Spine
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Prospective clinical, x-ray, and magnetic resonance imaging investigation following total lumbar disc replacement (TDR) with ProDisc II (Synthes, Paoli, PA). ⋯ TDR proved to have a beneficial effect with respect to adjacent level disc preservation. The degenerative changes were mild, occurred late after surgery and did not reveal a negative effect on postoperative clinical outcome. There was no significant correlation between index-level ROM and the occurrence of ALD (P > 0.05).TDR was, however, associated with a progression of index-level FJD in a considerable number of patients, particularly at the lumbosacral junction. Lower segmental mobility and less favorable clinical results point to the fact that a particular cohort of patients may predominantly be affected in which TDR shows inferior compatibility with the index-segment's biomechanics.
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Prospective study of normal sagittal global spinal balance in the Caucasian adult population. ⋯ Asymptomatic adults tend to stand with a stable global balance and it is expected that 95% of normal adults have an SSA and ST between 110° to 150° and 85° to 100°, respectively. C7 plumbline in front of the HA is not necessarily associated with a spinal pathology. Results suggest that in adults, anterior displacement of C7 plumbline with respect to sacrum cannot be attributed solely to aging and should raise a suspicion for the risk of developing spinal pathology.
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A cross-sectional population-based magnetic resonance imaging study of Schmorl nodes (SN) in the lumbar spine. ⋯ In a population-based cohort, 16.4% of Southern Chinese subjects had SN at 1 or more lumbar levels. Males, taller and heavier individuals had increased likelihood of SN. Interestingly, SN were highly associated with severity of disc degeneration.
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Case Reports
Intractable sciatica due to intraneural nodular fasciitis detected by positron emission tomography.
Case report. ⋯ This is the first reported case of intraneural nodular fasciitis presenting with severe radiculopathy. Nodular fasciitis should be considered in the differential diagnosis of severe sciatica. PET may be a useful tool for diagnosing sciatica of unknown origin that cannot be identified using conventional imaging tools.
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Systematic literature review. ⋯ Based on this systematic review of the literature only very low to moderate quality studies could be identified to address clinical questions related to TL spine trauma. These findings suggest the need for further study, including emphasis on higher quality studies.