Spine - Current Table Of Contents

This study investigated differences in pain behavior and dorsal root ganglion apoptosis following L5 nerve root crush injury, with or without sympathectomy. Mechanical allodynia and dorsal root ganglion neuronal apoptosis were significantly reduced in injured animals undergoing sympathectomy.

The loads on a vertebral body replacement were measured in 2 patients using telemeterized implants. Implant loads were low in lying positions. Standing caused a resultant force of about 300 N. Flexion of the upper body as well as going upstairs led to a considerable increase of the implant loads.

Human T-cell lymphotropic virus type 1 (HTLV-1) associated myelopathy can occur in the cervical spine and be investigated through vestibular-evoked myogenic potential (VEMP). Forty-two HTLV-1 seropositive and 30 seronegative individuals were tested. VEMP distinguished degrees of functional damage. Minor was related to latency prolongation and major to no VEMP response.

A prospective trial was performed to determine the reliability of plain radiographs, computed tomography (CT), and magnetic resonance imaging to detect a pseudarthrosis after an anterior cervical fusion. Our results indicate that CT most closely agrees with intraoperative findings. We therefore recommend that CT be used in any fusion status assessment.

Computed tomography scans of 37 consecutive patients, who underwent decompression and instrumented posterolateral lumbar/lumbosacral fusion, were evaluated prospectively. The incidence of sacroiliac joint degeneration in the fusion group 5 years after surgery was 75%, and was significantly higher than in the age-matched control group, 38.2%.

Despite circumferential spinal cord decompression through posterior approach for thoracic ossification of posterior longitudinal ligament providing effective neurologic recovery in some patients, there was a high rate of complications such as postoperative neurologic deterioration, especially in patients who underwent multiple level circumferential decompression of 5 or more vertebral levels.

Three-dimensional and volumetric thoracic growth was compared in 130 children with scoliosis and 126 children without spinal deformity using an optical system. A significant difference was not found for scoliosis ≤45 with a rib hump ≤25 mm. Thoracic volume triples from 4 to 16 years and doubles during puberty. Relationships between thoracic measurements and sitting height were established.

A retrospective review was performed comparing radiographic/clinical outcomes of adults and adolescents undergoing anterior correction of thoracolumbar idiopathic scoliosis. Flexibility, curve correction, and SRS-22 outcomes were evaluated. This technique is appropriate for adolescents and adults with flexible, moderate thoracolumbar/lumbar curves.

Increasing American Society of Anesthesiologists class was the only independent factor that had a significant correlation with increasing mortality; operative time, blood loss, surgical approach, patient age, number of fusion levels, and sex could not independently predict postoperative 30-day mortality after adult spinal deformity surgery.

Sixteen patients with severe (>70°) angular kyphosis with progressive myelopathy underwent anterior decompression and fusion, followed by posterior fusion with pedicle screws without attempted correction of the deformity were evaluated. This procedure revealed the satisfactory neurologic recovery without any neurologic complication, even sustained kyphosis.

The combination of the IL1 T-C haplotype and the 5A minor allele of the MMP3 acted synergistically to increase the odds of Modic type II changes observed by magnetic resonance imaging in an occupational cohort of middle-aged male workers.

A study evaluating pulmonary function and quality of life of children treated with early spinal fusion for progressive congenital scoliosis. Compared with healthy peers and early nonthoracic fused children, the study patients have worse pulmonary function and quality of life scores at an average of 6.9 years after fusion.

There is controversy over the safety of lumbar laminectomy in elderly. This study uses data from the National Inpatient Sample to report outcomes after lumbar laminectomy in this population on a national scale. We have demonstrated that elderly patients with comorbidities are at a higher risk for adverse outcome after lumbar surgery.

Insulin-like growth factor 1 (IGF-1) and its receptor regulate cartilage metabolism. The single nucleotide polymorphism in insulin-like growth factor 1 receptor gene at intron 1 was associated with spinal disc narrowing in Japanese postmenopausal women. We suggest that a genetic variation at the IGF1R gene locus is associated with spinal disc degeneration.

Existing evidence does not provide definite conclusions in the majority of the clinical questions regarding indications and factors that may affect outcomes. Where feasible, conclusions are mainly drawn from lower level, least reliable evidence. Highest quality data are short-term whereas longer term data are of lower quality and in many instances conflicting.

Dissatisfaction with job tasks and lack of social support at work are examined in a prospective cohort of patients with acute low back pain to see if there is an association with low back pain outcomes. There is a weak association with social support from coworkers; biomechanical demand is considered.

The need for revision of lumbar total disc arthroplasty has been reported in prospective, randomized trials. The potential for neurologic and vascular complications with revision surgery has diminished enthusiasm for disc arthroplasty. The use of a far lateral (transpsoas) approach and use of adhesion barriers may be beneficial.

Kyphoplasty has been shown to reduce pain and improve mobility in patients with painful osteoporotic vertebral fractures. In this controlled trial, we show that a calcium-phosphate cement is as effective and safe as polymethylmethacrylate-cement in pain reduction and improvement of mobility for at least 3 years after kyphoplasty.

This study demonstrates in female patients specific and discriminating motion characteristics between 2 different subgroups of back pain: low back pain and pelvic girdle pain. It is postulated that the measured differences in motor patterns reflect compensation strategies, specific for each subgroup.

The influence of pain-related fear on peak activation of 10 trunk muscles of individuals with chronic back pain is assessed during maximal isometric trunk exertions in a neutral spine posture. Participants with high pain-related have smaller peak activation of their trunk muscles compared to participants with low pain-related fear. The pattern of avoidance may be a significant contributing factor in their continuing disability.

We investigated the attachment of the nuchal muscles to the spinous process, and which muscles are spared, and to what extent, when the C7 spinous process is preserved in laminoplasty. It was confirmed that C3-C6 laminoplasty in which the C7 spinous process is preserved reduces invasion of the nuchal muscles.

Accuracy and repeatability were validated for a novel noninvasive dual fluoroscopic image matching method in measurement of spine kinematics. In vivo 6 DOF of human spine kinematics was studied under physiologic loadings. The technique provided a powerful tool for further investigate of spinal pathology and for improving surgical methods.

This study was conducted to investigate the validity and reliability of the Turkish version of Neck Disability Index. Neck Disability Index was found to be a valid and reliable tool in Turkish Patients with neck problems.

Bow Hunter stroke is a symptomatic vertebrobasilar insufficiency caused by stenosis or occlusion of the vertebral artery (VA) with physiologic head rotation. It most commonly occurs at the junction of C1 and C2 and less commonly as the VA enters the C6 transverse foramen. Rotational stenosis of the VA is quite rare during its passage through the foramen transversarium of C3-C6. This report describes such a case and its successful treatment by a combination of previously described therapies-a routine anterior cervical discectomy and fusion with the addition of decompression of the left transverse foramen.