Spine
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Comparative Study
Straight-forward versus anatomic trajectory technique of thoracic pedicle screw fixation: a biomechanical analysis.
A biomechanical study on cadaveric thoracic vertebrae using pullout strength, insertional torque, and bone mineral density to determine the optimal sagittal trajectory of thoracic pedicle screws. ⋯ The straight-forward technique results in a 39% increase in maximum insertional torque and a 27% increase in pullout strength compared to the anatomic technique. The maximum insertional torque at the neurocentral junction resulted in a 36% increase using the straight-forward technique versus the anatomic trajectory. Bone mineral density directly correlates with pullout strength for both techniques.
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A retrospective radiographic review was performed on 41 patients with scoliosis associated with a Chiari I malformation and/or syringomyelia. ⋯ Although the decision to obtain magnetic resonance imaging in a patient with scoliosis should be based on both clinical and radiographic criteria, we suggest that a heightened index of suspicion is warranted with certain curve patterns (left thoracic, double thoracic, triple, and a long right thoracic curve with end vertebra caudal to T12), and with a high or low apex and/or end vertebra, especially in males and patients with a normal to hyperkyphotic thoracic spine.
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A cross-sectional survey of 481 children aged 8-10 years and 325 adolescents aged 14-16 years obtained through a proportional two-stage cluster sample of children living in Odense, Denmark. ⋯ There is no obvious association between the objectively measured level of physical activity and back pain in children and adolescents. Simple self-reported levels of physical activity and inactivity cannot be used meaningfully on young people in back pain research.
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Review Meta Analysis Comparative Study
Muscle relaxants for nonspecific low back pain: a systematic review within the framework of the cochrane collaboration.
A systematic review of randomized and/or double-blinded controlled trials. ⋯ Muscle relaxants are effective in the management of nonspecific low back pain, but the adverse effects require that they be used with caution. Trials are needed that evaluate if muscle relaxants are more effective than analgesics or nonsteroidal anti-inflammatory drugs.
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The incidences of postoperative C5 palsy between a group treated by a standardized diagnostic and surgical treatment and a control group treated by a different cervical laminoplastic technique were prospectively compared. ⋯ Electromyography is a sensitive predictor of postoperative C5 palsy after laminoplasty. This complication may be avoided by performing selective foraminotomy in addition to posterior central canal decompression. Preexisting subclinical C5 root compression is a cause of C5 palsy after posterior cervical decompression for myelopathy.