Spine
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Comparative Study
Comparison of segmental pedicle screw instrumentation versus anterior instrumentation in adolescent idiopathic thoracolumbar and lumbar scoliosis.
A retrospective study. ⋯ Surgical correction of both the frontal and sagittal plane deformity are comparable to anterior instrumentation. Shorter lengths of surgery and hospital stay are the potential benefits of posterior surgery. Posterior segmental pedicle screw instrumentation offer significant advantages and is a viable alternative to standard anterior instrumentation in idiopathic thoracolumbar and lumbar scoliosis.
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Cadaveric biomechanical study and retrospective chart review. ⋯ Segmental fixation of burst fractures with screws at the level of the fracture offers improved biomechanical stability. Theoretically, segmental fixation provides for additional fixation points that may aid in fracture reduction and kyphosis correction. This specific parameter is not evaluated in this study but will be an important outcome measure for a planned randomized controlled trial.
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Retrospective radiographic/imaging study. ⋯ There is a close linear association between the facet fluid index and the amount of radiographic instability at L4-L5. Facet fluid on MRI should raise high suspicion of lumbar instability.
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Randomized Controlled Trial Comparative Study
Effectiveness and cost-effectiveness of three types of physiotherapy used to reduce chronic low back pain disability: a pragmatic randomized trial with economic evaluation.
Pragmatic, randomized, assessor blinded, clinical trial with economic analysis. ⋯ For chronic low back pain, all three physiotherapy regimens improved disability and other relevant health outcomes, regardless of their content. Physiotherapist-led pain management classes offer a cost-effective alternative to usual outpatient physiotherapy and are associated with less healthcare use. A more widespread adoption of physiotherapist-led pain management could result in considerable cost savings for healthcare providers.
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Comparative Study
The response of the nucleus pulposus of the lumbar intervertebral discs to functionally loaded positions.
Asymptomatic volunteers underwent magnetic resonance imaging to investigate how different positions affect lumbar intervertebral discs. ⋯ These results support for the first time the validity of clinical assumptions about disc behavior in functional positions: sitting postures may increase risk of posterior derangement, and prone and supine may be therapeutic for symptoms caused by posterior disc displacement.