Spine
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A retrospective clinical and radiographic review. ⋯ The data in the current study support the authors' belief that with current surgical techniques and perioperative management in an experienced center, the results for patients undergoing spinal fusion for neuromuscular scoliosis have been improved, and major complications have been minimized.
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The efficacy of a specially designed mineralized bovine collagen matrix as a carrier for bone marrow stem cells was studied in a rabbit posterolateral spinal fusion model. ⋯ These results show that Healos is an osteoconductive matrix that can be a useful carrier in the biologic and mechanical environment of a posterolateral intertransverse fusion site. In combination with bone marrow, it produces fusion rates that are comparable with those of autologous bone graft. However, it must be combined with an osteoinductive or osteogenic agent to ensure reliable fusion rates and alone cannot produce reliable osteogenesis. The Healos matrix was not compared with other commercially available matrices currently in use. Therefore, the efficacy of Healos relative to these other materials could not be determined.
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Randomized Controlled Trial Clinical Trial
Early active training after lumbar discectomy. A prospective, randomized, and controlled study.
A prospective, randomized, and controlled study was conducted. ⋯ Patients rehabilitated according to the early active training program had a better short-term outcome of objective values. At 2 years' follow-up, more patients were satisfied with the result of the operation. The early active treatment program is recommended.
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Comparative Study
Comparison of the strengths of lumbosacral fixation achieved with techniques using one and two triangulated sacral screws.
The strength of sacral screw fixation achieved with techniques using one sacral screw and two triangulated sacral screws with Chopin block was tested on 10 fresh human sacrum specimens. ⋯ This study showed that fixation with two divergent triangulated screws to the sacrum was significantly stronger than one-screw fixation for lumbosacral fusion. The strength of fixation seems to have a negative correlation with aging.
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Twenty-five patients with a pseudarthrosis after previous spinal fusion surgery were reviewed after a circumferential fusion was performed. ⋯ A fusion rate of 100% was noted in the face of factors often placing patients at high risk for developing a pseudarthrosis, namely multiple levels of previous spinal surgery, including previous pseudarthrosis, and a habit of heavy smoking. Complications were few. However, the satisfactory outcome rate was only somewhat better than 50%, based on a lack of substantial pain improvement and return to work.