Spine
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Meta Analysis
Statistical significance versus clinical importance: trials on exercise therapy for chronic low back pain as example.
Critical appraisal of the literature. ⋯ It seems that many conclusions of studies of exercise therapy for chronic low back pain have been based on statistical significance of results rather than on clinical importance and, consequently, may have been too positive. Authors of trials should report not only statistical significance of results but also clinical importance.
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A longitudinal assessment of the association between pain-related fear and joint motions in 36 participants with subacute low back pain. ⋯ Individuals with high pain-related fear adopt alternative movement strategies and avoid motion of the lumbar spine when performing a common reaching movement. Identifying how pain-related fear maps to actual motor behavior (i.e., alternative movement strategies) is a crucial first step in determining how pain-related fear and motor behavior interact to promote or delay recovery from acute low back pain.
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Comparative Study
Anterior screw fixation of odontoid fractures comparing younger and elderly patients.
A retrospective, comparative study. ⋯ We had encouraging results using anterior screw fixation for surgical treatment of odontoid fractures and favor this method as preferred management strategy for stabilization of these fractures. Comparing between age groups, we had similar results on cervical spine function. With regards to fracture healing as well as morbidity and mortality, younger patients had a superior outcome.
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Prospective cross-sectional measurement study. ⋯ Even though ceiling effects (>20%) were not common, scores clustered near the top of the SQLI scale. The SQLI score distribution may impair the questionnaire's sensitivity to change and discriminative ability, particularly in younger subjects with lesser low or moderate curve severity, under observation or after surgery. The clinical utility of some SQLI items within each domain may be limited by high ceiling effects.
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Case Reports
Atypical syringomyelia without cavity in a patient with Chiari malformation and hydrocephalus.
A case report is presented. ⋯ Obstruction of the cerebrospinal fluid pathways in the upper spine may result in spinal cord gray matter T2 prolongation that is reversible after restoration of patency of cerebrospinal fluid pathways and stress the importance of timely intervention to limit progression to syringomyelia.