Spine
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Case Reports
Upper-airway obstruction after short posterior occipitocervical fusion in a flexed position.
Case report. ⋯ An adequate fixation angle is necessary to avoid airway obstruction after an occipitocervical fusion, even for short upper cervical fusions, especially in patients with rheumatoid arthritis.
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A total of 46 patients undergoing lumbar spine surgery for degenerative lumbar disease and presenting with drop foot were included in this retrospective study. ⋯ Palsy duration and preoperative strength were factors that most affected drop foot recovery following surgical intervention for spinal degeneration.
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Review Comparative Study
Systematic review of randomized trials comparing lumbar fusion surgery to nonoperative care for treatment of chronic back pain.
Systematic review of randomized trials comparing surgical to nonsurgical treatment of discogenic back pain. ⋯ Surgery may be more efficacious than unstructured nonsurgical care for chronic back pain but may not be more efficacious than structured cognitive-behavior therapy. Methodological limitations of the randomized trials prevent firm conclusions.
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Comparative Study
The influence of fracture mechanism and morphology on the reliability and validity of two novel thoracolumbar injury classification systems.
The Thoracolumbar Injury Severity Score (TLISS) and the Thoracolumbar Injury Classification and Severity Score (TLICS) were prospectively evaluated. ⋯ Although both schemes were noted to have substantial reproducibility and validity, our results indicate the TLISS is more reliable than the TLICS, suggesting that the mechanism of trauma may be a more valuable parameter than fracture morphology for the classification and treatment thoracolumbar injuries. Since these injury characteristics are interrelated and are critical to the maintenance of spinal stability, we think that both concepts should be considered during the assessment and management of these patients.