Spine
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This study is a series of thoracic and lumbar spine fracture cases to assess the reliability of thoracolumbar injury classification and severity score (TLICS) in simulated clinical scenarios. ⋯ TLICS is a reliable system for assessing fractures of the thoracic and lumbar spine when used by experts. Similar to previous studies, the posterior ligamentous complex subcomponent score was the least reliable component. Reliability assessment using a generalizability coefficient is a robust method for validating fracture classifications.
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Prospective retrieval analysis of Prodisc-C cervical total disc replacements (CTDRs) from 24 explanting surgeons during a 6-year period. ⋯ Early clinical failures of Prodisc-C CTDRs display surface damage evidence of metal endplate-endplate impingement, most commonly posteriorly. Backside wear was not evident; however, third-body wear was found. Future studies will determine the clinical impact of these predominant modes of wear on long-term metal-on-polyethylene semiconstrained CTDR performance.
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We retrospectively analyzed prognostic factors for survival in patients with prostate cancer operated for metastatic spinal cord compression. ⋯ We present a new prognostic score for predicting survival of patients with prostate cancer after surgery for metastatic spinal cord compression. The score is easy to apply in clinical practice and may be used as additional support when making decision about treatment.
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A prospective minimum 5-year follow-up study of the cervical spine in patients with rheumatoid arthritis (RA) initially without cervical involvement. ⋯ A minimum 5-year follow-up reveals the occurrence of cervical instabilities in 43.6%, "severe" aggravation in 12.9%, and decreased SAC in 4.3% of patients with RA. Characteristics of severe disease activity-established mutilating changes, progressive development into mutilating changes, and potentially concomitant corticosteroid treatment-are indicators for poor prognosis of the cervical spine in RA.
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An in vitro biomechanical study. ⋯ In the setting of total sacrectomy, the double-rod double iliac screw method provided the most rigid fixation, followed by DIS fixation, single-rod single screw, and the MGT. In spinopelvic reconstruction, the use of double iliac screws is recommended compared with single iliac screw fixation techniques when treating unstable conditions caused by total sacrectomy.