Spine
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Clinical Trial
Magnetic resonance imaging analysis of lumbar disc changes below scoliosis fusions. A prospective study.
The authors of this prospective study examined the preoperative and 3-year postoperative magnetic resonance images of 14 patients undergoing anterior and posterior fusion and/or posterior fusion only for scoliosis. All magnetic resonance images were ready by two independent neuroradiologists, who were blinded to the purposes of the study, for the presence of disc narrowing, signal decrease on T2, or herniated nucleus pulposus before and after surgery. Particular attention was paid to the disc changes at the level directly below the end vertebral level of the fusion and two levels below the fusion in the lumbosacral spine existing before surgical intervention. ⋯ If these results are corroborated in a larger sample size, surgeons who manage deformity may have to consider altering fusion levels at the time of fusion based on magnetic resonance imaging predictors. The present data may help to inform patients about the risk of developing junctional degenerative changes and potential symptoms from these changes below scoliosis fusions.
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A retrospective study of 44 museum cases of spinal osteoid osteoma or osteoblastoma and a meta-analysis using 421 additional cases from a review of the literature. ⋯ The findings support the concept that scoliosis is secondary to asymmetric muscle spasm in patients with spinal osteoid osteoma or osteoblastoma.
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Randomized Controlled Trial Clinical Trial
Acute treatment of whiplash neck sprain injuries. A randomized trial of treatment during the first 14 days after a car accident.
A single-blinded, randomized treatment study with a follow-up period of 6 months. ⋯ The outcome was better for patients who were encouraged to continue engaging in their normal, pre-injury activities as usual than for patients who took sick leave from work and who were immobilized during the first 14 days after the neck sprain injury.
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Randomized Controlled Trial Clinical Trial
Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis.
A randomized, controlled trial, test--retest design, with a 3-, 6-, and 30-month postal questionnaire follow-up. ⋯ A "specific exercise" treatment approach appears more effective than other commonly prescribed conservative treatment programs in patients with chronically symptomatic spondylolysis or spondylolisthesis.
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In patients with sciatica or neurogenic claudication, the structures in and adjacent to the lumbar spinal canal were observed by computed tomographic myelography or magnetic resonance imaging in psoas-relaxed position and during axial compression in slight extension of the lumbar spine. ⋯ Axial loading of the lumbar spine in computed tomographic scanning and magnetic resonance imaging is recommended in patients with sciatica or neurogenic claudication when the dural sac cross-sectional area at any disc location is below 130 mm2 in conventional psoas-relaxed position and when there is a suspected narrowing of the dural sac or the nerve roots, especially in the ventrolateral part of the spinal canal in psoas-relaxed position. The diagnostic specificity of the spinal stenosis will increase considerably when the patient is subjected to an axial load.