Spine
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Potential precipitating events and risk factors for vertebrobasilar artery dissection were reviewed in an analysis of the English language literature published before 1993. ⋯ The literature does not assist in the identification of the offending mechanical trauma, neck movement, or type of manipulation precipitating vertebrobasilar artery dissection or the identification of the patient at risk. Thus, given the current status of the literature, it is impossible to advise patients or physicians about how to avoid vertebrobasilar artery dissection when considering cervical manipulation or about specific sports or exercises that result in neck movement or trauma.
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Comparative Study
Low back pain and lifestyle. Part II--Obesity. Information from a population-based sample of 29,424 twin subjects.
A cross-sectional postal survey of 29,424 twin subjects aged 12-41 years obtained from a population-generated panel. ⋯ Obesity is modestly positively associated with low back pain, in particular with chronic or recurrent low back pain. However, because the association is weak, because there is no consistent positive monotonic dose response, and because the link disappears in monozygotic twins who are dissimilar in body mass index, it is unlikely that this association is causal. It is possible, however, that obesity plays a part in the chronicity of simple low back pain. Therefore, those with recurring or long-term low back pain deserve further attention.
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Comparative Study
Markers of nerve tissue injury in the cerebrospinal fluid in patients with lumbar disc herniation and sciatica.
The light subunit of neurofilament protein, S-100 protein, neuron-specific enolase, and glial fibrillary acidic protein were determined in the cerebrospinal fluid in patients with lumbar disc herniation and in control patients. ⋯ Patients with disc herniation and sciatica have increased concentrations of neurofilament protein and S-100 in the cerebrospinal fluid, which indicates damage of axons and Schwann cells in the affected nerve root.
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Comparative Study
Contralateral recurrent lumbar disc herniation. Results of discectomy compared with those in primary herniation.
The surgical outcomes of patients who underwent discectomy for contralateral recurrent herniation and primary herniation were evaluated. ⋯ Clinical results in patients reoperated on for contralateral recurrent lumbar disc herniation compare favorably with those reported after primary discectomy. The improvement of pain in the low back and lower limbs reported by the majority of patients 2 years after reoperation suggests that fusion is not needed in this patient population.
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Comparative Study
Anterior interbody fusion versus posterolateral fusion with transpedicular fixation for isthmic spondylolisthesis in adults. A comparison of clinical results.
Clinical and radiographic results were assessed in adult patients who had undergone operation for isthmic spondylolisthesis. ⋯ There was no statistically significant difference in clinical results between anterior interbody fusion and posterolateral fusion with transpedicular fixation for the treatment of isthmic spondylolisthesis in adults (P < 0.05).