Spine
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To compare the expression of cytokines and core protein of proteoglycan in the scoliotic concave and convex cartilaginous endplate using immunohistochemical staining. ⋯ There was a significantly higher expression of TGFbeta1 and bFGF, although a lower expression of the core protein on the concave side, which suggests a possible etiological factor or a secondary change in the development of adolescent idiopathic scoliosis.
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Clinical Trial
Instrumented transforaminal lumbar interbody fusion with bioresorbable polymer implants and iliac crest autograft.
Twenty-seven patients underwent instrumented transforaminal lumbar interbody fusion (TLIF) procedures using bioresorbable implants as interbody spacers. The greater than 2-year clinical and radiographic results of this series are presented along with as a review of relevant preclinical and preliminary clinical studies of bioresorbables. ⋯ Bioresorbable implants have significant potential for use in spine surgery. This potential is realized in this first published clinical series using bioresorbable implants as interbody spacers with a minimum follow-up of 2 years, significantly exceeding the biologic "life expectancy" (12-18 months) of the implant material. Both the clinical and radiographic results of this study support the use of interbody devices manufactured from bioresorbable polymers for structural interbody support in the TLIF procedure.
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Randomized Controlled Trial Multicenter Study
Efficacy and safety of a novel moldable, resorbable, and degradable sealant of bone surfaces for hemostasis after bone graft harvesting from the iliac crest.
A prospective, controlled, open, randomized multicenter study. ⋯ Bone Seal is an effective and safe hemostatic material for sealing bleeding bone surfaces after iliac crest bone graft harvesting. By virtue of its hemostatic efficacy, Bone Seal is preventive for wound healing disorders.
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A systematic review of the medical literature regarding current intradiscal therapeutic methods. ⋯ Low back pain is an extremely common and potentially debilitating problem. Adding biophysical methods to well-tested biomechanical and newly investigated biomolecular solutions allows for multiple avenues of therapeutic interventions. With future clinical and basic science studies regarding intradiscal therapies forthcoming, we may soon alter our current treatment algorithms for the management of discogenic back pain.
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Review
Cost-effectiveness of single-level anterior cervical discectomy and fusion for cervical spondylosis.
Cost-effectiveness analysis with retrospective cost analysis and literature review. ⋯ ACDF with allograft offers a benefit relative to ACDF with autograft at a cost of 496 dollars per QALY. ACDFP has a benefit relative to ACDF with allograft at an approximate cost of 32,560 dollars per QALY. CEA provides a method for comparing the benefits and risks of these three procedures. Further research needs to be performed regarding these procedures, particularly examining the postoperative recovery period.