Spine
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The kinematic study of human lumbar spinal movements. ⋯ Our results support that facet joint degeneration is followed by disc degeneration according to age. Increased translational movements of the lumbar segments occurred in severe disc degeneration accompanied by facet joint degeneration or the presence of LFH even if the movements were stabilized in the advanced status. Therefore, the current status of the intervertebral discs, facet joints, and ligamentum flavum should be taken into consideration when evaluating stability within the lumbar spine.
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Retrospective clinical review and prospective report of postoperative delirium after cervical spine surgeries. ⋯ Early commencement of mobilization after cervical spine surgery would be crucial to the prevention of postoperative delirium in the elderly.
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Prospective clinical study. ⋯ The prevalence of depression was notable among 1-year postoperative spinal stenosis patients. Depressive symptoms in the preoperative and early recovery phase were strong predictors of a poorer self-reported surgery outcome on 1-year follow-up. The results call for intervention strategies to detect and treat depression during both the preoperative and postoperative phase.
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Primary clinical trial of limited fixation for unstable Atlas fracture. ⋯ Osteosynthesis of the atlas by C1 lateral mass screws C2 pedicle screws and crosslink compression fixation is an ideal option for C1 burst fracture with or without rupture of the transverse ligament. The procedure allows for partially physiologic reconstruction of the C0-C1-C2 joint and shortens external fixation.
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Prospective clinical study of total lumbar disc replacement (TDR) with ProDisc II (Synthes, Paoli, PA). ⋯ Baseline ODI and early postoperative outcome parameters (< or =6 months) revealed significant and strong associations with the final results following TDR. While the vast majority of patients with an early highly satisfactory outcome maintained satisfactory results at later FU stages, any significant improvement considered as "highly satisfied" is unlikely in a group of patients which reported early unsatisfactory results. In summary, any clinically relevant changes are unlikely to occur after the early postoperative period.The current findings offer a foundation for weighing both the patients and the spine surgeons expectations against possible realistic achievements. Although the data show that the midterm outcome at a FU of 4 years (mean: 45.5 months, range: 24.1-94.4 months) is predictable following TDR, the long-term results of lumbar disc replacements still need to be established.