Spine
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Comparative Study
A prospective study of centralization of lumbar and referred pain. A predictor of symptomatic discs and anular competence.
The presence or absence of rapidly centralizing, peripheralizing, or abolishing low back and radiating pain, as identified during a McKenzie mechanical lumbar assessment of patients with chronic lumbar pain, was compared prospectively with discographic pain provocation and anular competency. ⋯ The McKenzie assessment process reliably differentiated discogenic from nondiscogenic pain (P < 0.001) as well as competent from an incompetent anulus (P < 0.042) in symptomatic discs and was superior to magnetic resonance imaging in distinguishing painful from nonpainful discs.
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In this study, the authors analyzed the results of the release of the medial superior cluneal nerve in a prospective series of 19 patients with suspected entrapment. ⋯ Entrapment neuropathy of the medial superior cluneal nerve is a rare and easily treatable cause of unilateral low back pain.
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Comparative Study
Growth changes of solidly fused kyphotic bloc after surgery for tuberculosis. Comparison of four procedures.
A study to analyze the changes of the spinal deformity during the growth period, with regard to different operations for spinal tuberculosis in children. ⋯ Radical anterior surgery for spinal tuberculosis destroys the anterior growth and limits the capacity for spinal remodeling. Therefore, it should be avoided, if it is not absolutely necessary, for the healing of the infection or the primary correction of the tuberculous deformity.
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Appropriate application of an oncologic staging system is required to evaluate the relationship among histologic types, management, and outcome of primary bone tumors. A commonly accepted terminology for surgical procedures and for definition of tumor extent is needed for surgical planning and clinical reviews. The principles of the Enneking system for classifying stages of tumors are emphasized and applied to the spine using a practical approach for surgical staging.
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This study was designed to examine the possibility of a new spinal cord monitoring method using measurement of the refractory period to monitor spinal cord function. ⋯ The change of the responses elicited by the paired stimuli is more sensitive than those elicited by the single stimulus in the spinal cord evoked potentials. The absolute refractory periods and the recovery rate during 50% attenuation of the precompression amplitude is the critical alarm level in spinal cord monitoring.