Spine
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Trunk muscle strength and the effect of trunk muscle exercises on chronic low back pain were investigated in patients with chronic low back pain. ⋯ This difference in flexor/extensor ratio may have been due to reduced extensor strength resulting from neurogenic muscle weakness induced by the organic lumbar lesions in group 1. The exercise-associated increase in trunk muscle strength did not completely eliminate the low back pain induced by the organic lumbar lesions in group 1. However, increasing trunk muscle strength was extremely effective in patients of Group 2, in which decreased trunk muscle strength was a major factor in chronic low back pain.
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Anatomic study of the suboccipital region, specifically the deep muscles of the suboccipital triangle, was performed in cadaveric specimens. ⋯ Awareness of the physical relation between the rectus capitis posterior minor muscle and spinal dura via this connective tissue bridge should lessen the potential risk of dural damage during surgery. This connective tissue bridge may help resist dural infolding during head and neck extension.
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This is a report of a patient with severe cervical myelopathy due to pseudoarthrosis between the posterior tubercle of the atlas and the spinous process of the axis, associated with diffuse idiopathic skeletal hyperostosis. Radiographs of 170 patients with neck pain were reviewed to identify lesions involving abnormal contact between the atlas and axis. ⋯ In the group with pronounced hyperostosis, pseudoarthrosis or a variant can cause serious problems in the upper cervical spine that should not be overlooked.