Spine
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Systematic review of the literature and prospective survey study. ⋯ The majority of spine surgeons prefer to decompress the acutely injured spinal cord within 24 hours. The majority of spine surgeons prefer to decompress the cervical spine for patients with complete or incomplete cervical SCI within 24 hours. Early decompression (within 24 hours) should be considered as part of the therapeutic management of any patient with SCI, particularly those with cervical SCI. Very early decompression (within 12 hours) should be considered for a patient with an incomplete cervical SCI (with the possible exception of central cord syndrome).
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Randomized Controlled Trial
Neck pain in Hong Kong: a telephone survey on consequences and health service utilization.
A regionally representative telephone survey using a 2-stage randomization process. ⋯ Neck pain is highly prevalent with an increasing impact in Hong Kong. More than one-third of neck pain patients suffered from moderate to severe pain and around 20% of them had to limit their work. About 25% of neck pain patient have consulted medical or health professionals. Physiotherapy and private medical clinic were the 2 service providers with high percentage of perceived complete improvement. There was a general trend that more neck pain patients used complementary therapies.
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Comparative Study
The mechanical effect of commercially pure titanium and polyetheretherketone rods on spinal implants at the operative and adjacent levels.
Single-level cadaveric lumbar constructs were instrumented with either polyetheretherketone (PEEK) or commercially pure (CP) titanium (Ti) rods and biomechanically evaluated. Strain from gauged bone screws and interbody (IB) spacers, kinematic motion, and caudal disc pressure measurements were recorded during testing. ⋯ Rigid CP Ti rods resulted in increased screw strain (bone-screw interface forces) and less interbody spacer compression (higher stress shielding). Furthermore, there was a trend toward decreased intradiscal pressure with Ti rods at the caudal segment. These trends suggest that segments instrumented with PEEK more closely mimicked intact physiologic loading in the subadjacent level, which may reduce the likelihood of adjacent level disease.
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Content analysis of patient interviews, clinic letters, and radiology reports for patients with chronic low back pain of greater than 12 months duration. ⋯ A common language is shared between professionals and patients that may encourage unhelpful beliefs. The use of degenerative terms such as wear and tear by patients is associated with a poor perceived prognosis. The explanation of radiological findings to patients presents an opportunity to challenge unhelpful beliefs, thus facilitating uptake of active treatment strategies.
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Clinically based systematic review. ⋯ Literature regarding the optimal treatment of patients with transient neuropraxia is of low quality. On the basis of expert opinion, there was a recommendation that a return to full participation in high-energy contact sports could be based on radiographic findings: patients with transient neuropraxia without stenosis could return as a strong recommendation, whereas stenotic patients could not return as a weak recommendation. Furthermore, a strong recommendation was made to permit players to return to full participation after decompression with a single-level anterior cervical fusion.