Spine
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The authors hypothesized that the source of coccygodynia was a lesion of the coccygeal disc. ⋯ Common coccygeal pain could come from the coccygeal disc in approximately 70% of cases.
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Three-dimensional reconstructions of MRI scans measured volume, height, and diameter of intervertebral discs. These measurements were made in vivo. ⋯ The mean simulated diurnal volume decrease in the lower three lumbar discs is 16.2%. Most of the diurnal loss in disc height is due to volume loss. The effect of radial bulging is minimal.
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A prospective cross-sectional analytic approach was taken. ⋯ In patients with chronic low back pain, the combination of discogenic pain and zygapophyseal joint pain is uncommon.
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We measured the cross-sectional area of the intervertebral discs of normal volunteers after an overnight rest; before, during, and after 5 or 17 weeks of bed rest; and before and after 8 days of weightlessness. ⋯ Significant adaptive changes in the intervertebral discs can be expected during weightlessness. These changes, which are rapidly reversible after short-duration flights, may be an important factor during and after long-duration missions.
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Randomized Controlled Trial Clinical Trial
The functional restoration approach to the treatment of chronic pain in patients with soft tissue and back injuries.
A prospective randomized study of 542 injured workers with continuing pain compared 271 workers who were treated at either one of two clinics that provided functional restoration with a control group of 271 subjects. Chronic pain was caused by low back injury in 78% of patients; 79% of those treated were at work 12 months after completion of treatment compared with 78% of the control subjects. When the patients were divided into subsets, based on the accident date and followed monthly, the duration of absence from work, the compensation costs, the disability award costs, and the total costs were less for those treated than the control subjects, but these were not statistically significant. Using the difference in total costs as a measure of relative success, back injuries had better results than other injuries in this study.