Spine
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Epidemiological analysis using CTs. ⋯ The incidence of lumbar spondylolysis in the Japanese general population was 5.9% (males: 7.9%, females: 3.9%).
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Decision analysis. ⋯ Our model favors anterior/posterior spinal fusion for surgical correction of large thoracic curves in skeletally immature females. The probability of curve progression after spinal fusion is the main variable that dictates the optimal surgical approach and rates in the literature are based on outdated surgical instrumentation. Future observational studies are warranted to acquire more accurate curve progression rates.
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We investigated the mechanism of discogenic low back pain using an in vitro model. ⋯ Extracted medium from the NP and AF promoted axonal growth. Furthermore, NGF from the NP promoted axonal growth and induced SP. These in vitro results may suggest that NGF from the NP promotes the growth of sensory nerve fibers innervating the degenerated intervertebral disc and may induce SP related with pain transmission.
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Randomized Controlled Trial Multicenter Study Comparative Study
Degenerative spondylolisthesis: does fusion method influence outcome? Four-year results of the spine patient outcomes research trial.
Clinical trial subgroup analysis. ⋯ In patients with DS and associated spinal stenosis, no consistent differences in clinical outcomes were seen among fusion groups over 4 years.
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Comparative Study
2009 ISSLS Prize Winner: Does discography cause accelerated progression of degeneration changes in the lumbar disc: a ten-year matched cohort study.
Prospective, match-cohort study of disc degeneration progression over 10 years with and without baseline discography. Objectives. To compare progression of common degenerative findings between lumbar discs injected 10 years earlier with those same disc levels in matched subjects not exposed to discography. Summary of Background Data. Experimental disc puncture in animal and in vivo studies have demonstrated accelerated disc degeneration. Whether intradiscal diagnostic or treatment procedures used in clinical practice causes any damage to the punctured discs over time is currently unknown. ⋯ Modern discography techniques using small gauge needle and limited pressurization resulted in accelerated disc degeneration, disc herniation, loss of disc height and signal and the development of reactive endplate changes compared to match-controls. Careful consideration of risk and benefit should be used in recommending procedures involving disc injection.