Spine
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Review Case Reports
Radiotherapy-induced malignant peripheral nerve sheath tumor of the cauda equina.
Case report. ⋯ Postirradiation malignant peripheral nerve sheath tumors are rare and occur in a population at high risk of developing second malignancies. The authors report the fourth case resulting from adjuvant radiotherapy for testicular seminoma, with the present report being the first report of extensive intradural tumor leading to cauda equina syndrome.
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Comparative Study
Concurrent comparison of responsiveness in pain and functional status measurements used for patients with low back pain.
Prospective study of two samples of patients with acute and chronic low back pain, respectively. ⋯ The results suggest that all the outcome measures were appropriate for measuring changes in functional status and pain in patients with acute low back pain, whereas among chronic patients the RMDQ, ODI, DRI, and NRS were most appropriate.
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In the last 2 years, we have examined 9640 patients experiencing back pain or sciatica, using MRI. There were 13 (0.13%) patients who had radicular symptoms that clinically mimicked lumbar disc herniation or spinal stenosis. All of these patients had inferior vena caval obstruction or occlusion that caused engorgement in the epidural and paravertebral venous system, causing nerve root compression. ⋯ The authors believe that epidural venous engorgement should be considered when the symptoms of patients with deep venous and inferior vena cava thrombosis are accompanied by radicular and/or back pain, because pathologic processes compressing a nerve root can cause pain.
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Multicenter Study
Sensitivity and specificity of outcome measures in patients with neck pain: detecting clinically significant improvement.
Prospective, single-cohort study. ⋯ The present findings will assist in the choice of outcome measures in trials on neck pain. The study also illustrates a methodologic framework for interpreting change scores in terms of clinical improvement, facilitating the process of making sense of research data in the clinical setting.
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Clinical Trial
Course of nonsurgical management of burst fractures with intact posterior ligamentous complex: an MRI study.
Prospective study. ⋯ The present study revealed that an intact posterior ligamentous complex might not prevent loss of correction gained by nonsurgical management of burst fractures. Significant loss occurs in the first 3 months despite external stabilization. However, the magnitude of residual deformity usually remains close to the initial deformity. Although changes in the shape of adjacent discs occur due to trauma and/or natural course, significant loss in signal intensity of nucleus pulposus is unlikely. Patient outcome seems to be highly satisfactory despite residual deformity.