Spine
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This study is an analysis of the National Hospital Ambulatory Medical Care Survey (NHAMCS), a large sample representative of all emergency department (ED) visits throughout the United States. ⋯ Low back pain related disorders are a frequent cause of ED visit. Diagnostic imaging is performed in one-third of all patients. There was a strong secular trend in use of advanced imaging; patients were nearly 3 times as likely to receive a CT or MRI in 2006 as they were 4 years earlier. Although opioids were administered or prescribed to two-thirds of patients, use of therapeutic agents was generally in keeping with guideline recommendations.
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Retrospective review of a prospectively collected database. ⋯ Overall major complication rates for LD, ACDF, and LSD based on the SRS M and M database are comparable to those in previously reported smaller series, supporting the validity of this database for study of other less common spinal disorders. In addition, our data provide general benchmarks of clinically evident PE and DVT rates as a basis for ongoing efforts to improve care.
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Comparative Study
Concurrent validation of the DASH and the QuickDASH in comparison to neck-specific scales in patients with neck pain.
Concurrent validity study. ⋯ Though the QuickDASH reported higher disability compared to the full DASH in this patient group, high correlation between the QuickDASH and the NDI and agreement between both versions of the DASH provide preliminary evidence that the QuickDASH can be used to measure upper extremity disability in patients with neck pain.
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Comparative Study
Demographic factors affect Scoliosis Research Society-22 performance in healthy adolescents: a comparative baseline for adolescents with idiopathic scoliosis.
Prospective analysis. ⋯ We report that male gender, dual parent household, white race and increased household income were predictive of higher SRS-22 scores in healthy adolescents without scoliosis. The impact of these factors represents a meaningful clinical difference in SRS-22 performance.
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In vitro study of genipin crosslinking effect on disc water content changes under compressive loading and unloading. ⋯ The effects of genipin crosslinking on matrix permeability and proteoglycan retention can alter hydration levels and fluid flow in the intervertebral disc. Resulting increases in fluid flow, including a doubling of flow to and from the nucleus, could lead to enhanced nutritional inflow and waste product outflow for the disc, and may have implications for emerging cell-based therapies.