Spine
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Review Case Reports
Nail gun injury to the sacrum: case report and review of the literature.
Case report. ⋯ On the basis of our experience and a review of the literature, in terms of treating a nail gun injury to the sacrum we recommend the following: exploration in the operating room to investigate the possibility of a dural tear, thorough irrigation, and debridement, especially in the case of barbed nails, and consultation with general surgery to determine if there is any injury to intrapelvic contents before surgery. An infectious disease consultation postoperatively may also assist in proper selection and duration of antibiotic therapy.
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Literature review. ⋯ Current evidence from structural MRI based studies demonstrates the widespread presence of fatty infiltrates in neck muscles of patients with chronic whiplash. Such findings have not shown to feature in patients with chronic insidious onset neck pain, suggesting traumatic factors play a role in their development. Recent studies have revealed that muscle fatty infiltrates manifest soon after whiplash but only in those with higher pain and disability and symptoms of post-traumatic stress disorder. The possibility that such muscle changes are associated with a more severe injury including poor functional recovery remains the focus of current research efforts.
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Review
Does knowledge of predictors of recovery and nonrecovery assist outcomes after whiplash injury?
Nonsystematic review. ⋯ The understanding of factors predictive of poor recovery after whiplash injury is evolving. Although more research is required to validate predictive models, some factors show consistent predictive capacity and could be used in clinical practice as potential indicators of poor recovery. It is not known if the specific targeting of modifiable prognostic indicators can be achieved or will lead to improved outcomes.
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Nonsystematic review and discussion of the etiological processes involved in whiplash-associated disorders (WAD). ⋯ Research to date indicates that there are several physiological and psychological etiological processes that may underlie the initiation and maintenance of whiplash-related pain and disability. Further research is required to determine relationships and interactions between these factors and to determine whether their modification is possible and will improve outcomes after injury.
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Nonsystematic review and discussion of prognosis after whiplash injury. ⋯ The current evidence is not sufficiently robust to be able to confidently predict outcome after whiplash injury. A preliminary set of consistent factors has been proposed to assist clinicians in identifying individuals at risk of poor recovery. Directions for the development of improved prognostic models are discussed.