European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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This study evaluates the short-term clinical outcome, radiological, histological and device retrieval findings of two patients with second generation lumbar total disc replacement (TDR). ⋯ Although wear was unrelated to the reason for revision, this study demonstrates the presence of UHMWPE particles and inflammatory cells in second generation TDR. Long-term follow-up after TDR is indicated for monitoring wear and implant status.
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Spinal epidural lipomatosis (SEL) is a rare but well-recognized condition. In general, the onset of its symptoms is insidious and the disease progresses slowly. ⋯ These SEL patients developed neurologic symptoms after less than 5 months; these symptoms were confirmed to be due to SEL by serial MR images. After the debulking of the epidural fat, their symptoms improved.
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Comparative Study
An in vitro biomechanical comparison of Cadisc™-L with natural lumbar discs in axial compression and sagittal flexion.
The elastomeric, monobloc disc prosthesis (Cadisc™-L, Ranier Technology, Cambridge, UK) aims to preserve biomechanics of an implanted spinal motion segment. ⋯ Implantation of Cadisc™-L caused a reduction in axial stiffness, but maintained disc height and flexion stiffness. IAR loci remained mobile without large displacement of the centroid from the intact spine position.
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In order to minimize perioperative invasiveness and improve the patients' functional capacity of daily living, we have performed minimally invasive lumbar decompression and posterolateral fusion (MIS-PLF) with percutaneous pedicle screw fixation for degenerative spondylolisthesis with spinal stenosis. Although several minimally invasive fusion procedures have been reported, no study has yet demonstrated the efficacy of MIS-PLF in degenerative spondylolisthesis of the lumbar spine. This study prospectively compared the mid-term clinical outcome of MIS-PLF with those of conventional PLF (open-PLF) focusing on perioperative invasiveness and patients' functional capacity of daily living. ⋯ The MIS-PLF utilizing a percutaneous pedicle screw system is less invasive compared to conventional open-PLF. The reduction in postoperative pain led to an increase in activity of daily living (ADL), demonstrating rapid improvement of several functional parameters. This superiority in the MIS-PLF group was maintained until 2 years postoperatively, suggesting that less invasive PLF offers better mid-term results in terms of reducing low back pain and improving patients' functional capacity of daily living. The MIS-PLF utilizing percutaneous pedicle screw fixation serves as an alternative technique, eliminating the need for conventional open approach.
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Case report. ⋯ In patients with lower back and leg pain, physicians should consider non-spinal conditions that can cause signs and symptoms mimicking lumbar radiculopathy.