Spine
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An in vitro mechanical study on porcine motion segments. ⋯ The data show the limitations of an in vitro model for studying fluid flow-related intervertebral disc mechanics. During loading, outflow of fluid occurred, but inflow appears to be virtually absent during unloading. Poro-elastic behavior cannot be reproduced in an in vitro model.
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Retrospective review case series. ⋯ Scoliosis developed in 8.7% of patients with Down syndrome. There was a high rate of cardiac surgery within this population. Bracing was ineffective for the majority of the patients treated. Although surgery has a high rate of complications, there was only one patient who underwent reoperation.
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The issue of progression of congenital basilar invagination is evaluated on the basis of 3 clinical cases. The rationale of treatment of basilar invagination in general and, particularly, in the complex clinical situation encountered in the presented cases, by the authors' technique of atlantoaxial joint distraction, reduction of basilar invagination, and direct lateral mass plate and screw fixation is discussed. ⋯ The probable cause of basilar invagination and its progression is a congenital malformation ofalignment of the facets of the atlantoaxial joint. Distraction of the facets and direct interarticular atlantoaxial fixation presents a unique opportunity of reduction of the basilar invagination and fixation of the region.
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Review article regarding the developing field of cellular therapies for symptomatic disc degeneration. ⋯ Continued research is warranted to further define the optimal cell type, scaffolds, and adjuvants that will allow successful disc repair in human patients.
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Review article of current knowledge of animal models used in the investigations of fusionless scoliosis surgery. ⋯ Fusionless scoliosis surgery offers theoretical advantages over brace treatment and surgery. Like bracing, fusionless treatments preserve growth, motion, and function of the spine. Like surgery, these treatments offer substantial correction of deformity. However, minimally invasive fusionless scoliosis surgery is less extensive than fusion surgery and may avoid adjacent segment degeneration and other complications related to fusion. Additional investigations are required to identify optimal implant strategies, to evaluate the effects of these implants of the spine and surrounding structures, and to define the appropriate patient population for these interventions.