Spine
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Clinical Trial
The relation between the transversus abdominis muscles, sacroiliac joint mechanics, and low back pain.
Two abdominal muscle patterns were tested in the same group of individuals, and their effects were compared in relation to sacroiliac joint laxity. One pattern was contraction of the transversus abdominis, independently of the other abdominals; the other was a bracing action that used all the lateral abdominal muscles. ⋯ Contraction of the transversus abdominis significantly decreases the laxity of the sacroiliac joint. This decrease in laxity is larger than that caused by a bracing action using all the lateral abdominal muscles. These findings are in line with the authors' biomechanical model predictions and support the use of independent transversus abdominis contractions for the treatment of low back pain.
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The technical feasibility of percutaneous microendoscopic bilateral decompression of lumbar stenosis via a unilateral approach was evaluated in a human cadaver model. ⋯ Microendoscopic laminotomy can be used to decompress the spinal canal as effectively as an open laminotomy and may prove to be beneficial in decreasing the complications and morbidity of standard treatments for lumbar stenosis.
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Review Case Reports
Sacral stress fractures: an unusual cause of low back pain in an athlete.
A case report of a sacral stress fracture causing low back pain in an athlete. ⋯ Sacral stress fractures should be included in the differential diagnosis of athletes with low back pain, particularly runners and volleyball players. To the authors' best knowledge, this is the first report of a volleyball player with a sacral stress fracture. A review of the literature yielded 29 cases of sacral stress fractures in athletes, mainly runners.
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Randomized Controlled Trial Clinical Trial
Perioperative use of corticosteroid and bupivacaine combination in lumbar disc surgery: a randomized controlled trial.
A prospective and controlled study of perioperative use of combined local anesthetic and corticosteroid in lumbar disc surgery. ⋯ It is concluded that the perioperative use of bupivacaine and corticosteroids during lumbar discectomy maintains effective postoperative analgesia and decreases opioid usage without complications.
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This article highlights recent and pending United States Supreme Court cases interpreting employment provisions of the Americans with Disabilities Act and discusses their implications for spine professionals. The implications include how Spine readers approach evaluations of employees and job applicants with disabilities and workplace accommodations in light of the recent decisions. ⋯ Increasingly, spine professionals will be called on to assist in the analysis of these issues. This article will familiarize Spine readers with the legal interpretations under the Americans with Disabilities Act of "disability," "mitigating measures," "qualified individual," and "reasonable accommodations." It illustrates the ways in which spine professionals may be called on to help interpret and apply qualification and safety standards under the Americans with Disabilities Act to assist individuals, employers, attorneys, and other stakeholders in the employment of people with disabilities.