Spine
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Anecdotal reports and limited data suggest that the use of spinal injections is increasing, despite equivocal evidence about efficacy. ⋯ Lumbosacral injections increased dramatically in the Medicare population from 1994 to 2001. Less than half were performed for sciatica or radiculopathy, where the greatest evidence of benefit is available. These findings suggest a lack of consensus regarding the indications for ESIs and are cause for concern given the large expenditures for these procedures.
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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.
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The results for 37 surgical interventions in 31 consecutive patients with non-small cell lung cancer (NSCLC) with symptomatic spinal cord compression were reviewed retrospectively. ⋯ Even though lung cancer is considered an aggressive tumor, it is justifiable to aggressively treat patients with symptomatic spinal cord compression. Surgery by PTA can lead to good results in these patients.
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A retrospective study was performed through measurements on MRI images in adolescent idiopathic scoliosis (AIS) patients and age-matched adolescents. ⋯ Tonsillar ectopia with the extent >2 mm in AIS patients should be regarded as abnormal. AIS patients had a lower tonsil position and a higher prevalence of tonsillar ectopia than controls, and tonsillar ectopia was found to be associated with curve patterns. It is suggested that a lower position of the cerebellar tonsil might be associated with the etiopathogenesis of AIS and might contribute to subclinical neurologic dysfunction in AIS patients.
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Prospective cohort follow-up study. ⋯ A longer duration of the current episode is the worst detected prognostic factor for response to NRT, but prognostic models are inaccurate for predicting the clinical outcome of a given patient. In order to improve the success rate of this technology, these results only support earlier referral for patients complying with current indication criteria.