Long-term follow-up showed that even without spinal fusion, more than half the patients were evaluated as excellent or good. Patients with more than a 10 degrees sagittalrotation angle who need multiple laminectomy, should be given information about the possibility of earlier deterioration of the outcome, and alternative or additional treatment such as concomitant spinal fusion with decompression may be considered.
Sequences of the nuclear internal transcribed spacer 1 (ITS1) region and the chloroplast rbcL gene were obtained from 86 specimens of Ulva (including “Enteromorpha”) from five of the main Hawaiian Islands. These 86 specimens were divided into 11 operational taxonomic units (OTUs) based on analyses of primary sequence data and comparisons of ITS1 secondary structure. Of the 11 OTUs, six have not previously been reported from anywhere in the world. Only three represented exact sequence matches to named species (Ulva lactuca L., syn. U. fasciata Delile; U. ohnoi Hiraoka et Shimada); two others represented exact sequence matches to unnamed species from Japan and New Zealand. Of the 12 species names currently in use for Hawaiian Ulva, only one, U. lactuca (as U. fasciata), was substantiated. General morphology of the specimens did not always correspond with molecular OTUs; for example, reticulate thallus morphology, previously considered diagnostic for the species U. reticulata Forssk., was expressed in thalli assigned to U. ohnoi and to one of the novel OTUs. This finding confirms a number of recent studies and provides further support for a molecular species concept for Ulva. These results suggest that Ulva populations in tropical and subtropical regions consist of species that are largely unique to these areas, for which the application of names based on types from temperate and boreal European and North American waters is inappropriate. Ulva ohnoi, a “green tide” species, is reported from Hawaii for the first time.
Radiographs of 3,259 outpatients with low back disorders were examined for age, gender, level, direction, degree of slip, lumbar lordosis, pedicle-facet (P-F) angle, facet shape, and disc height. Degenerative lumbar spondylolisthesis was found in 284 (8.7%) of the patients, of which 83 were excluded. Single-level spondylolisthesis was present in 132 of the 201 patients studied, including 93 cases of anterolisthesis and 39 of retrolisthesis, the former being predominant at L4 and in women and the latter at L2 and equal between the genders. Multilevel spondylolisthesis in 69 patients included 65 (94%) of two-segment slip, 21 anterior, 25 posterior, and 19 combined, and 4 cases of three-segment retrolisthesis. Factors related to anterolisthesis were increased P-F angle and W-shaped facet joint; statistically, however, no factors were found statistically related to retrolisthesis. Multilevel anterolisthesis was considered to occur from factors similar to those previously reported for single-level anterolisthesis, and the pathomechanism of retrolisthesis is different from that of anterolisthesis.
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