Many cervical dural tears can be managed by observation alone or by placement of a lumbar cerebrospinal fluid shunt either during the index procedure or in the postoperative period. At an average follow-up of 5.4 years, there were no long-term sequelae of the cervical dural tears in our series.
The use of nonsteroidal anti-inflammatory drugs for the treatment of tendon inflammation might increase the levels of leukotriene B(4) within the tendon, potentially contributing to the development of tendinopathy.
There is a close linear association between the facet fluid index and the amount of radiographic instability at L4-L5. Facet fluid on MRI should raise high suspicion of lumbar instability.
It is known that human tendon fibroblasts produce PGE(2) in vitro and in vivo in response to repetitive mechanical loading. This study demonstrates that repetitive exposure of the tendon to PGE(2) can result in degenerative changes within the tendon. Therefore, PGE(2) produced by tendon fibroblasts in response to repetitive mechanical loading in vivo might contribute to the development of exercise-induced tendinopathy.
Based on these in vitro findings, we speculate that production of prostaglandin E2 in tendons might play some role in the acellularity and matrix disorganization seen in exercise-induced tendinopathy.
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