Spine
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Review Comparative Study
Transcutaneous electrical nerve stimulation for the treatment of chronic low back pain: a systematic review.
Systematic review. ⋯ Evidence for the efficacy of TENS as an isolated intervention in the management of chronic LBP is limited and inconsistent. Larger, multicenter, RCTs are needed to better resolve its role in this condition. Increased attention should be given to the risks and benefits of long-term use, which more appropriately addresses the realities of managing chronic low back pain.
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A case report. ⋯ Patients with ankylosing spondylitis have a strong susceptibility to spine fracture from minor trauma, which can have devastating outcomes. Nonregion-specific multiple and simultaneous spine fractures can occur, and require thorough radiographic evaluation with imaging of the entire spinal axis, appropriate operative planning, and meticulous perioperative treatment. Preexisting internal spine instrumentation may predispose the ankylosing spondylitis spine to multiple fractures, even following a minor traumatic event. As such, the clinician should be cognizant of the possible existence of multiple and simultaneous fractures in patients with ankylosing spondylitis with preexisting internal spine instrumentation.
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Cadaveric motion segment experiment. ⋯ Two physical aspects of disc degeneration (dehydration and endplate disruption) cause marked segmental instability. Back pain associated with instability may be attributable to stress concentrations in degenerated discs.
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Comparative Study
The positional magnetic resonance imaging changes in the lumbar spine following insertion of a novel interspinous process distraction device.
Patients with symptomatic lumbar spinal stenosis underwent magnetic resonance imaging to study changes in the lumbar spine in various postures before and after implantation of the X STOP Interspinous Process Distraction Device (St. Francis Medical Technologies, Concord, CA). ⋯ This study shows that the X STOP device increases the cross-sectional area of the dural sac and exit foramens without causing changes in posture.