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The effect of minimally invasive lumbar decompression surgery on sagittal spinopelvic alignment in patients with lumbar spinal stenosis: a 5-year follow-up study.

J Neurosurg Spine 2021 Jun 11:1-8. Epub 2021 Jun 11.

1Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka; and.

Objective: Several studies have examined the relationship between sagittal spinopelvic alignment and clinical outcomes after spinal surgery. However, the long-term reciprocal changes in sagittal spinopelvic alignment in patients with lumbar spinal stenosis after decompression surgery remain unclear. The aim of this study was to investigate radiographic changes in sagittal spinopelvic alignment and clinical outcomes at the 2-year and 5-year follow-ups after minimally invasive lumbar decompression surgery. Read More

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Neurosurgery Research and Education Foundation funding conversion to National Institutes of Health funding.

J Neurosurg 2021 Jun 11:1-8. Epub 2021 Jun 11.

1Department of Neurological Surgery, Ohio State University Wexner Medical Center, Columbus, Ohio.

Objective: The Neurosurgery Research and Education Foundation (NREF) provides research support for in-training and early career neurosurgeon-scientists. To define the impact of this funding, the authors assessed the success of NREF awardees in obtaining subsequent National Institutes of Health (NIH) funding.

Methods: NREF in-training (Research Fellowship [RF] for residents) and early career awards/awardees (Van Wagenen Fellowship [VW] and Young Clinician Investigator [YCI] award for neurosurgery faculty) were analyzed. Read More

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Supraspinal functional and structural plasticity in patients undergoing surgery for degenerative cervical myelopathy.

J Neurosurg Spine 2021 Jun 11:1-9. Epub 2021 Jun 11.

2Neurosurgery, and.

Objective: The aim of this study was to investigate cerebral reorganization, both structurally and functionally, occurring in patients with degenerative cervical myelopathy (DCM) after surgical decompression.

Methods: In the current observational study of 19 patients, high-resolution T1-weighted structural MRI and resting-state functional MRI scans were obtained pre- and postoperatively in patients with DCM and healthy controls (HCs). The resting-state functional MRI data were utilized to perform region-of-interest (ROI)-to-ROI and ROI-to-voxel functional connectivity (FC) analysis and were similarly compared between and within cohorts. Read More

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Predictors of an academic career among fellowship-trained spinal neurosurgeons.

J Neurosurg Spine 2021 Jun 11:1-8. Epub 2021 Jun 11.

1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Objective: Although fellowship training is becoming increasingly common in neurosurgery, it is unclear which factors predict an academic career trajectory among spinal neurosurgeons. In this study, the authors sought to identify predictors associated with academic career placement among fellowship-trained neurological spinal surgeons.

Methods: Demographic data and bibliometric information on neurosurgeons who completed a residency program accredited by the Accreditation Council for Graduate Medical Education between 1983 and 2019 were gathered, and those who completed a spine fellowship were identified. Read More

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Use of available crop by-products as alternative bedding materials to wheat straw for rearing broilers.

Animal 2021 Jun 8;15(7):100260. Epub 2021 Jun 8.

Poultry Production Department, Agriculture College, Damietta University, Damietta 34517, Egypt.

The provision of suitable bedding for rearing broilers is an ongoing challenge for poultry producers. The aim of the present study was to evaluate the effect of using different types of crop residues as alternative bedding materials to wheat straw on growth performance, carcass traits, health, and welfare of broilers; moreover, the effects on the bedding and air quality were analyzed. We randomly assigned 180 1-day-old chickens (Cobb 500) across six bedding groups (three replicates of 10 birds each). Read More

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Motion of the multi-segmented spine in elite dancers during passé and arabesque.

Gait Posture 2021 Jun 6;88:198-202. Epub 2021 Jun 6.

Harkness Center for Dance Injuries, NYU Langone Health, 614 2ndAv, Suite G, 2nd Floor, New York, NY 10016, USA. Electronic address:

Background: The spinal biomechanics of dance tasks have received little study and no studies have used a multi-segmented spinal model. Knowledge of how the segments of the spine move may be useful to the dance clinician and dance educator.

Research Question: What is the direction and amount of motion of the primary segments of the spine in elite dancers during an arabesque and a passé?

Methods: This observational study examined 59 elite dancers performing an arabesque and a passé using a three-dimensional motion analysis system with the trunk divided into a series of five segments: pelvis, lower lumbar, upper lumbar, lower thoracic and upper thoracic spine. Read More

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Energy balance of torrefied microalgal biomass with production upscale approached by life cycle assessment.

J Environ Manage 2021 Jun 8;294:112992. Epub 2021 Jun 8.

Mechanical Engineering Department, De La Salle University, 2401 Taft Avenue, 0922, Manila, Philippines; Center for Engineering and Sustainable Development Research, De La Salle University, Manila, 0922, Philippines.

Torrefaction is a thermochemical process used to convert the biomass into solid fuel. In this study, torrefaction increased the raw microalgal biomass' energy content from 20.22 MJ⋅kg to 27. Read More

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Changes in kinematics, kinetics, and muscle activity in patients with lumbar spinal stenosis during gait: systematic review.

Spine J 2021 Jun 8. Epub 2021 Jun 8.

Department of Orthopaedic Surgery, University of Arkansas for Medical Science, Little Rock, AR; Mechanical and Biomedical Engineering Department, College of Engineering, Boise State University, Boise, ID.

Background Context: Lumbar spinal stenosis (LSS) is one of the most common orthopaedic conditions and affects more than half a million people over the age of 65 in the US. Patients with LSS have gait dysfunction and movement deficits due to pain and symptoms caused by compression of the nerve roots within a narrowed spinal canal.

Purpose: The purpose of the current systematic review was to summarize existing literature reporting biomechanical changes in gait function that occur with LSS, and identify knowledge gaps that merit future investigation in this important patient population. Read More

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Exercise attenuates low back pain and alters epigenetic regulation in intervertebral discs in a mouse model.

Spine J 2021 Jun 8. Epub 2021 Jun 8.

Faculty of Dentistry, McGill University, Montreal, Quebec, H3A 0G1, Canada; Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, H3A 0G1, Canada; Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba, Japan, 260-8677; Faculty of Medicine, Departments of Pharmacology and Toxicology, Anesthesiology and Neurology and Neurosurgery, McGill University, Montreal, Quebec, H3A 0G1, Canada; Faculty of Medicine, Department of Anesthesiology, University of Minnesota, Minneapolis, MN, 55455, USA. Electronic address:

Background Context: Chronic low back pain (LBP) is a multifactorial disorder with complex underlying mechanisms, including associations with intervertebral disc (IVD) degeneration in some individuals. It has been demonstrated that epigenetic processes are involved in the pathology of IVD degeneration. Epigenetics refers to several mechanisms, including DNA methylation, that have the ability to change gene expression without inducing any change in the underlying DNA sequence. Read More

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Which traumatic spinal injury creates which degree of instability? A systematic quantitative review.

Spine J 2021 Jun 8. Epub 2021 Jun 8.

Institute of Orthopaedic Research and Biomechanics, Trauma Research Centre Ulm, Ulm University, Ulm, Germany. Electronic address:

Background Context: Traumatic spinal injuries often require surgical fixation. Specific three-dimensional degrees of instability after spinal injury, which represent criteria for optimum treatment concepts, however, are still not well investigated.

Purpose: The aim of this review therefore was to summarize and quantify multiplanar instability increases due to spinal injury from experimental studies. Read More

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Tuberculosis of the spine in children - Does drug resistance affect surgical outcomes?

Spine J 2021 Jun 8. Epub 2021 Jun 8.

Paediatric TB Clinic, Bai Jerbai Wadia Hospital for Children, Mumbai, India. Electronic address:

Background Context: The emergence of drug resistance has complicated the management of spinal tuberculosis (TB). While it is well known that the medical management of drug-resistant spinal TB is more difficult, the surgical outcomes of the same have not been studied sufficiently, particularly in children.

Purpose: To analyze the surgical outcomes in a cohort of children treated for spinal TB, and to thus assess whether drug resistant (DR) disease is associated with poorer surgical outcomes. Read More

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External validation of a predictive model of adverse events following spine surgery.

Spine J 2021 Jun 8. Epub 2021 Jun 8.

Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA.

Background Context: We lack models that reliably predict 30-day postoperative adverse events (AEs) following spine surgery.

Purpose: We externally validated a previously developed predictive model for common 30-day adverse events (AEs) after spine surgery.

Study Design/setting: This prospective cohort study utilizes inpatient and outpatient data from a tertiary academic medical center. Read More

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Prospective, Randomized, Double-Blinded Clinical Trial Comparing PEEK and Allograft Spacers in Patients Undergoing Transforaminal Lumbar Interbody Fusion Surgeries.

Spine J 2021 Jun 8. Epub 2021 Jun 8.

Boulder Neurosurgical Associates, Boulder, Colorado, USA; Justin Parker Neurological Institute, Boulder, Colorado, USA. Electronic address:

Background Context: Allograft and polyether-ether-ketone (PEEK) radiographic, biomechanical, histological properties have been extensively studied and both spacers have their advantages and shortcomings. There are no comparative randomized or double-blinded spinal fusion clinical trials reported to date.

Purpose: The study's primary objective was to prospectively investigate clinical and radiological outcomes in patients undergoing lumbar interbody fusions and randomized to receive either PEEK or structural bone allografts. Read More

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Coexistence of immune-mediated diseases in sarcoidosis Frequency and clinical significance in 1737 patients.

Joint Bone Spine 2021 Jun 8:105236. Epub 2021 Jun 8.

Department of Medicine, Universitat de Barcelona, Barcelona, Spain; Department of Autoimmune Diseases, ICMiD, Hospital Clinic, Barcelona, Spain. Electronic address:

Objective: To analyze whether immune-mediated diseases (IMDs) occurs in sarcoidosis more commonly than expected in the general population, and how concomitant IMDs influence the clinical presentation of the disease.

Methods: We searched for coexisting IMDs in patients included in the SARCOGEAS-cohort, a multicenter nationwide database of consecutive patients diagnosed according to the ATS/ESC/WASOG criteria. Comparisons were made considering the presence or absence of IMD clustering, and odds ratios (OR) and their 95% confidence intervals (CI) were calculated as the ratio of observed cases of every IMD in the sarcoidosis cohort to the observed cases in the general population. Read More

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Effect of backbone circularization on colloidal stability: Compaction of unfolded structures improves aggregation resistance of granulocyte colony-stimulating factor.

Int J Pharm 2021 Jun 8:120774. Epub 2021 Jun 8.

Biomedical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Central 6, 1-1-1 Higashi, Tsukuba, Ibaraki 305-8566, Japan; Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa, Chiba 277-8562, Japan. Electronic address:

Aggregation of protein therapeutics can lead to immunogenicity and loss of function in vivo. Its effective prevention requires an understanding of the conformational and colloidal stability of protein and the improvement of both. Granulocyte colony-stimulating factor (G-CSF), which is one of the most widely used protein therapeutics, was previously shown to be conformationally stabilized by connecting its N- and C-termini with amide bonds (backbone circularization). Read More

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Aspartic protease-pepstatin A interactions: Structural insights on the thermal inactivation mechanism.

Biochimie 2021 Jun 8. Epub 2021 Jun 8.

Kaypeeyes Biotech Private Limited, R&D Center, Hebbal Industrial Area, Mysuru, 570016, Karnataka, India. Electronic address:

Aspartic proteases are the targets for structure-based drug design for their role in physiological processes and pharmaceutical applications. Structural insights into the thermal inactivation mechanism of an aspartic protease in presence and absence of bound pepstatin A have been obtained by kinetics of thermal inactivation, CD, fluorescence spectroscopy and molecular dynamic simulations. The irreversible thermal inactivation of the aspartic protease comprised of loss of tertiary and secondary structures succeeded by the loss of activity, autolysis and aggregation The enthalpy and entropy of thermal inactivation of the enzyme in presence of pepstatin A increased from 81. Read More

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The PHY domain dimer interface of bacteriophytochromes mediates cross-talk between photosensory modules and output domains.

J Mol Biol 2021 Jun 8:167092. Epub 2021 Jun 8.

Institute of Biochemistry, Graz University of Technology, 8010 Graz, Austria; BioTechMed-Graz, 8010 Graz, Austria. Electronic address:

Protein dynamics play a major role for the catalytic function of enzymes, the interaction of protein complexes or signal integration in regulatory proteins. In the context of multi-domain proteins involved in light-regulation of enzymatic effectors, the central role of conformational dynamics is well established. Light activation of sensory modules is followed by long-range signal transduction to different effectors; rather than domino-style structural rearrangements, a complex interplay of functional elements is required to maintain functionality. Read More

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An interdomain hydrogen bond in the Rag GTPases maintains stable mTORC1 signaling in sensing amino acids.

J Biol Chem 2021 Jun 8:100861. Epub 2021 Jun 8.

Program in Molecular Medicine, University of Massachusetts Medical School, 373 Plantation St, Worcester, MA 01605, USA. Electronic address:

Cellular growth and proliferation are primarily dictated by the mechanistic target of rapamycin complex 1 (mTORC1), which balances nutrient availability against the cell's anabolic needs. Central to the activity of mTORC1 is the RagA-RagC GTPase heterodimer, which under favorable conditions recruits the complex to the lysosomal surface to promote its activity. The RagA-RagC heterodimer has a unique architecture in that both subunits are active GTPases. Read More

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Low back pain.

Lancet 2021 Jun 8. Epub 2021 Jun 8.

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Neurology, Physical Medicine and Rehabilitation, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Department of Physical Medicine and Rehabilitation and Anesthesiology, Walter Reed National Military Medical Center, Bethesda, MD, USA.

Low back pain covers a spectrum of different types of pain (eg, nociceptive, neuropathic and nociplastic, or non-specific) that frequently overlap. The elements comprising the lumbar spine (eg, soft tissue, vertebrae, zygapophyseal and sacroiliac joints, intervertebral discs, and neurovascular structures) are prone to different stressors, and each of these, alone or in combination, can contribute to low back pain. Due to numerous factors related to low back pain, and the low specificity of imaging and diagnostic injections, diagnostic methods for this condition continue to be a subject of controversy. Read More

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Automatic classification of medical image modality and anatomical location using convolutional neural network.

PLoS One 2021 11;16(6):e0253205. Epub 2021 Jun 11.

Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.

Modern radiologic images comply with DICOM (digital imaging and communications in medicine) standard, which, upon conversion to other image format, would lose its image detail and information such as patient demographics or type of image modality that DICOM format carries. As there is a growing interest in using large amount of image data for research purpose and acquisition of large amount of medical image is now a standard practice in the clinical setting, efficient handling and storage of large amount of image data is important in both the clinical and research setting. In this study, four classes of images were created, namely, CT (computed tomography) of abdomen, CT of brain, MRI (magnetic resonance imaging) of brain and MRI of spine. Read More

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Is a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation?

PLoS One 2021 11;16(6):e0253076. Epub 2021 Jun 11.

Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland.

The cortical bone trajectory (CBT) has been introduced with the aim of better screw hold, however, screw-rod constructs with this trajectory might provide less rigidity in lateral bending (LB) and axial rotation (AR) compared to the constructs with the traditional trajectory (TT). Therefore, the addition of a horizontal cross-connector could be beneficial in counteracting this possible inferiority. The aim of this study was to compare the primary rigidity of TT with CBT screw-rod constructs and to quantify the effect of cross-connector-augmentation in both. Read More

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The health response to the Rohingya refugee crisis post August 2017: Reflections from two years of health sector coordination in Cox's Bazar, Bangladesh.

PLoS One 2021 11;16(6):e0253013. Epub 2021 Jun 11.

Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.

On August 25 2017, an unprecedented influx of Rohingya refugees began from Rakhine State in Myanmar into Bangladesh's district of Cox's Bazar. The scale and acuteness of this humanitarian crisis was unprecedented and unique globally, requiring strong coordination of a multitude of actors. This paper reflects on the health sector coordination from August 2017 to October 2019, focusing on selected achievements and persisting challenges of the health sector strategic advisory group (HSSAG), and the health sector working groups including epidemiology and case management, sexual and reproductive health, community health, mental health and psychosocial support, and emergency preparedness. Read More

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Preclinical Safety of a 3D-Printed Hydroxyapatite-Demineralized Bone Matrix Scaffold for Spinal Fusion.

Spine (Phila Pa 1976) 2021 Jun 10. Epub 2021 Jun 10.

Department of Orthopaedic Surgery, Northwestern University, Chicago, IL Center for Regenerative Nanomedicine, Simpson Querrey Institute, Chicago, IL Dimension Inx Corp, Chicago, IL Department of Radiology, Northwestern University, Chicago, IL.

Study Design: Prospective, randomized, controlled preclinical study.

Objective: The objective of this study was to compare the host inflammatory response of our previously described hyperelastic, 3D-printed (3DP) hydroxyapatite (HA)-demineralized bone matrix (DBM) composite scaffold to the response elicited with the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in a preclinical rat posterolateral lumbar fusion model.

Summary Of Background Data: Our group previously found that this 3D-printed HA-DBM composite material shows promise as a bone graft substitute in a preclinical rodent model, but its safety profile had yet to be assessed. Read More

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Lumbar Thecal Sac Dimensions and Axial Spinal Cord Areas on Magnetic Resosnace Imaging in 626 Healthy Subjects.

Spine (Phila Pa 1976) 2021 Jun 10. Epub 2021 Jun 10.

Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan Department of Orthopedics Surgery, Chubu Rosai Hospital, Minato-ku, Nagoya, Japan.

Study Design: A cross-sectional study.

Objective: The aim of this study was to investigate the lumbar thecal sac dimensions and spinal cord area on magnetic resonance (MR) imaging in healthy volunteers.

Summary Of Background Data: There are few reports regarding lumbar spine MRI in healthy subjects, and the difference in spinal canal dimensions by age remains unclear. Read More

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Corannulene: A Curved Polyarene Building Block for the Construction of Functional Materials.

Acc Chem Res 2021 Jun 11. Epub 2021 Jun 11.

Division of Chemistry and Biological Chemistry, School of Physical and Mathematical Sciences, Nanyang Technological University, 21-Nanyang Link, 637371 Singapore.

ConspectusThis Account describes a body of research in the design and synthesis of molecular materials prepared from corannulene. Corannulene (CH) is a molecular bowl of carbon that can be visualized as the hydrogen-terminated cap of buckminsterfullerene. Due to this structural resemblance, it is often referred to as a buckybowl. Read More

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The impact of the SARS-CoV-2 pandemic on referral characteristics in a national tertiary spinal injuries unit.

Ir J Med Sci 2021 Jun 11. Epub 2021 Jun 11.

National Spinal Injuries Unit, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland.

Background: The SARS-CoV-2 pandemic has had profound implications on healthcare institutions.

Aims: This study aims to assess and compare referral patterns during COVID-19 to corresponding dates for the preceding 3 years (2017-2019), in order to preemptively coordinate the logistics of the surgical unit for similar future experiences.

Methods: Retrospective review for our institution, a national tertiary referral centre for spine pathology. Read More

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Comparison of novel DXA system, Shimazu SONIALVISION G4, with GE-Lunar PRODIGY.

J Bone Miner Metab 2021 Jun 11. Epub 2021 Jun 11.

Department of Radiological Technology, Anjo Kosei Hospital, 28 Higashihirokute, Anjo City, Aichi, Japan.

Introduction: SONIALVISION G4 (Shimadzu, Kyoto, Japan) is a fluoroscopic imaging system capable of dual-energy X-ray absorptiometry (DXA) using the additional application. However, bone mineral density (BMD) with this system is calibrated only by a phantom, and the necessity to confirm the reliability of BMD measurement in human subjects has been pointed out. This study aimed to evaluate the clinical reliability of BMD measurement using SONIALVISION G4 by comparing it with PRODIGY (GE Healthcare, Madison, WI, USA), a reference system in developing the DXA application. Read More

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Complete genome sequence of a novel fish papillomavirus detected in farmed wels catfish (Silurus glanis).

Arch Virol 2021 Jun 11. Epub 2021 Jun 11.

Institute for Veterinary Medical Research, Centre for Agricultural Research, ELKH, 1143 Budapest, Hungária krt. 21., P.O. Box 18, 1581, Budapest, Hungary.

A novel papillomavirus (PV) was detected in farmed wels catfish (Silurus glanis) in Hungary showing clinical signs resembling those of wels catfish herpesvirus disease. The whole genome of Silurus glanis papillomavirus 1 (SgPV1) was identified using next-generation sequencing. The 5,612-bp complete genome contains four predicted protein coding regions (E1, E2, L1, and L2), which seem to have homologues in every PV genome sequenced to date. Read More

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Spinal involvement in juvenile idiopathic arthritis: what do we miss without imaging?

Rheumatol Int 2021 Jun 11. Epub 2021 Jun 11.

Department of Pediatrics, Division of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease of childhood. Enthesitis-related arthritis (ERA) has been one of the most controversial subtypes of JIA with a higher risk of axial involvement.  Our aim was to assess the frequency and spectrum of MRI findings of spine involvement in patients with JIA and determine if the axial involvement is always clinically symptomatic in patients with positive MRI findings. Read More

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