Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Mar 2011
Sagittal segmental alignment as predictor of adjacent-level degeneration after a cloward procedure.
The Cloward anterior interbody fusion is commonly performed for cervical disc herniation or spondylosis. In followup studies, various authors have noted clinically relevant adjacent-level degeneration. However, factors associated with adjacent-level degeneration are not well known. ⋯ Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Mar 2011
Percutaneous vertebroplasty relieves pain in metastatic cervical fractures.
Percutaneous vertebroplasty is currently an alternative for treating vertebral fractures of the thoracic and lumbar spine, providing both pain control and vertebral stabilization. In the cervical spine, however, percutaneous vertebroplasty is technically challenging because of the complex anatomy of this region. ⋯ Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Mar 2011
Progress report: the prevalence of required medical school instruction in musculoskeletal medicine at decade's end.
In a 2003 report, required courses in musculoskeletal medicine were found in only 65 of the 122 medical schools in the United States. Since then, national efforts to promote musculoskeletal medicine education were led by the US Bone and Joint Decade, the American Medical Association, the Association of American Medical Colleges, the American Academy of Orthopaedic Surgeons, and the National Board of Medical Examiners, among others. Whether these efforts resulted in any changes in curricula is unclear. ⋯ The prevalence of required instruction in musculoskeletal medicine is greater compared with the prevalence reported in previous studies. Musculoskeletal medicine appears to have attained a more prominent place in the curriculum at most schools.
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Clin. Orthop. Relat. Res. · Mar 2011
Case ReportsThe development and evaluation of the subaxial injury classification scoring system for cervical spine trauma.
Fractures and dislocations of the subaxial cervical spine may give rise to devastating consequences. Previous algorithms for describing cervical trauma largely depend on retrospective reconstructions of injury mechanism and utilize nonspecific terminology which thus diminish their clinical relevance add to the difficulty of educating doctors and performing prospective research. ⋯ This scheme will hopefully facilitate the development of evidence-based guidelines that may influence other aspects of the therapeutic decision-making process (eg, which operative approach is most appropriate for a particular injury). We anticipate its accuracy and reproducibility will increase over time as surgeons become more familiar with the protocol.
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Clin. Orthop. Relat. Res. · Mar 2011
Femur fractures in the pediatric population: abuse or accidental trauma?
Child abuse represents a serious threat to the health and well-being of the pediatric population. Orthopaedic specialists will often become involved when child abuse is suspected as a result of the presence of bony injury. Distinguishing abuse from accidental trauma can be difficult and is often based on clinical suspicion. ⋯ Level III, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.