRA patients reported a greater return to work rate.
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Human nucleus pulposus cells were cultured in alginate beads and activated with IL-1 beta or TNF-alpha, with and without inhibition of p38 mitogen activated protein kinase (p38 MAPK) activity. Cell production of factors modulating the anabolic/catabolic balance of the disc was determined. ⋯ Inhibition of p38 MAPK in cytokine-activated disc cells blunts production of factors associated with inflammation, pain, and disc matrix catabolism. The data support further analysis of these effects on the anabolic/catabolic balance of nucleus pulposus cells and suggest that molecular techniques blocking this signal could provide a therapeutic approach to slow the course of intervertebral disc degeneration.