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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We evaluated the consequences of cobalt-chromium alloy (CoCr) wear debris challenge in the peri-spine region to determine the inflammation and toxicity associated with submicron particulates of CoCr-alloy and nickel on the peri-spine. ⋯ Subtle peri-spine inflammation associated with CoCr-alloy implant particles was dose dependent and persistent. Neuropathy can be induced by highly reactive Ni particles. This suggests peri-spine challenge with CoCr-alloy implant debris (e.g., TDA) is consistent with past reports using titanium alloy particles, i.e., mild persistent inflammation.
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Anterior cervical decompression and fusion is a well-established procedure for the treatment of cervical spinal canal stenosis. In this study, we evaluated the necessity of spinal instrumentation after four-level anterior cervical decompression and cage fusion. ⋯ Stand-alone intersomatic cage fusion is an acceptable line of treatment for four-level cervical disc disease, both clinically and radiologically. Although the addition of posterior instrumentation yields better radiological results, the difference does not reach the statistical significance level.
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Everyday activities such as walking may elicit spinal shrinkage in an order of magnitude that has been related to lower back pain. The present study aims to compare the effects of unloaded treadmill walking with walking carrying loads representing everyday shopping tasks. ⋯ Results suggest that the body adopts less anterior lean with an immediate load-bearing demand, to decrease the necessary extension moment generated by the spinal extensors for spinal stability. Further postural alteration in the same direction is observed with prolonged loading. In combination with lumbar spinal shrinkage, such postural changes are likely to increase the loading on the facet joints and subsequently unload the discs which may be beneficial for those with low back pain.