Spine
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Segmental arteries were interrupted bilaterally at up to three levels to study the influence on spinal cord blood flow (SCBF) and function in dogs. ⋯ Interruption of bilateral segmental arteries at three levels did not damage spinal cord function in dogs, suggesting that in patients, preoperative embolization at three levels to reduce blood loss during surgery for spinal tumors would not compromise spinal cord function.
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Review Case Reports
Reduction of severe adolescent isthmic spondylolisthesis: a new technique.
The case of a 14-year-old boy with a severe-grade isthmic spondylolisthesis who underwent reduction and stabilization using this technique is described. ⋯ In severe-grade lumbosacral spondylolisthesis, isolated posterior fusion, even when supplemented with internal fixation, is not sufficient to prevent deformity progression. Therefore, a combined anterior and posterior fusion is necessary. Reduction of the deformity leads to restoration of normal sagittal alignment with an excellent cosmetic result. Reduction without release of posterior structures may lead to neurologic deficit. This 3-stage shortening procedure can provide sudden reduction of deformity with minimal risk of neurologic deficit. The procedure is technically demanding, and should be performed by spinal surgeons who are familiar with the principles of anterior and posterior fusions.
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Comparative Study
A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis.
A semi-prospective clinical study was conducted. ⋯ The prognostic criteria using the total scores from our revised scoring system were useful for the pretreatment evaluation of metastatic spinal tumor prognosis irrespective of treatment modality or local extension of the lesion.
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A systematic review within the Cochrane Collaboration Back Review Group. ⋯ There is moderate evidence suggesting that back schools, in an occupational setting, reduce pain and improve function and return-to-work status, in the short- and intermediate-term, compared with exercises, manipulation, myofascial therapy, advice, placebo, or waiting list controls, for patients with chronic and recurrent LBP. However, future trials should improve methodologic quality and clinical relevance and evaluate the cost-effectiveness of back schools.
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Observational study conducted within a randomized clinical trial. ⋯ Patient satisfaction may confer small short-term clinical benefits for low back pain patients. Long-term perceived improvement may reflect, in part, perceived past improvement as measured by satisfaction.