Restorative Neurostimulation Therapy Compared to Optimal Medical Management: A Randomized Evaluation (RESTORE) for the Treatment of Chronic Mechanical Low Back Pain due to Multifidus Dysfunction.

Introduction: Many interventional strategies are commonly used to treat chronic low back pain (CLBP), though few are specifically intended to target the distinct underlying pathomechanisms causing low back pain. Restorative neurostimulation has been suggested as a specific treatment for mechanical CLBP resulting from multifidus dysfunction. In this randomized controlled trial, we report outcomes from a cohort of patients with CLBP associated with multifidus dysfunction treated with restorative neurostimulation compared to those randomized to a control group receiving optimal medical management (OMM) over 1 year.

Thoracic pedicle screws: comparison of start points and trajectories.

Study Design: Experimental design using cadaveric computerized tomography (CT) scans and a computer-assisted image guidance system to compare various thoracic pedicle screw start points and trajectories.

Objective: To compare described thoracic pedicle screw start points and trajectories to determine which allows strictly intrapedicular screw placement with the most margin of error.

Summary Of Background Data: Thoracic pedicle screws are being used in a variety of spinal conditions to include fracture, tumor, and deformity.

Use of fluoroscopy to evaluate iliac screw position.

Iliac screw fixation is often used for long fusions to the sacropelvis. Maximum iliac screw purchase is obtained both by placing the screws within 1.5 cm of the greater sciatic notch and by extending them anterior to the axis of rotation in flexion-extension.

Comparison of sagittal contour and posterior disc height following interbody fusion: threaded cylindrical cages versus structural allograft versus vertical cages.

Objective: Segmental restoration of sagittal contour is recognized as critical for improved long-term success following instrumented lumbar fusions. As such, the use of wedged implants has become more popular. Few studies exist to assess the postoperative lordotic and disc height changes following these varied techniques in spinal fusion.

Volumetric spinal canal intrusion: a comparison between thoracic pedicle screws and thoracic hooks.

Study Design: A computer-aided design analysis.

Objectives: To introduce the concept of volumetric spinal canal intrusion and report the relative intrusion volumes for thoracic pedicle screws compared to thoracic laminar and pedicle hooks.

Summary Of Background Data: Thoracic pedicle screws are being used more frequently; however, there is concern about neurologic risk from medial misplacement.

Anterior thoracic scoliosis constructs: effect of rod diameter and intervertebral cages on multi-segmental construct stability.

Background Context: Many studies have reported on the use of anterior instrumentation for thoracolumbar scoliosis and more recently thoracic scoliosis. However, the optimal construct design remains an issue of debate.

Purpose: To optimize construct design and enhance implant survival until a successful spinal arthrodesis is achieved.

Osteoporosis and anterior femoral notching in periprosthetic supracondylar femoral fractures: a biomechanical analysis.

Background: This biomechanical study was designed to evaluate the predictive ability of dual-energy x-ray absorptiometry, cortical bone geometry as determined with computed tomography, and radiography in the assessment of torsional load to failure in femora with and without notching.

Methods: Thirteen matched pairs of cadaveric femora were randomized into two groups: a notched group, which consisted of femora with a 3-mm anterior cortical defect, and an unnotched group of controls. Each pair then underwent torsional load to failure.

Braided hamstring tendons for reconstruction of the anterior cruciate ligament. A biomechanical analysis.

Background: In an effort to improve the strength and stiffness of anterior cruciate ligament grafts, several authors have advocated alterations of graft structure and orientation, including braiding the tendons in hamstring tendon grafts.

Hypothesis: Braiding hamstring tendons does not increase graft strength and stiffness.

Study Design: Controlled laboratory study.

Accuracy of thoracic pedicle screws in patients with and without coronal plane spinal deformities.

Study Design: This retrospective observational study evaluated 399 transpedicular thoracic screws using postoperative computed tomography (CT).

Objectives: To examine the in vivo accuracy of transpedicular thoracic screws in patients with and without coronal plane spinal deformities.

Summary Of Background Data: There are no comparative studies regarding the safety and accuracy of thoracic pedicle screws in patients with and without coronal plane spinal deformities.

The effects of tibial malrotation on the biomechanics of the tibiotalar joint.

The effects of tibial malrotation on the biomechanics of the tibiotalar joint were studied using a cadaveric model loaded in an Instron 8521 materials testing device and a TEKScan I-Scan thin-film resistive ink pressure measuring system. Testing of 23 legs was performed using rotational conditions of 10 and 20 degrees internal and external rotation as well as neutral rotation. All rotational conditions were found to decrease joint contact area.

Microradiographic and histopathologic findings in a human cage explant after two-level corpectomy: a case report.

Study Design: A case involving microradiographic and histopathologic analysis of an explanted human corpectomy mesh cage is reported.

Objective: To describe the clinical circumstance, the radiographic appearance, and the histopathologic assessment of a titanium mesh device explanted from a two-level corpectomy.

Summary Of Background Data: To the authors' knowledge, no published microradiographic or histopathologic reports have described a retrieved human corpectomy cage.