Spine
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Prospective study of patients making primary care visits for back pain. ⋯ Although back pain frequently is associated with limitation of activity, pain's interference with activities is assessed inconsistently in primary care visits.
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A report of a case of lumbar spine duplication with the clinical appearance of adolescent scoliosis. ⋯ This rare malformation typically has severe neurologic sequelae. Conservative management in the reported patient did not result in a progressive neurologic lesion at the time of skeletal maturity.
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A retrospective radiographic and medical record analysis of 58 patients. ⋯ The use of preoperative dynamic radiographs should improve the selection of patients undergoing laminectomy for the treatment of multilevel cervical cord compression. Dynamic radiographs may also reinforce the need for such adjunctive procedures as fusion and instrumentation, to prevent postoperative destabilization. Preoperative olisthesis with hypermobility in sagittal or horizontal planes must be fused and instrumented.
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An experimental immunohistochemical investigation using an antibody for proliferating cell nuclear antigen. Surgically-extirpated specimens of posterior longitudinal ligament tissues from patients with hypertrophy of the posterior longitudinal ligament and other disorders of the cervical spine were analyzed. ⋯ Cell growth activity was accelerated in posterior longitudinal ligament tissues in cases of hypertrophy of the posterior longitudinal ligament; such an unusual phenotype of posterior longitudinal ligament cells was also expressed in cases of ossification of cervical disc herniation and cervical spondylotic myelopathy. Therefore, up-regulation of the growth of posterior longitudinal ligament cells may contribute to the development of hypertrophy of the posterior longitudinal ligament, and some common regulatory mechanism(s) on the proliferation of posterior longitudinal ligament cells seem to underlie the development of hypertrophy of the posterior longitudinal ligament and ossification of the posterior longitudinal ligament.
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A 1-year prospective study of the influence of surveillance methods on the surgical wound infection rates in a tertiary care spinal surgery unit. ⋯ Postdischarge surveillance, surgical procedure classification methods, and the indications for surgery (e.g., trauma, congenital deformity) influence the surgical wound infection rate. Current adjustments for some of these factors in the National Nosocomial Infection Surveillance system appear to be inadequate when used in a tertiary care facility.