Spine
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Comparative Study
Guidelines on low back pain disability: interprofessional comparison of use between general practitioners, occupational therapists, and physiotherapists.
Individual semistructured qualitative interviews. ⋯ To address identified barriers, a process of care is proposed by fitting tasks to the most compatible providers. The task of GPs could focus on pain management through medication, red flag screening, encouragement to stay active, and reassurance. The tasks of PTs could center on pain management, general exercise, and encouragement to stay active. The tasks of OTs could focus on disability prognosis, yellow flags management, and return to activity parameters. The efficacy of this process of care to prevent persistent LBP disability should be assessed in a trial.
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Prospective, longitudinal cohort (nonrandomized). ⋯ Our results suggest that Th alone, DVBD alone, or both Th and DVBD provide equivalent inclinometer results in patients with mild preoperative rib prominences (≤ 9°), but higher SRS-22 self-image scores are achieved using both Th and DVBD. For larger rib prominences, better inclinometer readings are achieved with Th, although SRS-22 self-image scores are comparable.
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Case Reports
Cervical neurofibromatosis with tetraplegia: management by cervical suspensory traction.
A case report. ⋯ Cervical suspensory traction is a viable and safe adjunct technique for applying gradual and sustained effort to maximize postoperative correction in the treatment of NF-1 patients with severely rigid and large curves. This report should contribute to expanding the alternative method for the staged treatment strategy to complex abnormalities.
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Prospective longitudinal study. ⋯ The recovery of the lumbar intervertebral discs after 60-day bed rest is a prolonged process and incomplete within 2 years.
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Case Reports
Epidural hematoma and intraoperative hemorrhage in a spine trauma patient on Pradaxa (dabigatran).
The authors present a case report of a 72-year-old man who presented with back pain and lower extremity weakness after a fall from his roof. ⋯ As dabigatran (Pradaxa) has recently been approved by the Food and Drug Administration, many spine specialists are not familiar with this agent. Many of the reversal agents (e.g., vitamin K and protamine), useful for other classes of anticoagulants, have no impact on Pradaxa. Similarly, prothrombin time and partial thromboplastin times have limited utility in estimating the patient's true clotting status. The purpose of this case report is to alert spine specialists to this drug and its implications on spine care. The drug's pharmacokinetics, clinical assessment of clotting status, and reversal options are discussed.