Spine
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Review
Psychosocial interventions for low back pain in primary care: lessons learned from recent trials.
Workshop discussion and literature overview. ⋯ Despite the publication of recent "negative" results of psychosocial interventions for back pain, workshop participants remained optimistic about the importance of this line of research. Suggestions are given for a refocused research agenda on the effectiveness of psychosocial interventions for back pain in primary care.
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Review Comparative Study
Clinical decision rules for identification of low back pain patients with neurologic involvement in primary care.
Descriptive study. ⋯ This study has identified differences between the guidelines in the clinical decision rules for identification of neurologic involvement including omission of categories. Decision-making that employs all 3 categories of neurologic involvement will arguably facilitate accurate and timely identification of patients with low back pain so affected in primary care.
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Literature review, expert panel, and a workshop during the "VIII International Forum on Primary Care Research on Low Back Pain" (Amsterdam, June 2006). ⋯ For a range of commonly used back pain outcome measures, a 30% change from baseline may be considered clinically meaningful improvement when comparing before and after measures for individual patients. It is hoped that these proposals facilitate the use of these measures in clinical practice and the comparability of future studies. The proposed MIC values are not the final answer but offer a common starting point for future research.
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Prospective clinical series. ⋯ Lumbar decompression surgery results in a 58% incidence of asymptomatic compressive postoperative epidural hematoma. Adjacent level compression by hematoma occurs in 28% of patients. Advanced age, multilevel procedures, and international normalized ratio are independently associated with postoperative hematoma volume.
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Comparative Study
A comparison of the lenke and king classification systems in the surgical treatment of idiopathic thoracic scoliosis.
Retrospective case control study. ⋯ At intermediate follow-up, there does not seem to be significant radiographic or patient reported differences whether fusion levels are in agreement, longer, or shorter than those recommended by the Lenke or King classification systems.