Spine
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The relationship between epidural pressure and lumbar posture was assessed in patients with lumbar spinal stenosis. ⋯ Epidural pressure was significantly related to posture. These pressure changes correlated with the development of cauda equina symptoms. The increase of epidural pressure by posture may induce compression of the cauda equina. These pressure changes may explain the postural dependency in eliciting symptoms.
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One-hundred-eight patients from a consecutive series of 125 anterior lumbar interbody fusions were invited to participate in a radiographic and magnetic resonance imaging assessment more than 10 years after the original surgery. ⋯ The findings of this study suggest that degeneration after an anterior lumbar interbody fusion is determined more by individual characteristics than by the fusion itself.
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Comparative Study
Development of degenerative spondylosis of the lumbar spine after partial discectomy. Comparison of laminotomy, discectomy, and posterolateral discectomy.
The development of degenerative spondylosis after successful operative decompression of the affected nerve root was prospectively evaluated in a comparative case series of 100 patients with a herniated lumbar nucleus pulposus. ⋯ The increased incidence of spondyloarthrosis with the posterior approach suggests that minimally invasive posterolateral extradural procedures should be considered for the decompression of a compromised lumbar nerve root.
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Prospective histologic comparison of perineural tissues from patients requiring decompression surgery for herniated intervertebral disc with those from cadaveric controls. ⋯ The vascular abnormalities detected in patients may represent an important etiopathologic factor predisposing to intraneural and perineural fibrosis, and hence to chronic pain symptoms, after disc herniation. It seems important to preserve the perineural microcirculation following disc herniation.