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https://www.selleckchem.com/products/azeliragon.html Additive manufacturing has been used in complex spinal surgical planning since the 1990s and is now increasingly utilized to produce surgical guides, templates, and more recently customized implants. Surgeons report beneficial impacts using additively manufactured biomodels as pre-operative planning aids as it generally provides a better representation of the patient's anatomy than on-screen viewing of computed tomography (CT) or magnetic resonance imaging (MRI). Furthermore, it has proven to be very beneficial in surgical training and in explaining complex deformity and surgical plans to patients/parents. This paper reviews the historical perspective, current use, and future directions in using additive manufacturing in complex spinal surgery cases. This review reflects the authors' opinion of where the field is moving in light of the current literature. Despite the reported benefits of additive manufacturing for surgical planning in recent years, it remains a high niche market. This review raises the question as to why the use of this technology has not progressed more rapidly despite the reported advantages - decreased operating time, decreased radiation exposure to patients intraoperatively, improved overall surgical outcomes, pre-operative implant selection, as well as being an excellent communication aid for all medical and surgical team members. Increasingly, the greatest benefits of additive manufacturing technology in spinal surgery are custom-designed drill guides, templates for pedicle screw placement, and customized patient-specific implants. In view of these applications, additive manufacturing technology could potentially revolutionize health care in the near future. Sleep difficulties are common among older adults and are associated with cognitive decline. We used data from a large, nationally representative longitudinal survey of adults aged older than 50 in the United States to examine the relatio

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