Spine
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Systematic review. ⋯ Based on the current evidence, intermittent or continuous traction as a single treatment for LBP cannot be recommended for mixed groups of patients with LBP with and without sciatica. Neither can traction be recommended for patients with sciatica because of inconsistent results and methodological problems in most of the studies involved. However, because high-quality studies within the field are scarce, because many are underpowered, and because traction often is supplied in combination with other treatment modalities, the literature allows no firm negative conclusion that traction, in a generalized sense, is not an effective treatment for patients with LBP.
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Randomized Controlled Trial
Contrast flow characteristics in the cervical epidural space: an analysis of cervical epidurograms.
A single-center prospective analysis of cervical epidurograms, using a crossover design. ⋯ In cervical epidural steroid injections performed in the midline at C6-C7 and C7-T1, the contrast consistently covers the dorsal cervical epidural space bilaterally, irrespective of the volume used or neck flexion angle used. This suggests that solutions introduced here would cover the dorsal cervical epidural space. This questions the utility of performing potentially more dangerous injections at higher cervical levels or more invasive procedures, such as the use of epidural catheters.
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Randomized Controlled Trial
Natural course of disc morphology in patients with sciatica: an MRI study using a standardized qualitative classification system.
A prospective observational study of patients with sciatica. ⋯ This classification system could be used to identify the majority of symptomatic disc levels. At 14 months, the MRI outcome was generally good for disc herniations and nerve root compromise. Nerve root compromise had the best MRI prognosis if the disc was extruded at baseline. There were significant differences between men and women in relation to baseline findings as well as in relation to development of MRI findings over time.
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Cross-cultural translation and psychometric testing were performed. ⋯ The Persian versions of the ODI, RDQ, and QDS are reliable and valid instruments to measure functional status in Persian-speaking patients with LBP. They are simple and fast scales, and the use of them can be recommended in a clinical setting and future outcome studies in Iran.
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Prospective cohort study. ⋯ Poor overall physical function and depression symptomatology are associated with LBP and consequences of LBP in persons 70 years of age and older.