Does Spinal Instrumentation Influence the Healing Process of Posterolateral Spinal Fusion?: An In Vivo Animal Model
Masahiro Kanayama, Bryan W. Cunningham, John C. Sefter, Jeffrey A. Goldstein, Geoffrey Stewart, Kiyoshi Kaneda, and Paul C. McAfee

A sheep model was developed to examine the role of spinal instrumentation during the healing process of posterolateral spinal fusion. The use of spinal instrumentation increased the fusion mass stiffness, bone formation, and solid union rate in the early postoperative phase. These results suggest that spinal instrumentation enhances faster development of spinal fusion.

Serial Changes in the Rate of Proteoglycan Synthesis After Chemonucleolysis of Rabbit Intervertebral Discs
Kenji Sumida, Koji Sato, Masayuki Aoki, Yukihiro Matsuyama, and Hisashi Iwata

Serial changes in the rate of proteoglycan synthesis in rabbit discs injected with chymopapain and chondroitinase ABC were calculated using an in vitro method. The average rate of proteoglycan synthesis after chemonucleolysis decreased to 30% of that in normal discs and no significant recovery of disc height was observed.

Action of Chondroitinase ABC on Epidurally Transplanted Nucleus Pulposus in the Rabbit
Hiroki Ishikawa, Yutaka Nohara, and Satoshi Miyauti

Chondroitinase ABC was administered into the epidural space of rabbits after autotransplantation of the nucleus pulposus. The results demonstrate that chondroitinase ABC accelerates resolution of the nucleus pulposus.

Clinical Validity and Stability of Active and Passive Cervical Range of Motion With Regard to Total and Unilateral Uniplanar Motion
Charles A. Lantz, Jasper Chen, and Daniel Buch

Reliability and validity of an electrogoniometer were established for total and half-cycle motions. Active and passive motion values were compared with those reported previously, with active motions found to be more reliable than passive motions. Intraclass correlation coefficient values often exceeded 0.95, with somewhat lower values for flexion-extension.

The Association Between Cigarette Smoking and Back Pain in Adults
Susan C. Scott, Mark S. Goldberg, Nancy E. Mayo, Susan R. Stock, and Benoit Poîtras

An increased prevalence of back pain in relation to level of smoking cigarettes was found separately in men and women who were part of a retrospective cohort study of adolescent idiopathic scoliosis. Increased risks also were found among women without scoliosis in the general population group, but not among the men. The finding that smokers have more frequent episodes of back pain may imply that smoking exacerbates back pain, and the observation that stronger associations between back pain and smoking were found in the scoliosis cohorts suggests that smoking may have a greater impact on persons with damaged spines.

Cross-Cultural Adaptation of the Roland-Morris Questionnaire for German-Speaking Patients With Low Back Pain
Günther F. Wiesinger, Martin Nuhr, Michael Quittan, Gerold Ebenbichler, Gabriele Wölfl, and Veronika Fialka-Moser

Cross-cultural adaptation and cross-sectional psychometric testing of the Roland-Morris Questionnaire for German-speaking patients with low back pain are discussed. The final version for use in clinical trials is presented.

Evaluation of Two Time-Specific Back Pain Outcome Measures
Martin R. Underwood, Adrian G. Barnett, and Madge R. Vickers

The Roland-Morris Questionnaire and Von Korff's Chronic Pain Scales were modified to measure back pain and disability occurring over the preceding 4 weeks and were used in a postal survey. Both measures appear valid and repeatable in this form. However, the modified Von Korff scales yielded more usable data.

The Effectiveness of Acupuncture in the Management of Acute and Chronic Low Back Pain: A Systematic Review Within the Framework of the Cochrane Collaboration Back Review Group
Maurits W. van Tulder, Daniel C. Cherkin, Brian Berman, Lixing Lao, and Bart W. Koes

A systematic review was performed within the Cochrane Collaboration Back Review Group to evaluate the effectiveness of acupuncture for the management of low back pain. Eleven randomized controlled trials were included, but most of them were of very poor methodologic quality. This review did not clearly indicate that acupuncture is effective in the management of back pain.

The Effect of Industrial Back Belts and Breathing Technique on Trunk and Pelvic Coordination During a Lifting Task
Raymond W. McGorry and Simon M. Hsiang

Previous studies have described the lumbar and pelvic rotation patterns during trunk flexion-extension. Little has been reported on the effect of industrial back belts on this coordination. In the current study, phase angle analysis showed that back belts interacted with breathing technique to significantly alter this coordination during the initial stages of lifting.

Neurologic Compromise After an Isolated Laminar Fracture of the Cervical Spine
Pradeep Makan

The author reports on a patient who sustained a laminar fracture of the cervical spine that caused a significant neurologic deficit. Attention is drawn to the importance of the spinolaminar line in this injury.

Membranocystic Lesion in Lumbar Yellow Ligament
Kyoji Okada, Naoto Hoshi, Koichi Kawamura, Kozo Sato, and Masahiro Yamamoto

Membranocystic lesions in the yellow ligament between the fourth and fifth lumbar vertebrae were examined histologically in surgical cases. The lesion was present in 8 (18%) of 44 cases. Histologically, degeneration of the chondrocytes probably has a causal association with the formation of the lesion.

Seat Belt Fracture With Late Development of an Enterocolic Fistula in a Child: A Case Report
Merv Letts, Darin Davidson, Philip Fleuriau-Chateau, and Shirley Chou

A case of flexion-extension spiral fracture in a 9-year-old boy, with late development of an enterocolic fistula subsequent to a high-velocity motor vehicle accident, is reported.

Metastatic Cardiac Angiosarcoma of the Cervical Spine: Case Report
Merv Letts, Darin Davidson, Philip Fleuriau-Chateau, and Shirley Chou

A case of flexion-extension spiral fracture in a 9-year-old boy, with late development of an enterocolic fistula subsequent to a high-velocity motor vehicle accident, is reported.

Metastatic Cardiac Angiosarcoma of the Cervical Spine: Case Report
Scott Shapiro, John Scott, and Kevin Kaufman

A case of a symptomatic and very rare cervical vertebral body metastasis from cardiac angiosarcoma is reported. The behavior of the vascular lesion resembled that of an arteriovenous malformation and required embolization before corpectomy and anterior reconstruction with banked fibula and a locking plate. A literature review also is provided.

The Influence of Occupation on Lumbar Degeneration
Tapio Videman and Michele C. Battié

Virtually all adults to some degree are exposed to commonly suspected environmental risk factors for disc degeneration. Yet, these factors play a relatively modest role in explaining the variability in degeneration found in the adult population. In particular, occupational factors appear to make a minor contribution when compared with familial influences, which reflect the combined effects of genes and early childhood environment.