Spine
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Clinical Trial
Soft and rigid collars provide similar restriction in cervical range of motion during fifteen activities of daily living.
Prospective cohort study. ⋯ Although subjects exhibited less full, active ROM of the cervical spine when immobilized in a rigid collar than when they were placed in a soft collar, the motion recorded during various functional tasks was not significantly different for nearly all of the ADLs in this study, regardless of which cervical device was applied. One potential explanation for this finding is that both collars may serve as proprioceptive guides, which allow patients to regulate their own cervical motion based on their level of comfort. Given the paucity of data supporting the use of postoperative bracing, especially after procedures which incorporate internal fixation, this study indicates that a rigid orthosis may be unnecessary in many cases because even a soft collar seems to be sufficient for restricting motion during routine activities until the normal, physiologic ROM of the cervical spine has been restored.
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Retrospective review of consecutive case series. ⋯ Thoracic transdiscal osteotomy with vertebral shortening is a safe and effective option for the treatment of infectious discitis/osteomyelitis with associated kyphosis. With adjuvant antibiotics, it effectively eradicates the infection through a posterior only approach, avoiding the need for anterior procedures and long anterior struts.
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Prospective cohort study. ⋯ Discectomy improved low back pain in patients suffering from lumbar disc herniation. Patients with or without Modic type 1 change showed a similar improvement of low back pain score. Low back pain in patients with disc herniation appears to mainly originate from disc or nerve root compression, and decompression surgery without fusion is an option for these patients, even those with Modic type 1 changes.
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Case report and review of literature. ⋯ Interlaminar CEI is thought to be a relatively safe procedure. Spinal cord injury is a documented complication of spinal anesthesia at any level of the spinal cord, even with fluoroscopic guidance, but most complications are thought to be minor and transient in nature. Syrinx formation with focal myelomalacia following spinal anesthesia has been reported in the lumbar area Pradhan et al, J Neurol Sci 2006;251:70-2, but we know of no existing reports involving the cervical region. We report this rare complication in this case report.