The spine journal : official journal of the North American Spine Society
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Lateral spacers (LSs) are the standard of care for a lateral lumbar interbody fusion. However, various types of fixation, such as bilateral pedicle screws (BPSs), unilateral pedicle screws (UPSs), bilateral facet screws (BFSs), and lateral plates (LPs) have been reported to increase the stability of LSs. The biomechanics of a novel lateral interbody implant, which is an interbody spacer with an integrated plate and two bone screws (lateral integrated plate-spacer [IPS-L]), has not been investigated yet. ⋯ The IPS-L evaluated in the present study demonstrated equivalent biomechanical stability compared with standard lateral interbody fusion constructs. The addition of BPSs to the IPS-L showed significant reduction in ROM in FE, and the addition of BFSs showed significant reduction in ROM in FE and AR, compared with the integrated plate-spacer alone construct. The IPS-L with supplemental fixation may be a viable option for lateral interbody fusion. Long-term clinical studies are further required to confirm these results.
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Pain intensity in various chronic pain disorders has been associated with catastrophizing. Considering the pathomechanism and clinical symptoms of lumbar spinal stenosis (LSS), pain catastrophizing could be associated with pain intensity and disability in patients with LSS. ⋯ Pain catastrophizing was a mediator of gender differences for back pain and disability in patients with LSS. In addition, pain catastrophizing was associated with disability in LSS, which was partially mediated by increased back pain intensity.
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Case Reports
Laminar screw fixation of the axis in the pediatric population: a series of eight patients.
Instability of the atlantoaxial spine is a recognized problem in children. Safe passage of pedicle screws at C2 poses challenges because of the proximity to the vertebral artery, size of the pedicles, and variations in the location of the foramen transversarium. ⋯ Children as young as 2 years can undergo safe and rigid fixation of the axis. The technique is especially valuable in patients with dysplastic bone and distorted anatomy where more traditional methods of C2 fixation cannot be safely used. To our knowledge, this is the largest reported series of C2 laminar screw fixation in a pediatric population.