Spine
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A case report. ⋯ This case confirms the existence and clinical relevance of the fourth column of the thoracic spine and its role in providing added spinal stability in the patient with ankylosing spondylitis. As such, it is still possible to achieve a favorable clinical outcome in a select subpopulation of patients with ankylosing spondylitis that sustain three-column flexion-distraction injuries who are neurologically intact and are not candidates for surgical stabilization.
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Randomized Controlled Trial
The efficacy of rhBMP-2 for posterolateral lumbar fusion in smokers.
Retrospective review of prospectively collected data, as part of an IRB-approved, FDA-regulated, randomized, nonblinded IDE trial of rhBMP-2 matrix for lumbar spinal fusion. ⋯ The results of this study suggest that rhBMP-2 may enhance fusion rate in cigarette smokers undergoing single-level instrumented posterolateral lumbar fusion. Despite the improvement in fusion rate with rhBMP-2, clinical outcomes measures were still adversely affected in smokers.
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Randomized Controlled Trial
Does shaving the incision site increase the infection rate after spinal surgery?
A prospective randomized clinical study. ⋯ The shaving of the incision site immediately before spinal surgery may increase the rate of postoperative infection.
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Cadaveric motion segment experiment. ⋯ The cervical spine has approximately 20% of the bending strength of the lumbar spine but 45% of its compressive strength. This suggests that the neck is relatively vulnerable in bending.
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Prospective imaging study of patients undergoing surgery for cervical compressive myelopathy. OBJECTIVES.: To investigate whether the classification of increased signal intensity (ISI) on magnetic resonance imaging (MRI) in patients with cervical compressive myelopathy reflects the severity of symptoms and surgical outcome. ⋯ Preoperative ISI on T2-weighted sagittal MRI was correlated with patient age, duration of disease, postoperative JOA score, and postoperative recovery rate. Patients with the greatest ISI had the worst postop erative recovery. Classification of ISI can be a predictor of surgical outcome.