Spine
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A cross-sectional study. ⋯ Positive personality characteristics could play a crucial role in patient adjustment, and thus clinicians should take into account the positive path to capacity to better understand the chronic pain experience.
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An in vitro study using ovine intervertebral discs to correlate the effects of increasing advanced glycation end-products (AGEs) with disc hydration evaluated by magnetic resonance imaging (MRI). ⋯ This study demonstrates that levels of AGEs in the IVD may affect the tissue water content. Moreover, these ribosylation-mediated changes in tissue hydration were detectable using T2 relaxation MRI. T2 relaxation MRI may provide a noninvasive tool to measure in vivo changes in disc hydration that are negatively correlated with the accumulation of AGEs.
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In vitro cadaveric study of thoracic spinal cord intramedullary pressure (IMP) in kyphotic deformity. ⋯ Thoracic kyphosis less than +51° resulted in no meaningful increase in IMP, whereas kyphosis measuring +51° to +63° resulted in minor increases in IMP. After the thoracic kyphosis exceeded +63°, IMP increased significantly. ΔIMP with spinal alignment may help explain the wide range of "normal" thoracic neutral upright sagittal alignment in studies of asymptomatic adult individuals and may help further define thoracic kyphotic deformity.
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Retrospective study of a consecutive series of patients treated for proximal junctional kyphosis (PJK) of the upper thoracic and cervicothoracic spine. ⋯ For a selected cohort of patients who develop PJK of the upper thoracic and cervicothoracic spine, osteotomies, cervical traction, and intraoperative manual reduction provide a significant improvement of proximal junctional Cobb angles. To our knowledge, this is the first study to address treatment for symptomatic patients with this condition.
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Case Reports
Posterior column reconstruction with autologous rib graft after en bloc tumor excision.
Retrospective review of consecutive case series. ⋯ The use of autologous rib graft with a proximal step-cut and distal saddle-cut supplemented with posterior instrumentation allowed immediate stabilization of the posterior column defect created by the en bloc tumor resection. This technique of fashioning the graft and taking advantage of its natural curved structure for immediate press-fit was associated with graft incorporation in our cases.