Spine
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Prospective magnetic resonance imaging (MRI) study of patients low back pain (LBP) requiring discography as part of their routine clinical diagnoses and asymptomatic age-matched volunteers. ⋯ T1ρ and OP are quantitative measures of degeneration that are consistent across both control subjects and LBP patients. A significant and strong correlation exists between T1ρ values and in vivo OP measurements obtained by discography in LBP patients.
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Narrative review of the literature and commentary. ⋯ The current evidence suggests that too much health care too early after the injury is associated with delayed recovery. Clinicians need to be educated about the risk of iatrogenic disability.
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Review
Considerations in the physical rehabilitation of patients with whiplash-associated disorders.
Review of research identifying physical impairments in the neuromuscular system in subjects with whiplash-associated disorders. ⋯ Pain and injury result in reorganization of the motor control strategies of neck muscles and movement. Further research is required to determine if outcomes after a whiplash injury can be improved by using research informed, individually prescribed exercise programs matched to the individual's presentation. Research into best methods of pain management is also required to facilitate physical rehabilitation.
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Narrative review. ⋯ The fact that multiple lines of evidence, using independent techniques, consistently implicate the cervical zygapophysial joints as a site of injury and source of pain, strongly implicates injury to these joints as a common basis for chronic neck pain after whiplash.
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Comparative Study
A comparison of three types of postoperative pain control after posterior lumbar spinal surgery.
Retrospective, nonrandomized, comparative study. ⋯ A single low-dose epidural MMCHS is effective for postoperative pain control and minimizes the occurrence of PONV after posterior lumbar spinal surgery.