Spine
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Spinal cord injury (SCI) has occurred in 2.5 million people worldwide, and 130,000 new cases are reported each year. SCI most commonly consists of a compression injury with hemorrhage into gray matter and loss of neurons, oligodendroglia, and astrocytes, followed by invasion of lymphocytes and macrophages; cavitation of the cord follows, then Wallerian degeneration of ascending and descending tracts and loss of neuronal circuitry, culminating in glial scar perpendicular to the direction of the axon. Onset of necrosis occurs within 24 hours. Spontaneous repair is incomplete and involves limited sprouting of axons and new spinal circuits that bypass the lesion and move into descending tracts, resulting in indirect connections with lumbar motor neurons.
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Computational modeling with finite element analysis (FEA) is an integral component of medical device design and development. Researchers assess dimensions and stability of the experimental device; test load sharing, stresses, and strains; and analyze failures and modifications. ⋯ Prerequisites of quality FEA include a solid understanding of morphology and material properties of the model, a firm grasp of the effects of loads on body structures, and the work of a skilled bioengineer who can translate the ideas of surgeons into an appropriate FEM. With today's modern techniques-computed tomography/magnetic resonance imaging, etc.-the bioengineer moves from scan to FEM in just weeks.
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Randomized Controlled Trial
Can Decision Support Help Patients With Spinal Stenosis Make a Treatment Choice?: A Prospective Study Assessing the Impact of a Patient Decision Aid and Health Coaching.
A prospective, randomized study on patients with lumbar spinal stenosis who received a decision support intervention to facilitate their treatment choice. ⋯ 3.