Publications by authors named "Robert Mulholland"

Biomass-derived polyester coatings for coil applications have been successfully developed and characterized. The coatings were constituted by carbohydrate-derived monomers, namely 2,5-furan dicarboxylic acid, isosorbide, succinic acid, 1,3-propanediol, and 1,5-pentanediol, the latter having previously been used as a plasticizer rather than a structural building unit. The effect of isosorbide on the coatings is widely studied.

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This is a review of some 50 papers published in the European Spine Journal in the year 2014. They are selected on the basis that the author felt they were significant contributions to the spinal literature in that year. A brief precis is provided of each paper, and each is accompanied by a short discussion explaining its importance and relevance.

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A new liposuction technology for adipocyte lipolysis and uniform three-dimensional tissue heating and contraction is presented. The technology is based on bipolar radiofrequency energy applied to the subcutaneous adipose tissue and subdermal skin surface. Preliminary clinical results, thermal monitoring, and histologic biopsies of the treated tissue demonstrate rapid preaspiration liquefaction of adipose tissue, coagulation of subcutaneous blood vessels, and uniform sustained heating of tissue.

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Over the last couple of years the European Spine Journal has become truly international with papers from all over the world, and at the same time it has increased its size. Professor Mulholland has selected and reviewed some 40 papers from over 200 published in 2007 and that he felt were of particular interest to practicing surgeons and would influence their management of patients, or papers that challenged established beliefs. Papers dealing with back pain, spondylolysis, tumors, spinal stenosis, spinal infection, clinical examination, lumbar disc herniation, spinal fractures, etc.

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Randomized comparative study of the efficacy of nerve root infiltration (NRI) guided by neurostimulator to find the value of nerve stimulators in nerve root infiltration was undertaken. The response to nerve root infiltration using local anaesthetics and steroid is unpredictable, partly because the exact nerve root giving rise to pain may not be truly infiltrated. The nerve stimulator is advocated to identify the nerve root of concern prior to infiltration.

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The literature reports on the safety and efficacy of titanium cages (TCs) with additional posterior fixation for anterior lumbar interbody fusion. However, these papers are limited to prospective cohort studies. The introduction of TCs for spinal fusion has resulted in increased costs, without evidence of superiority over the established practice.

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Study Design: A 2-dimensional axisymmetric finite element model of an intervertebral segment was used to investigate the stress patterns in the adjacent vertebrae of fused spinal segment incorporating 4 common cage designs. The same was used to study the effect of maturation of bone graft on stress distribution pattern.

Objectives: To study and compare the stress distribution patterns in a normal spinal segment and in the adjacent vertebrae of a fused spinal segment.

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Study Design: An experimental study on cadaver spine and spine model for biomechanical evaluation of a novel dynamic stabilization device.

Objectives: First, to test the hypothesis that in dynamic stabilization of a lumbar spine using pedicle screws and ligament, addition of a fulcrum in front of the ligament can unload the disc. Second, to determine the relationship between the length and stiffness of the fulcrum and the ligament on disc unloading, lordosis and motion preservation.

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The Deputy Editor has explained in his editorial the reason for this review. I found it a challenging but very rewarding project. The overall quality of papers was so good that it was very difficult to select the necessarily few which space would allow me to review.

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The apparent clinical success of spinal stabilization methods that restrict rather than abolish movement in relieving mechanical back pain indicates that the concept of the aetiology of back pain should be reviewed. Further understanding of how degeneration affects disc biomechanics, and an understanding of how current soft stabilization systems alters them, may allow us to define more precisely what are the essential requirements of an ideal soft stabilization system. It appears that abnormal patterns of loading rather than abnormal movement are the reason that disc degeneration causes back pain in some patients.

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Background: Recent cadaver studies show stability against axial rotation with a cylindrical cage is marginally superior to a rectangular cage. The purpose of this biomechanical study in cadaver spine was to evaluate the stability of a new rectangular titanium cage design, which has teeth similar to the threads of cylindrical cages to engage the endplates.

Methods: Ten motion segments (five L2-3, five L4-5) were tested.

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The Adams classification for discogram morphology is based on a cadaveric study. It provides the basis for several subsequent classifications proposed in the literature. However, little or no attention has been paid to its reproducibility in the clinical setting.

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The object of this study was to create a database for the biomechanical and certain functional anatomical parameters of the deer spine, for comparison with the human spine. This was done with a view toward using the deer spine as an alternative model for various biomechanical experiments, as it is difficult to procure nonembalmed, fresh human spine specimens. Bovine spongiform encephalopathy (BSE) and its human variant, Creutzfeld Jakob disease (CJD), prevent us from using bovine and sheep spine.

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