Spine
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This retrospective study was conducted to analyze the clinical results in 45 patients with nontraumatic lesions of the cervical spine treated by pedicle screw fixation. ⋯ Pedicle screw fixation is a useful procedure for posterior reconstruction of the cervical spine. This procedure does not require the lamina for stabilization, and should be especially valuable for simultaneous posterior decompression and fusion. The risk to neurovascular structures, however, cannot be completely eliminated.
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This is a case report and review of the literature. ⋯ This is the first report of a patient with hypertrophic spinal pachymeningitis treated with expansive laminoplasty. Spinal canal decompression and autogenous bone grafting are accepted treatments in the young patient. Careful observation of the patient to watch for local progression is necessary.
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Ten fresh, cadaveric, two-vertebrae, functional spinal units were used to study the pathoanatomy, intervertebral foraminal area, and flexibility changes after posterior and transforaminal decompression. ⋯ Transforaminal decompression produced a significantly larger increase in the intervertebral foraminal area than posterior decompression, without increasing the range of motion or neutral zone in any direction. Because there was no violation of the anatomic integrity of the spine in the transforaminal approach, the risk of surgically induced instability was minimized. Endoscopic transforaminal decompression is a feasible alternative to current approaches.
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A cross-sectional study to assess the lumbar spinal and proximal femoral bone mineral density in girls aged 12, 13, or 14 years with adolescent idiopathic scoliosis and to compare them with bone mineral densities of an age-matched control group. ⋯ There is a persistently lower bone mineral density in patients between 12 years and 14 years of age with idiopathic scoliosis. The decreased bone mineral density occurred in patients with idiopathic scoliosis before the age of 12 years, with no further progression from the age 12 to age 14, and did not correlate with the scoliosis degree or pattern. These findings suggest that the osteopenia in idiopathic scoliosis may be related to the primary etiology of the disease rather than secondary to the asymmetrical mechanical forces associated with the back deformities.
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A criteria-based review of the literature. ⋯ The disparity in low back pain rates within categories of countries, high-income and low-income, calls attention to the high proportion of studies on the epidemiology of low back pain that are methodologically questionable. Recommendations are offered to improve the methodologic quality of this type of study. Conclusions may be drawn from comparisons between studies, although, in the absence of set methodologic standards, they are tentative. The considerably lower rates among populations of low-income farmers compared with rates of the affluent populations of selected northern European countries indicate that, contrary to the hypothesis proposed here, hard physical labor itself is not necessarily related to low back pain. The higher rates in urban low-income populations as compared with rates in rural low-income populations and the sharply higher rates among workers in enclosed workshops of low-income countries suggest a disturbing trend: low back pain prevalence may be on the rise among vast numbers of workers as urbanization and rapid industrialization proceed.