Exploring Perceptions of Early-Career Psychiatrists About Their Relationships With the Pharmaceutical Industry.

Objectives: The pharmaceutical industry has engaged physicians through medical education, patient care, and medical research. New conflict of interest policy has highlighted the challenges to these relationships. The objective of this study was to explore the perceptions that early career psychiatrists (e.

Long-term Outcomes of 2-Level Total Disc Replacement Using ProDisc-L: Nine- to 10-Year Follow-up.

Study Design: A prospective clinical data analysis.

Objective: To determine the long-term clinical success of 2-level total disc replacement (TDR) in patients with degenerative disc disease.

Summary Of Background Data: Early successful clinical results of 2-level TDR have been reported.

Segmental contribution toward total cervical range of motion: a comparison of cervical disc arthroplasty and fusion.

Study Design: Prospective radiographic evaluation of patients that underwent cervical total disc replacement (TDR-C) or anterior cervical discectomy and fusion (ACDF) for one-level cervical disc disease.

Objective: To evaluate the following: (1) total cervical range of motion (ROM) from C2 to C7, and (2) the relative contribution to total cervical ROM from the operative level and each adjacent level after one-level TDR-C or ACDF.

Summary Of Background Data: The development of symptomatic adjacent segment disease after ACDF has served as the impetus for the development of motion-preserving alternatives, most notably cervical disc arthroplasty.

Prospective, randomized, multicenter Food and Drug Administration investigational device exemption study of the ProDisc-L total disc replacement compared with circumferential arthrodesis for the treatment of two-level lumbar degenerative disc disease: results at twenty-four months.

Background: Disc replacement arthroplasty previously has been shown to be an effective alternative to spine fusion for the treatment of single-level lumbar degenerative disc disease. The purpose of the present study was to determine the twenty-four-month results of a clinical trial of the ProDisc-L total disc replacement as compared with spinal fusion for the treatment of degenerative disc disease at two contiguous vertebral levels from L3 to S1.

Methods: A total of 237 patients were treated in a randomized controlled trial designed as a non-inferiority study for regulatory application purposes.

T1ρ magnetic resonance imaging and discography pressure as novel biomarkers for disc degeneration and low back pain.

Study Design: Prospective magnetic resonance imaging (MRI) study of patients low back pain (LBP) requiring discography as part of their routine clinical diagnoses and asymptomatic age-matched volunteers.

Objective: To determine whether T1ρ MRI and discography opening pressure (OP) are quantitative biomarkers of disc degeneration in LBP patients and in asymptomatic volunteers.

Summary Of Background Data: Disc degenerative disease, a common cause of LBP, is related to the patient's prognosis and serves as a target for therapeutic interventions.

Augmentation improves human cadaveric vertebral body compression mechanics for lumbar total disc replacement.

Study Design: Cadaveric biomechanical study.

Objective: To quantify the effects of vertebral body augmentation on biomechanics under axial compression by a total disc replacement (TDR) implant.

Summary Of Background Data: TDR is a surgical alternative to lumbar spinal fusion to treat degenerative disc disease.

The effect of implant size and device keel on vertebral compression properties in lumbar total disc replacement.

Background Context: Vertebral end plate support is necessary for successful lumbar total disc replacement (TDR) surgery. Failure to achieve anterior column support as a result of lumbar TDR device undersizing could lead to implant subsidence and fracture.

Purpose: The purpose of the study was to examine the compressive biomechanical behavior of the vertebral end plate with varying sizes of disc replacement implants.

Segmental contribution toward total lumbar range of motion in disc replacement and fusions: a comparison of operative and adjacent levels.

Study Design: Radiographic results from a prospective, randomized, multicenter trial assessing patients who underwent lumbar total disc replacement (TDR) or circumferential arthrodesis for 1-level degenerative disc disease.

Objective: To quantify the relative segmental contribution to total lumbar range of motion (ROM) at the operative level at each adjacent level in lumbar TDR and arthrodesis.

Summary Of Background Data: Although previous studies have evaluated ROM in TDR and fusion, no study has quantified or compared the relative segmental contribution to total lumbar ROM.

Sagittal cervical alignment after cervical disc arthroplasty and anterior cervical discectomy and fusion: results of a prospective, randomized, controlled trial.

Study Design: Radiographic results of a multicenter, prospective randomized study comparing 1-level cervical total disc replacement (TDR-C) with anterior cervical discectomy and fusion (ACDF).

Objective: To evaluate the effect on device-level lordosis, cranial and caudal adjacent level lordosis, and overall cervical sagittal alignment (C2-C6) after TDR-C or ACDF.

Summary Of Background Data: Cervical total disc replacement (TDR-C) has emerged as a promising alternative to ACDF in a select group of patients.

Total disc replacement positioning affects facet contact forces and vertebral body strains.

Study Design: A validated nonlinear three-dimensional finite element (FE) model of a single lumbar motion segment (L3-L4) was used to evaluate the effects of total disc replacement (TDR). The model was implanted with a fixed-bearing TDR (ProDisc-L) at 2 surgically relevant positions and exercised about the 3 anatomic axes. Facet forces, range of motion (RoM), and vertebral body strains were evaluated.

The parallax effect in the evaluation of range of motion in lumbar total disc replacement.

Background: Range of motion (ROM) has been shown to influence clinical outcomes of total disc replacement (TDR). While the parallax effect in image acquisition has been shown in the literature to influence the accuracy of a variety of measurements, this concept has not been investigated in the assessment of ROM analysis following TDR. We performed an evaluation of the influence of radiograph beam angle on "by hand" and on "gold standard" flexionextension ROM measurements in lumbar total disc replacement.

Advances in Magnetic Resonance Imaging for the assessment of degenerative disc disease of the lumbar spine.

The intervertebral disc is characterized by a tension-resisting annulus fibrosus, and a compression-resisting nucleus pulposus composed largely of proteoglycan. Both the annulus and the nucleus function in concert to provide the disc with mechanical stability. Early disc degeneration begins in the nucleus with proteoglycan depletion.

Results of the prospective, randomized, multicenter Food and Drug Administration investigational device exemption study of the ProDisc-L total disc replacement versus circumferential fusion for the treatment of 1-level degenerative disc disease.

Study Design: A prospective, randomized, multicenter, Food and Drug Administration-regulated Investigational Device Exemption clinical trial.

Objective: To evaluate the safety and effectiveness of the ProDisc-L (Synthes Spine, West Chester, PA) lumbar total disc replacement compared to circumferential spinal fusion for the treatment of discogenic pain at 1 vertebral level between L3 and S1.

Summary Of Background Data: As part of the Investigational Device Exemption clinical trial, favorable single center results of lumbar total disc replacement with the ProDisc-L have been reported previously.

Evaluation of spinal kinematics following lumbar total disc replacement and circumferential fusion using in vivo fluoroscopy.

Study Design: In vivo fluoroscopic analysis of lumbar spinal motion with total disc replacement (TDR), fusions, and controls.

Objectives: Compare and contrast lumbar spinal motion profiles in TDR, circumferential fusion, and controls.

Summary Of Background Data: TDR has been shown to preserve motion and possibly prevent abnormal loading at the adjacent level.

In vivo quantification of human lumbar disc degeneration using T(1rho)-weighted magnetic resonance imaging.

Diagnostic methods and biomarkers of early disc degeneration are needed as emerging treatment technologies develop (e.g., nucleus replacement, total disc arthroplasty, cell therapy, growth factor therapy) to serve as an alternative to lumbar spine fusion in treatment of low back pain.

Preoperative evaluation of adult isthmic spondylolisthesis with diskography.

Fourteen consecutive patients with a diagnosis of isthmic spondylolisthesis (grade I and II) underwent provocative lumbar diskography (L2-S1) to evaluate the disk adjacent to the spondylolisthesis. Seven (50%) of 14 patients had concordant pain at the disk above the slip and 2 patients had no pain at the slip level. Surgical treatment included anteroposterior fusion of the slip level and any adjacent concordant levels.

Clinical and radiographic outcomes of anterior lumbar interbody fusion using recombinant human bone morphogenetic protein-2.

Study Design: A prospective, nonblinded, multicenter study of outcomes in patients undergoing single-level anterior lumbar discectomy and interbody fusion with InFUSE Bone Graft.

Objective: To determine the safety and effectiveness of InFUSE Bone Graft applied to an absorbable collagen sponge in anterior lumbar interbody fusion with threaded cortical allografts.

Summary Of Background Data: In primates, InFUSE Bone Graft used with allograft dowels was shown to increase rates of interbody fusion by promoting osteoinduction and enhancing incorporation of the allograft.

Placement of pedicle screws in the human cadaveric cervical spine: comparative accuracy of three techniques.

Study Design: This investigation was conducted in two parts. In the first part, a morphometric analysis of critical cervical pedicle dimensions were measured to create guidelines for cervical pedicle screw fixation based on posterior cervical topography. In the second part of the study, a human cadaver model was used to assess the accuracy and safety of transpedicular screw placement in the subaxial spine using three different surgical techniques: 1) using surface landmarks established in the first part of the study, 2) using supplemental visual and tactile cues provided by performing laminoforaminotomies, and 3) using a computer-assisted surgical guidance system.

Magnetic resonance evaluation of the intervertebral disc, spinal ligaments, and spinal cord before and after closed traction reduction of cervical spine dislocations.

Study Design: A prospective clinical study using magnetic resonance imaging of the cervical spine in a consecutive series of patients with cervical spine dislocations.

Objectives: To determine the incidence of intervertebral disc herniations and injury to the spinal ligaments before and after awake closed traction reduction of cervical spine dislocations.

Summary Of Background Data: Prior series in which the prereduction imaging of disc herniations in the dislocated cervical spine are described have been anecdotal and have involved small numbers of patients.

The changing nature of admissions to a spinal cord injury center: violence on the rise.

The purpose of this study was to analyze changing etiologies for admission to a spinal cord injury center. This study was designed to retrospectively analyze the etiology of admissions to a spinal cord injury center during a 15-year period, specifically gunshot versus nongunshot wound injuries. Gunshot wounds are a well-recognized cause of spinal cord injury.

Foraminal pressure changes during intervertebral distraction simulating anterior cervical discectomy.

Distraction of the disc space over baseline height has been shown to increase foraminal size. The purpose of this procedure is to determine pressure changes, with disc space distraction simulating an anterior cervical discectomy and fusion (ACDF). An analysis of pressure changes during disc space distraction at C5-C6 was performed.

Accuracy of SPECT scanning in diagnosing pseudoarthrosis: a prospective study.

The present study attempted to analyze the efficacy of single photon emission computed tomography (SPECT) in diagnosing pseudoarthrosis after fusion using surgical exploration as the gold standard. This study examined the SPECT scans of 38 patients before they underwent surgical exploration of their fusion mass for suspected pseudoarthrosis or in conjunction with instrumentation removal. Surgical findings were compared with the radiologists' findings to determine the efficacy of SPECT in diagnosing pseudoarthrosis.

Neurologic deterioration after cervical spinal cord injury.

Neurologic deterioration after cervical spinal cord injury (SCI) at a regional spinal cord center was examined. This study examined the incidence of neurologic deterioration as well as associated risk factors in our patient population. Up to 5.