The spine journal : official journal of the North American Spine Society
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Modic changes (MC) are bone marrow lesions on magnetic resonance imaging (MRI), suggestive of being associated with low back pain (LBP). Data on determinants of MC and their association with disc degeneration and other spinal phenotypes, as well as that of LBP, rely mostly on small-scale patient populations and remain controversial. ⋯ Based on one of the largest MRI studies to assess lumbar MC, we noted that MC were associated with both disc degeneration and the presence and severity of LBP. Determinants and association of MC with disc degeneration and clinical symptoms in the upper versus the lower lumbar spine were different. Our study further stresses the significance of MC as important imaging phenotypes associated with LBP.
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Review Meta Analysis
Symptoms of depression as a prognostic factor for low back pain: a systematic review.
It has been proposed that depression plays an important role in the course of low back pain; however, there is considerable uncertainty on its predictive value. ⋯ Although a definitive answer on the effect of depression on the course of low back pain is not available, the findings of this systematic review suggest that depression might have an adverse effect on the prognosis of low back pain. Future large studies that enroll an inception cohort and that employ a standardized method for assessing depression and low back pain are needed.
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Rapidly progressing extrinsic spinal cord compression syndromes are rare, especially when the compression is associated with the supine position. ⋯ To our knowledge, no other case of spinal protection shield in compressions caused by the supine position have been studied. The surgical and technical management therefore remains innovative.
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The anterior-only surgical procedure is used as a recommended approach in the treatment of cervical facet dislocations, but an anterior cervical spine implant that offers higher three-column instabilities for stronger fixation is lacking. ⋯ Anterior pedicle screw and plate fixation represents a safe and efficacious but technically challenging option for the treatment of cervical facet dislocations.
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Observational Study
The importance of identifying and modifying unemployment predictor variables in the evolution of a novel model of care for low back pain in the general population.
Care for low back pain (LBP) is costly, fragmented and, in non-compensation populations, rarely specifically addresses factors associated with maintaining employment status or return to work (RTW). ⋯ From a societal perspective, employment status as an outcome measure is paramount in assessing the value of a new model of care for LBP. Mitigation strategies for the predictor variables identified will be included in ISAEC pathways to translate clinical improvement into societal added value.