Spine
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Meta Analysis
Methodological quality of randomized clinical trials on treatment efficacy in low back pain.
This was a review of criteria-based meta-analyses. ⋯ Although a considerable number of randomized clinical trials have been carried out to evaluate the efficacy of interventions in low back pain, their methodological quality appears to be disappointingly low. Future trials are clearly needed, but much more attention should be paid to the methods of such studies.
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Case Reports
Brown-Séquard syndrome associated with Horner's syndrome in cervical epidural hematoma.
This report analyzed the likely locations of lesions that cause a combination of Horner's and Brown-Séquard syndromes. One must know the anatomic structure of spinal cord and the sympathetic nerve chain. ⋯ The spinal epidural hematoma rarely is a surgical emergency. The patient presented with Brown-Séquard and Horner's syndromes. Magnetic resonance imaging made a rapid and correct diagnosis. The patient received an emergent right hemilaminectomy from C2 to C6 with removal of hematoma and subsequently made a complete recovery.
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The ability of three new methods of scoring the Pain Drawing to predict psychological distress in two cohorts of 100 patients with chronic low back pain was investigated. ⋯ Using the new scoring systems, it was not possible to identify distressed patients with sufficient sensitivity/specificity, nor to differentiate between organic and nonorganic pain patterns.
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This study quantified changes in the size of the stenotic neuroforamen in degenerative lumbar spines. The volume and area of the neuroforamen were measured before and after the application of anterior distraction using the BAK interbody fusion system. ⋯ The results indicated that anterior systems such as the BAK system, which increase disc heights, can significantly increase neuroforaminal volume and area, providing adequate space for the nerve root and improving neuroforaminal stenosis.
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This was a cross-sectional analytic study. ⋯ The sacroiliac joint is a significant source of pain in patients with chronic low back pain and warrants further study.