Spine
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In vitro biomechanical investigation of lumbosacropelvic spinal instrumentation. ⋯ There were no biomechanical differences between bilateral and unilateral iliac screw fixation. Intervertebral cage with full discectomy was significantly less stiff than intact. This study provides biomechanical data to correlate with improved clinical outcomes using unilateral iliac screw fixation, and evidence contraindicating full discectomy with intervertebral cage placement.
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The gene expression of interleukin (IL)-20 on human herniated intervertebral disc. OBJECTIVE.: To elucidate the role of novel cytokine IL-20 in the pathogenesis of human intervertebral disc (IVD) herniation. ⋯ IL-20 induces proinflammatory, chemotaxtic, and matrix degradative responses in IVD cells especially in combination with IL-1beta. Our study suggests that IL-20 plays an important role in the pathogenesis of disc herniation.
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Biomechanical load-to-failure findings correlated with anatomic dissection measurements and intact (prefailure) 3-Tesla (3-T) magnetic resonance images (MRI). ⋯ Axial distraction across the cranio-vertebral junction can produce either OAD or AAD. The SCL and ICL dimensions, alar ligament orientations, and apical ligament presence may affect the injury site. Visualization with 3-T MRI allows better understanding of the injury mechanism and location, which is important clinically in selecting single- or multilevel fixation.
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Meta analysis of randomized control trials. ⋯ Although the radiographic results appeared better in the group of BMPs, the exact role of type, dose and carrier of BMPs and the cost-effectiveness of their use need further clinical delineation.
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Randomized Controlled Trial Comparative Study
The cost effectiveness of surgical versus nonoperative treatment for lumbar disc herniation over two years: evidence from the Spine Patient Outcomes Research Trial (SPORT).
Spine Patient Outcomes Research Trial observational and randomized cohort participants with a confirmed diagnosis of intervertebral disc herniation (IDH) who received either usual nonoperative care and/or standard open discectomy were followed from baseline at 6 weeks, 3, 6, 12, and 24 months at 13 spine clinics in 11 US states. ⋯ Surgery for IDH was moderately cost-effective when evaluated over 2 years. The estimated economic value of surgery varied considerably according to the method used for assigning surgical costs.