Spine
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Randomized Controlled Trial Clinical Trial
Discriminative and predictive validity assessment of the quebec task force classification.
A prospective cohort study of workers with low back pain who had been absent from work for more than 4 weeks was conducted. ⋯ The Quebec Task Force Classification demonstrated good predictive ability by discriminating between subjects with and those without distal radiating pain.
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A test-retest design was used. ⋯ Interexaminer reliability of the McKenzie lumbar spine assessment in performing clinical tests and classifying patients with low back pain into syndromes were good and statistically significant when the examiners had been trained in the McKenzie method.
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The assignment of idiopathic scoliosis curves to the curve types,1-6 to the lumbar spine modifier (A, B, or C), and to the sagittal thoracic modifier (-, N, +), as recently described by Lenke et al, was evaluated by five observers on two occasions. ⋯ Lenke's new classification system is more reliable than the older King classification, but proper classification of high thoracic and lumbar curves seems to be difficult.
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Comparative Study
Factors related to false- versus true-positive neuromonitoring changes in adolescent idiopathic scoliosis surgery.
A retrospective study of 134 adolescent patients who underwent surgical correction of idiopathic scoliosis between June 1992 and August 1998 was conducted. ⋯ Questions remain about the predictive accuracy of somatosensory-evoked and neurogenic motor-evoked potentials. According to the findings in this study, in which there were no false-negative readings and a modest false-positive rate, continued use of these methods is recommended. Higher false-positive rates were seen in patients with greater lability in mean arterial pressure. A wake-up test is recommended for all cases in which threshold monitoring changes occur because cases of spinal cord injury may exist even when monitored variables return to baseline.
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A biomechanical study of human cadaveric sacra using insertional torque and bone mineral density was conducted to determine the optimal sagittal trajectory of S1 pedicle screws. ⋯ The screws directed into the apex of the sacral promontory of the S1 pedicle resulted in an average 99% increase in peak insertional torque (P = 0.005), as compared with bicortical S1 pedicle screw fixation. Tricortical pedicle screw fixation correlates directly with bone mineral density.