Spine
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Peer-reviewed literature was reviewed and summarized. ⋯ A successful arthrodesis is the fundamental surgical goal for patients with chronic pain of spinal origin. However, a successful fusion does not always correlate with a successful clinical result.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effects of side-posture positioning and spinal adjusting on the lumbar Z joints: a randomized controlled trial with sixty-four subjects.
A blinded, randomized controlled trial was conducted. ⋯ Spinal adjusting produced increased separation (gapping) of the Z joints. Side-posture positioning also produced gapping, but less than that seen with lumbar side-posture adjusting. This study helps to increase understanding about the mechanism of action for spinal manipulation.
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A literature review was conducted. ⋯ Current BT-CBT helps many patients with chronic pain. Continuing clinical research should improve the matching of treatments with patient characteristics and refine the focus of treatments on behavior changes most associated with positive outcome. Further study of fear, attention, readiness to adopt self-management strategies, acceptance of pain, and new combinations of interdisciplinary treatments may lead to improved interventions.
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Retrospective literature review. ⋯ The studies published so far suggest that the pain resulting from lumbar disc disease may be diminished by intradiscal electrothermal annuloplasty. All these studies project a positive therapeutic effect. However, all the studies suffer from the same methodologic flaws. A prospective cohort design or a nonrandomized prospective design is used with a biased control. The scientific validity of various study designs is discussed, and a randomized prospective study is recommended. Additionally, more investigation into the basic science of the action of intradiscal electrothermal annuloplasty is required.
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Comparative Study Clinical Trial
Intraoperative neurophysiologic detection of iatrogenic C5 nerve root injury during laminectomy for cervical compression myelopathy.
A retrospective and prospective study was conducted to investigate intraoperative neurophysiologic monitoring during cervical laminectomy to detect iatrogenic C5 nerve root palsy. ⋯ In an effort to reduce postoperative C5 nerve root palsy, the clinician should consider intraoperative deltoid and biceps transcranial electrical motor-evoked potential and spontaneous electromyography monitoring whenever there is potential for iatrogenic C5 nerve root injury.