Spine
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Comparative Study
Lumbar lordosis in spinal fusion. A comparison of intraoperative results of patient positioning on two different operative table frame types.
One hundred one patients undergoing spine surgery for degenerative conditions were entered into a prospective radiographic evaluation of changes in lumbar lordosis as affected by positioning on two different operative tables. ⋯ Results from the present study display a statistically significant difference between multisegmental and total lumbar lordosis, depending on the type of operative table used in patient positioning. Segmental lordosis at L5-S1 depended less on frame type. This table-dependent positional change in lumbar lordosis could be incorporated easily into a lumbar fusion procedure, especially when supplemented with instrumentation, affecting the permanent overall degree of lordosis. These results suggest that a more physiologic degree of lumbar lordosis is obtained accurately with use of an operative table similar to the four-poster frame.
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The measurement properties and validity of a newly developed patient questionnaire for the assessment of patients with lumbar spinal stenosis was tested in an ongoing prospective multicenter observational study of patients undergoing decompressive surgery in three teaching hospitals. ⋯ This short self-administered spinal stenosis measure is reproducible, internally consistent, valid, and highly responsive. It can be used to complement generic instruments in outcome assessment of patients with lumbar spinal stenosis.
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This study analyzed the sacroiliac articulation at the level of the second sacral vertebra (S2). Anthropometric measurements were performed on 20 cadaveric pelves to determine the optimal starting point for lag screw fixation of the sacroiliac joint at S2. ⋯ During lag screw fixation of posterior pelvic ring disruptions, aberrant screw placement may impose considerable risk to adjacent vascular, visceral, or neural structures. After anatomic reduction of the sacroiliac joint, safe and accurate screw fixation can be achieved by utilizing the starting point and insertion trajectory described in this paper.
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A survey of pain intensity and psychological symptoms in patients with chronic neck pain after whiplash injury. ⋯ The SCL-90-R is a convenient instrument to administer to patients with whiplash. It yielded a characteristic profile of pain and appears to be more expedient than other psychometric tests for these patients.