Spine
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Mechanical testing of cadaveric motion segments. ⋯ IDET has a significant but inconsistent effect on compressive stresses within intervertebral discs. These results may partly explain the variable clinical success of IDET.
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Case Reports
Utilization of iliac screws and structural interbody grafting for revision spondylolisthesis surgery.
Retrospective case analysis and presentation. ⋯ For many of these cases of both high-grade dysplastic spondylolisthesis and low-grade adult isthmic spondylolisthesis, a reasonable combination of anterior column support and/or iliac screw fixation may be logical to reduce the incidence of failure and need for revision. The biggest concern with using iliac screw fixation is that these screws are prominent in a percentage of patients and the ultimate impact on the sacroiliac joint is not fully investigated. However, at our institution with 5- to 10-year follow-up, the impact on the sacroiliac joint has been minimal.
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An anatomic study of the extraforaminal attachments of the lumbar spinal nerves was performed using human lumbar spinal columns. ⋯ Ligamentous connections exist between lumbar extraforaminal spinal nerves and nearby structures.
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An anatomic and radiographic study of archeological skeletal remains from two genetically and geographically distinct groups with high occurrence rates of spondylolytic spondylolisthesis was done. Specimens were Aleut (27% known occurrence rate, n = 48) and Arikara Plains Indians (9% occurrence, n = 250+ of 1,062). ⋯ The STA in the normal population for each genetic group varies and relates significantly to the occurrence rate and is thus probably etiologic. STA is more highly associated with the occurrence of pars defect than is PI. Upper sacral deformities appear due to the growth plate response to the changed pressure gradients across the epiphyseal plate rather than interosseous remodeling of the ilium and acetabular area. Thus, changes in PI would be secondary.
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Review Comparative Study
The updated cochrane review of bed rest for low back pain and sciatica.
A systematic review within the Cochrane Collaboration Back Review Group. ⋯ For people with acute low back pain, advice to rest in bed is less effective than advice to stay active. For patients with sciatica, there is little or no difference between advice to rest in bed and advice to stay active.