Herniated discs: when is surgery necessary?

In all levels of disc herniations the absolute surgical indications include deteriorating neurological deficits with myelopathy or cauda equina syndrome. However, this review summarized the relative indications for surgery in each level.In cervical disc herniation (CDH), the indications for surgery consist of six months of persisting symptoms, not responding to conservative treatment.

Essential lordosis revisited.

Aims: Significant correction of an adolescent idiopathic scoliosis in the coronal plane through a posterior approach is associated with hypokyphosis. Factors such as the magnitude of the preoperative coronal curve, the use of hooks, number of levels fused, preoperative kyphosis, screw density, and rod type have all been implicated. Maintaining the normal thoracic kyphosis is important as hypokyphosis is associated with proximal junctional failure (PJF) and early onset degeneration of the spine.

The outcome of pedicle screw instrumentation removal for ongoing low back pain following posterolateral lumbar fusion.

Background: Our aim was to determine whether patients derived benefit from removal of pedicle screw instrumentation for axial pain without other cause using our surgical technique and patient selection. A secondary aim was to investigate factors that were associated with poorer outcomes for this procedure as well as complication rate in this cohort.

Methods: Theater records from a single spinal surgeon's practice were reviewed to identify patients that had undergone lumbar fusion for discogenic back pain with subsequent pedicle screw instrumentation removal (Expedium, DePuy Synthes) in the preceding 3 years with a minimum of 18 months follow-up.

Metal concentrations in the blood and tissues after implantation of titanium growth guidance sliding instrumentation.

Background: Growth guidance sliding treatment devices, such as Shilla (Medtronic, Minneapolis, MN USA) or LSZ-4D (CONMET, Moscow, Russia), used for the treatment of scoliosis in children who have high growth potential have unlocked fixtures that allow rods to slide during growth of the spine, which avoids periodical extensions. However, the probability of clinical complications associated with metallosis after implantation of such devices is poorly understood. The content of metal ions in the blood and tissues of pediatric patients treated for scoliosis using fusionless growth guidance sliding instrumentation has not yet been investigated.

Role of nanotopography in the development of tissue engineered 3D organs and tissues using mesenchymal stem cells.

Recent regenerative medicine and tissue engineering strategies (using cells, scaffolds, medical devices and gene therapy) have led to fascinating progress of translation of basic research towards clinical applications. In the past decade, great deal of research has focused on developing various three dimensional (3D) organs, such as bone, skin, liver, kidney and ear, using such strategies in order to replace or regenerate damaged organs for the purpose of maintaining or restoring organs' functions that may have been lost due to aging, accident or disease. The surface properties of a material or a device are key aspects in determining the success of the implant in biomedicine, as the majority of biological reactions in human body occur on surfaces or interfaces.

Analysis of retrieved growth guidance sliding LSZ-4D devices for early onset scoliosis and investigation of the use of nitinol rods for this system.

Study Design: Analysis of volumetric wear loss of retrieved growth guidance sliding devices LSZ-4D for treatment of early onset scoliosis and laboratory in vitro wear test for comparison of wear resistance of alloys Nitinol, Ti, and cobalt chromium (CoCr).

Objective: To evaluate quantitatively the amount of wear debris from the sliding LSZ-4D device and to investigate the potential of using Nitinol for replacing Ti alloys in spinal instrumentation. To do that, wear resistance of Nitinol, Ti, and CoCr was compared.

The use of ultrasound in comparison to radiography in magnetically controlled growth rod lengthening measurement: a prospective study.

Purpose: This study investigated whether ultrasound (U/S) is an alternative to radiography when measuring magnetically controlled growth rod (MCGR) length in order to reduce radiation exposure. Distractible spinal growth rods are the gold standard when treating early-onset scoliosis (EOS).

Methods: This was a prospective series.

Improvement of pulmonary function in children with early-onset scoliosis using magnetic growth rods.

Study Design: Case series.

Objective: To determine whether there is improvement in pulmonary function in children with early-onset scoliosis (EOS) using magnetic growth rods (MGRs).

Summary Of Background Data: EOS deformities have large impacts on lung function and volumes.