Spine
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This study describes recent United States trends and regional variations in the management of low back pain. ⋯ Rapidly increasing surgical rates and wide geographic variations suggest the need for a more consistent approach to back problems.
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Patients with intradural herniation of an intervertebral disc were identified and managed surgically. ⋯ This entity should be suspected when a calcified disc within the spinal canal is being treated. The optimal exposure is a posterolateral extracavitary costotransversectomy with a hemilaminotomy. Alternative approaches to a typical thoracic disc would be problematic in managing these patients.
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In a prospective, single-blinded study, the incidence of false-positive screening tests for sacroiliac joint dysfunction was investigated using the standing flexion, seated flexion, and Gillet tests in 101 asymptomatic subjects. ⋯ This study suggests that asymmetry in sacroiliac motion due to relative hypomobility as determined by these tests can occur in asymptomatic joints. Obviously, one should not rely solely on these tests to diagnose symptomatic sacroiliac dysfunction.
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Review Case Reports
Postoperative toxic shock syndrome after lumbar laminectomy in a male patient.
Postoperative toxic shock syndrome in a male patient who underwent a lumbar laminectomy has not been reported. This case report identifies a rare, and potentially fatal, postoperative complication. ⋯ Spine surgeons should consider postoperative toxic shock syndrome as a diagnosis in a patient with fever, gastrointestinal symptoms, and hypotension in the presence of a benign-appearing lumbar laminectomy wound.
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This study is a prospective cross-sectional analytic study. ⋯ The zygapophysial joint is an important source of pain but the existence of a "facet syndrome" must be questioned.