Spine
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Case Reports
Complete rotational burst fracture of the third lumbar vertebra managed by posterior surgery. A case report.
Case report of a young man with rotational burst fracture of the third lumbar vertebra, treated by posterior surgery. ⋯ Surgery to manage lumbar burst fracture must include reduction, decompression, restoration and fusion of anterior and posterior elements by using autologous pelvic spongious autografts, and anterior or posterior instrumentation. Posterior surgery including suturing of dural sac tears, fusion of damaged structures, and transpedicular fixation is successful in young patients and patients with good bone quality.
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A sample of convenience of children with moderate idiopathic scoliosis without bracing or surgery was studied. The sample consisted of 19 children, aged 9 to 16 years, with mean Cobb angle of 24 degrees. The spinal configurations and paraspinal muscle activity in several commonly assumed postures were examined. ⋯ The findings indicate that in self-selected postures the gravitational effect of leaning and the muscle activity in paraspinal muscles may serve to reduce the apex angle. Thus, a fully upright, centered posture may not be best for correction of every patient's spinal curve.
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Comparative Study
Pedicle instrumentation in the thoracic spine. A morphometric and cadaveric study for placement of screws.
In part 1 of the study, the morphometry of thoracic pedicles and bony landmarks for pedicle screw placement were evaluated. In part 2, pedicle screws were inserted in fresh cadavers, using a different entry point in the left and right pedicles. ⋯ Pedicles between T4 and T8 may not be wide enough for screw fixation. An entry point for pedicle screws located at the intersection between the superior border of the transverse process and the lateral two thirds of the superior facet seems more likely to be in line with the pedicle axis than do other entry points. In the lower thoracic vertebrae this entry point, in combination with insertion of the screws more medially oriented than the pedicle axis, significantly reduces the risk of violating the anterior vertebral cortex.
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A prospective, longitudinal cohort study assessing quantitative socioeconomic outcomes of tertiary rehabilitation for chronically disabled patients with cervical spinal disorders compared with those with more common chronic lumbar spinal disorders. ⋯ This first large cohort study of outcomes in chronically disabled patients with work-related cervical spinal disorder produced results similar to those found in tertiary functional restoration rehabilitation in chronic lumbar spinal disorders. In spite of poor outcomes reported in the literature for similar cervical and lumbar spinal disorders in patients receiving workers' compensation for disability, successful outcomes can be anticipated after effective rehabilitation, regardless of response to prerehabilitation treatment.
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Comparative Study
A comparative study of chemonucleolysis with recombinant human cathepsin L and chymopapain. A radiologic, histologic, and immunohistochemical assessment.
Investigation of the effects of recombinant human cathepsin L on intervertebral discs and comparison with the effects of chymopapain. ⋯ Cathepsin L seems to be an effective agent for chemonucleolysis. Its enzymatic action on proteoglycan appears to be different from that of chymopapain.