Spine
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Clinical Trial Controlled Clinical Trial
Increased limb lengths in patients with shortened spines due to tuberculosis in early childhood.
The spine and limb lengths of 26 patients who had a severe spinal deformity due to tuberculosis in childhood were measured and compared with similar data from 79 normal adult volunteers. ⋯ Patients whose spinal growth was stunted due to disease in childhood have longer legs and upper limbs than healthy people. A compensatory stimulatory growth mechanism may be responsible for this. This has implications for the whole gamut of childhood spinal disorders that result in stunted spinal growth.
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Experimental axial pullout tests of a new type of pedicle screw were done on cadaveric lumbar vertebrae. The manner in which specimens were secured in the testing apparatus was varied to determined influence of specimen fixation method on the maximum pedicle screw pullout force. ⋯ Polymer resin intrusion can have a significant effect on the biomechanical characteristics of the bone-pedicle screw interface. When polymer resins are used to secure vertebral specimens for in vitro biomechanical tests of the bone-pedicle screw interface, it is important to either prevent intrusion (e.g., with a latex wrapping) or document post-test (e.g., through the methods described in this article) that intrusion did not occur for the specimens included in the analysis.
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This is a brief review of the life and contributions to neurologic science of Sir William Gowers. He was a neurologist in England in the late 19th century who, before the availability of modern diagnostic aids, established the importance of clinical examination, including history and physical signs, in the diagnosis of neurologic disorders. ⋯ He arranged for his colleague, Sir Victor Horsley, to remove it and the operation was completely successful. He invented the patella hammer and his book "Manual of Diseases of the Nervous System" (in two volumes) was the standard reference until early in the 20th century.
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This case report illustrates two patients with paraplegia of late onset resulting from cord compression in the hyperlordotic thoracic or thoracolumbar spine proximal to a healed tuberculous kyphosis. ⋯ Compensatory hyperlordosis of the thoracic or thoracolumbar spine commonly occurs in patients with severe tuberculous thoracolumbar or lumbosacral kyphosis. Degenerative spinal stenosis and cord compression at such hyperlordotic segment can cause late onset paraplegia. The blood supply of these chronically compressed cords is precarious and the risk of surgery is high.
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Forty-one patients undergoing lumbar laminectomy for radiculopathy resulting from herniated discs assessed their health status using a generic health outcome instrument (Medical Outcomes Study Short Form 36) before surgery and at an average of 2 years after surgery. ⋯ This study shows that the patients' self-reported health outcomes after lumbar laminectomy correlate with the excellent results previously seen using physician-driven outcome measures in an appropriately selected population with radiculopathy. The excellent results shown here did not deteriorate with age (> 40 years compared with < 40 years) or with complications after surgery.