Spine
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Cerebral activation by lumbar mechanical stimulus was investigated by functional magnetic resonance imaging in healthy subjects and patients with chronic low back pain (LBP). ⋯ Chronic LBP patients showed increased tenderness at the lower back, higher aversive reaction to pain, and augmented LBP-related cerebral activation. The LBP-related activation is characterized by the absence of sensory-discriminative component and the involvement of PCC.
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Narrative review. ⋯ Key opinion leaders using the GRADE System made treatment recommendations based on systematically reviewed evidence, blended with clinical expertise and patient preference on critical, controversial questions in spine oncology.
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A prospective cohort study evaluating the quantitative lumbar flexion-relaxation phenomenon (QLFRP), measured with surface electromyographic (SEMG) signals from the erector spinae during trunk flexion pre- and postrehabilitation, in patients with chronic disabling occupational lumbar disorders (CDOLD). ⋯ A majority of patients in an interdisciplinary functional restoration program failed to demonstrate either the QLFRP or normal ROM on admission to the program. A majority of program completers, however, achieved both normal ROM and QLFRP and another 30% demonstrated either normal QLFRP or normal ROM. Both QLFRP and ROM measures were responsive to relevant self-report scales.
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Systematic review of the literature. ⋯ There is strong recommendation and moderate evidence for vertebral augmentation as safe and effective in providing pain relief and improving functional outcome in patients with vertebral body fractures and axial pain due to metastatic disease. There is a strong recommendation and very low evidence for embolization techniques as safe and effective in decreasing intraoperative blood loss in hypervascular tumors.
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Systematic review. ⋯ The present data suggest that calcitonin administration in the treatment for neurogenic claudication has no benefit in patients with lumbar spinal stenosis.