Spine
-
Tethered cord syndrome (TCS) occurs as a constellation of neurologic signs and symptoms resulting from longitudinal traction on the spinal cord between fixed points. This condition involves a tug-of-war between ascent and inhibition of ascent of intrathecal nervous tissue within the vertebral canal during growth. ⋯ Patients report low back, lower extremity, and perineal pain; lower extremity sensory and motor deficits; urinary and bowel incontinence; and sexual dysfunction. When not treated early or adequately, TCS can lead to neurologic devastation.
-
Spine research has advanced substantially over the past 25 years through a highly multidisciplinary process. Through early work on fracture healing, osteosynthesis, tissue engineering, and joint biomechanics, researchers discerned 2 main areas of study: musculoskeletal biomechanics and musculoskeletal regeneration. Investigations of the spine continually move from the research bench-through endeavors that incorporate basic science, biology, biomaterials, mechanical testing, finite element analysis, and mathematical modeling-to the bedside-through treatments, devices, and procedures designed to improve patient health while safeguarding quality of life.
-
Spinal cord injury (SCI) can be complete or incomplete. The level of injury in SCI is defined as the most caudal segment with motor function rated at greater than or equal to 3/5, with pain and temperature preserved. The standard neurological classification of SCI provided by the American Spinal Injury Association (ASIA) assigns grades from ASIA A (complete SCI) through ASIA E (normal sensory/motor), with B, C, and D representing varying degrees of injury between these extremes. The most common causes of SCI include trauma (motor vehicle accidents, sports, violence, falls), degenerative spinal disease, vascular injury (anterior spinal artery syndrome, epidural hematoma), tumor, infection (epidural abscess), and demyelinating processes (). (SDC Figure 1, http://links.lww.com/BRS/B91)(Figure is included in full-text article.).
-
Taking a product from concept to commercialization requires careful navigation of the regulatory pathway through a series of steps: (A) moving the idea through proof of concept and beyond; (B) evaluating new technologies that may provide added value to the idea; (C) designing appropriate test strategies and protocols; and (D) evaluating and mitigating risks. Moving an idea from the napkin stage of development to the final product requires a team effort. When finished, the product rarely resembles the original design, but careful steps throughout the product life cycle ensure that the product meets the vision.
-
In treating patients with idiopathic scoliosis and Lenke 1C curves, surgeons must choose between selective fusion of the thoracic spine (STF) and nonselective fusion of the thoracic and lumbar spines. Research shows mixed results. Demura et al reported that 40% of patients who had undergone selective fusion of the thoracic curve were decompensated 2 cm after 2 years, and 89% of those treated with nonselective fusion were balanced in the thoracic and lumbar planes, regardless of preoperative balance.