The spine journal : official journal of the North American Spine Society
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The association of low back pain, neuromuscular imbalance, and trunk extension strength in athletes.
Imbalanced patterns of erector spinae activity and reduced trunk extension strength have been observed among patients with low back pain (LBP). The association between LBP and neuromuscular imbalance still remains unclear. ⋯ A direct relationship between LBP and neuromuscular imbalance was documented in athletes with LBP. Maximum isometric trunk extension strength had no relationship to the presence of LBP or the occurrence of neuromuscular imbalance of erector spinae. Common clinical testing of spinal mobility and muscular flexibility had only limited correlation to LBP and neuromuscular imbalance.
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Using biochemical, histological, and radiological parameters in a rabbit model of intervertebral disc (IVD) degeneration, the intradiscal injection of a growth factor, such as osteogenic protein-1 (OP-1), has been shown to regenerate the IVD. However, very little is known about how such a biological therapeutic approach affects the biomechanical properties of the degenerated IVD. ⋯ We have shown for the first time that an injection of the growth factor, OP-1, restored the biomechanical properties of IVDs in a rabbit model of IVD degeneration. Comparing biomechanical with biochemical data suggests that the OP-1-induced biomechanical restoration was a consequence of increased activities of anabolic pathways that resulted in biochemical changes in the IVD.
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Randomized Controlled Trial Comparative Study
Lumbar microdiscectomy under epidural anesthesia: a comparison study.
Lumbar microdiscectomy is most commonly performed under general anesthesia, which can be associated with several perioperative morbidities including nausea, vomiting, atelectasis, pulmonary aspiration, and prolonged post-anesthesia recovery. It is possible that fewer complications may occur if the procedure is performed under epidural anesthesia. ⋯ Epidural anesthesia as an alternative to general anesthesia has shown less postoperative nausea and vomiting in lumbar microdiscectomy. Nevertheless, given the small number of patients, this study should be considered as preliminary, showing small differences in minor potential complications.
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Randomized Controlled Trial
Validity of the new Backache Index (BAI) in patients with low back pain.
The Backache Index (BAI) is applied to patients with low back pain (LBP) in order to help therapists, doctors, and surgeons perform physical examinations easily. It is carried out within a short space of time (<2 min) without using inclinometric instruments. ⋯ The BAI appears to be a reliable and valid assessment of overall restricted spinal movements in case of LBP and discriminates between successful and unsuccessful treatment outcome.
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To our knowledge, the presence of noncontiguous fracture-dislocation of the lumbosacral spine occurring at two levels has not been reported. The etiology, evaluation, and treatment of the unusual injury is presented. ⋯ Noncontiguous double fracture-dislocation of the lumbosacral spine is an unusual injury, which results from a very high-energy trauma. Prompt recognition of the injuries, reduction of the fracture-dislocations, and posterior stabilization is recommended for neural decompression, spinal alignment, and long-term stabilization.