Spine
-
Cross-sectional survey. ⋯ Fifty-three percent of the Web sites reviewed were authorized by a private physician group, 4% by an academic physician group, 13% by industry, 16% were news reports, and 14% were not otherwise categorized. Sixty-five percent of Web sites offered a mechanism for direct contact and 19% provided clear patient eligibility criteria. Benefits were expressed in 80% of Web sites, whereas associated risks were described in 35% or less. European experiences were noted in 17% of Web sites, whereas only 9% of Web sites detailed the current US experience. CONCLUSION.: The results of this study demonstrate that much of the content of the Internet-derived information pertaining to the cervical artificial disc replacement is for marketing purposes and may not represent unbiased information. Until we can confirm the content on a Web site to be accurate, patients should be cautioned when using the Internet as a source for health care information related to cervical disc replacement.
-
A retrospective analysis of patients undergoing spinal deformity correction surgery by the assistance of intraoperative computed tomography (iCT) with or without navigation system. ⋯ The iCT navigation system provides desirable accuracy of posterior spinal instrumentation for patients during surgical correction of spinal deformity without radiation exposure to the medical staff, especially in thoracic spine instrumentation. Meanwhile, the iCT in itself is an effective means of assessing complex instrumentation of the spinal deformity.
-
Finite element (FE) method was used to compare the biomechanics of L3-S1 lumbar spine with graded facetectomy before and after placement of Dynesys. ⋯ Partial facetectomy had a minimal effect on range of motion on the Dynesys-implanted segment. However, in the case of total facetectomy the motion increased by almost 40% in flexion and by 200% in axial rotation. The higher stresses applied to the screws in Dynesys in specific loadings may lead to higher risk of screw failure in Dynesys than in a generic rigid fixation construct.
-
This study explores the use of bilaminar coculture pellets of mesenchymal stem cells (MSCs) and nucleus pulposus cells (NPCs) as a cell-based therapy for intervertebral disc regeneration. The pellets were tested under conditions that mimic the degenerative disc. ⋯ This study shows that BCPs outperform controls in a simulated degenerated disc environment. Adapting inductive mechanisms from development to trigger differentiation and restore diseased tissue has many advantages. As opposed to strategies that require growth factor supplements or genetic manipulations, our method is self-sustaining, targeted, and minimally invasive injection.
-
Multicenter Study
Postoperative segmental motion of the unfused spine distal to the fusion in 100 patients with adolescent idiopathic scoliosis.
A cross-sectional study. ⋯ In a group of postoperative patients with adolescent idiopathic scoliosis, evaluation of the distal unfused intervertebral motion showed that preservation of vertebral motion segments allowed greater distribution of functional motion across more levels. With each distal fusion level, motion was significantly increased at the L2-L3, L3-L4, and L4-L5 segmental levels in lateral bending. The relationship between the increased motion and subsequent disc degeneration with a more distal fusion is unknown, but suspected.