Spine
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Intraoperative recording of somatosensory-evoked potentials is useful for monitoring spinal cord tolerance during spinal fusion with instrumentation. Volatile anesthetic agents are known to have prominent suppressive effects on somatosensory-evoked potentials. This study evaluates the effect of intrathecal administration of opioid, consisting of morphine sulfate and sufentanil, on somatosensory-evoked potential monitoring. ⋯ Somatosensory-evoked potential monitoring was possible in all patients undergoing extensive spinal surgery. Intrathecal opioid anesthesia with low concentrations of isoflurane in air and oxygen seems to have no effects on somatosensory-evoked potentials.
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This article is the second in a series examining the employment practices of Sears, Roebuck and Co. in light of its compliance with the Americans with Disabilities Act of 1990. Sears employs approximately 20,000 persons with disabilities, nearly 7000 individuals with orthopedic disabilities. The article describes findings from two major areas of inquiry relevant for spine professionals: 1) the costs and benefits of workplace accommodations, and 2) the ways in which Sears and other companies informally and formally resolve Americans with Disabilities Act Title I disputes.
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Data were obtained in a Danish cross-sectional postal survey and compared with information from four methodologically similar studies conducted in some of the Nordic countries between 1977-1985. ⋯ When data were examined from five methodologically similar studies on the 30- to 50-year-old Nordic population, there was reasonable consistency of prevalence figures. Thus, approximately 66% report having had low back pain at least sometime during their lifetime and approximately 50% sometime during the preceding year, with no significant differences relating to age or sex. The best method to investigate whether low back pain is on the increase might be through replicate studies.
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Comparative Study
Reducing the lifetime risk of cancer from spinal radiographs among people with adolescent idiopathic scoliosis.
Data from a retrospective cohort study of people with adolescent idiopathic scoliosis were combined with information on full-spinal radiographs to estimate contemporary x-ray doses and lifetime risks for development of cancer. ⋯ The cancer risks from full-spinal radiographs for scoliosis are not negligible and can be reduced from one half to three quarters if the anteroposterior view is replaced with the posteroanterior view.
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Twenty-one cases of chordoma arising in the mobile spine were retrospectively reviewed. ⋯ En bloc excision--even if marginal--is the treatment of choice of chordomas of the spine. Early diagnosis and careful surgical staging and planning are necessary. Megavoltage radiation can be administered as an adjuvant.