Spine
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A prevalence and reliability study of Modic changes (MCs) in the cervical spine. ⋯ A high prevalence of MCs was observed with type 2 predominating. The C5/6 and C6/7 levels are most effected. Patients with MC are more likely to have a DH at the same level. MC type 2 predominates. The classification is reliable.
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Clinical study correlating preoperative pulmonary function tests (PFTs) to radiographic measures of thoracic deformity severity in adolescent idiopathic scoliosis (AIS) patients. ⋯ Preoperative PFTs are clinically impaired in 19% of AIS patients, and correlate significantly with the MT and sagittal plane deformity severity, and with PT curve severity to a lesser degree. PFTs do not correlate with degree of axial deformity. From a purely pulmonary standpoint, attention directed to coronal and sagittal plane deformity correction appears warranted, to address the specific deformities which are associated with PFT impairment.
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Retrospective study. ⋯ In Lenke 1A type scoliosis, the selection of LIV is highly correlated with the presence of adding-on; incidence increases dramatically when the preoperative LIV+1 deviation from CSVL is more than 10 mm. Choosing DV (the first vertebra in cephalad direction from sacrum with deviation from CSVL of more than 10 mm) as LIV may provide the best outcome as it not only prevents adding-on but also conserves more lumbar motion.
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Vertebral growth plates at different postnatal ages were assessed for active intercellular signaling pathways. ⋯ During growth and differentiation of the vertebral growth plate, its different components respond at different times to different intercellular signaling ligands. Response to most of these signals is dramatically downregulated at the end of vertebral growth.
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Review Meta Analysis
Spinal manipulative therapy for chronic low-back pain: an update of a Cochrane review.
Systematic review of interventions. ⋯ High-quality evidence suggests that there is no clinically relevant difference between SMT and other interventions for reducing pain and improving function in patients with chronic low-back pain. Determining cost-effectiveness of care has high priority.