Spine
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Experimental investigation of the electrical conductivity of normal and trypsin-treated lumbar anulus fibrosis specimens. ⋯ Measured electrical conductivity was sensitive to tissue porosity, but not to fixed charged density for anulus fibrosis specimens in phosphate-buffered saline.
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Comparative Study
The feasibility of anterior thoracoscopic spine surgery in children under 30 kilograms.
A retrospective comparison of pediatric patients weighing less than 30 kg who underwent thoracoscopic anterior spinal release and fusion for deformity correction. This group was compared to two control groups: patients weighing over 30 kg (thoracoscopic) and patients under 30 kg (open). ⋯ Despite the decreased working space within the chest and difficulties of selective intubation, anterior thoracoscopic surgery for spinal release and fusion can be performed as safely in "small" children as in "large" children; however, additional intraoperative challenges should be anticipated. Although the outcomes were similar in the small thoracoscopic children compared to the small open children, the authors believe that very small patients (under 20 kg) should remain a relative contraindication to thoracoscopic surgery, especially during a surgeon's learning curve.
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Review Case Reports
Hysterical paralysis: a report of three cases and a review of the literature.
Three cases of hysterical paralysis are reported and the literature is reviewed. ⋯ Hysterical paraplegia is a type of conversion disorder. It is a diagnosis of exclusion that typically presents as mono-, hemi-, para-, or quadriplegia. The pursuit of a diagnosis for the hysterical paraplegic patient necessarily consumes valuable resources and time. The typical patient is a female from a low socioeconomic background with limited education. The DSM-IV-TR criteria must be met to fulfill the diagnosis of conversion disorder. Electrodiagnostic and imaging studies can aid in the diagnosis. Treatment revolves around explaining the normal diagnostic results to the patients and guiding them to appropriate psychiatric and physiotherapy. Rapid recovery should be expected, but can take up to 6 months.
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Case Reports Clinical Trial
Spinal wedge osteotomy by a single posterior approach for correction of severe and rigid kyphosis or kyphoscoliosis.
Seven patients with severe angular kyphotic deformity of the spine were treated by circumferential spinal wedge osteotomy using a single posterior approach. ⋯ Spinal wedge osteotomy by the single posterior approach is a reliable and safe surgical technique for correcting severe rigid angular kyphosis or kyphoscoliosis.
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized trial of medical care with and without physical therapy and chiropractic care with and without physical modalities for patients with low back pain: 6-month follow-up outcomes from the UCLA low back pain study.
A randomized clinical trial. ⋯ After 6 months of follow-up, chiropractic care and medical care for low back pain were comparable in their effectiveness. Physical therapy may be marginally more effective than medical care alone for reducing disability in some patients, but the possible benefit is small.