Spine
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In this study, the authors analyzed the results of the release of the medial superior cluneal nerve in a prospective series of 19 patients with suspected entrapment. ⋯ Entrapment neuropathy of the medial superior cluneal nerve is a rare and easily treatable cause of unilateral low back pain.
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Comparative Study
Growth changes of solidly fused kyphotic bloc after surgery for tuberculosis. Comparison of four procedures.
A study to analyze the changes of the spinal deformity during the growth period, with regard to different operations for spinal tuberculosis in children. ⋯ Radical anterior surgery for spinal tuberculosis destroys the anterior growth and limits the capacity for spinal remodeling. Therefore, it should be avoided, if it is not absolutely necessary, for the healing of the infection or the primary correction of the tuberculous deformity.
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Appropriate application of an oncologic staging system is required to evaluate the relationship among histologic types, management, and outcome of primary bone tumors. A commonly accepted terminology for surgical procedures and for definition of tumor extent is needed for surgical planning and clinical reviews. The principles of the Enneking system for classifying stages of tumors are emphasized and applied to the spine using a practical approach for surgical staging.
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This study was designed to examine the possibility of a new spinal cord monitoring method using measurement of the refractory period to monitor spinal cord function. ⋯ The change of the responses elicited by the paired stimuli is more sensitive than those elicited by the single stimulus in the spinal cord evoked potentials. The absolute refractory periods and the recovery rate during 50% attenuation of the precompression amplitude is the critical alarm level in spinal cord monitoring.
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Clinical Trial
Prediction of success from a multidisciplinary treatment program for chronic low back pain.
The study included 90 disabled patients with chronic low back pain recruited from a pain clinic who were admitted to an 8-week program of functional restoration and behavioral support. Initial evaluations included a medical examination, rating of the physical impairment, a personal interview, a visual analogue scale to record pain intensity, an assessment of limitations for daily activities, a pain disability index, a depression and psychovegetative scale, and a scale to evaluate general living standards. The physical assessment included different flexibility measurements, measurement of power and endurance through standardized exercises, and measurements of isokinetic trunk and lifting strength and general endurance. The measurements were repeated at the end of the 8-week program and thereafter an intervals of 6 and 12 months. Final analyses were carried out on 82 patients. ⋯ This study has demonstrated that the most important variable in determining a successful treatment of chronic low back pain is the reduction of subjective feelings of disability in patients.