Spine
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Comparative Study
Region-dependent aggrecan degradation patterns in the rat intervertebral disc are affected by mechanical loading in vivo.
Immunoblotting study to evaluate aggrecan degradation patterns in rat intervertebral discs (IVDs) subjected to mechanical overload. ⋯ Aggrecan G1 regions resulting from proteolysis were found to have a strong regionally specific pattern in the rat IVD, which was altered under excessive loading. The shift from aggrecanase to MMP-induced degradation products with dynamic compression overloading suggests that protein degradation and loss can precede major structural disruption in the IVD, and that MMP-induced aggrecan degradation may be a marker of mechanically induced disc degeneration.
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Case Reports
Inadvertent injection of a cervical radicular artery using an atraumatic pencil-point needle.
Case report and review of the literature. ⋯ This case demonstrates that the use of pencil-point (Whitacre) needles does not eliminate the risk of inadvertent arterial injection during cervical transforaminal epidurals. Further investigation is required to determine whether the incidence of inadvertent vascular injection is reduced with pencil-point needles compared with sharp-beveled needles.
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Review Comparative Study
A Cochrane review of combined chiropractic interventions for low-back pain.
Cochrane systematic review of randomized controlled trials. ⋯ Combined chiropractic interventions slightly improved pain and disability in the short term and pain in the medium term for acute/subacute LBP. However, there is currently no evidence that supports or refutes that these interventions provide a clinically meaningful difference for pain or disability in people with LBP when compared to other interventions.
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Randomized Controlled Trial
Prevalence of neck and low back pain in community-dwelling adults in Spain: a population-based national study.
Cross-sectional epidemiological study. ⋯ This Spanish population-based survey showed that neck and low back pain are prevalent and highly associated between them, more frequent in female (particularly neck pain) and associated to worse self-reported health status. Individuals with neck and low back pain were more likely than those without pain to have depression and other painful conditions, including headache and osteoporosis.
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Randomized Controlled Trial Comparative Study
Repeat use of human recombinant bone morphogenetic protein-2 for second level lumbar arthrodesis.
Prospective randomized controlled animal model. ⋯ rhBMP-2 appears to be successful in promoting intertransverse fusions when used in both primary and repeat fusion environments. The infrequent development of antibodies to rhBMP-2 after re-exposure occurs without a predictable time course suggesting that host immunologic variation may play a role. This animal study would tend to support early clinical data emerging on the reuse of BMP-2 for lumbar fusion, suggesting an acceptable fusion rate without a high incidence of complications.