The spine journal : official journal of the North American Spine Society
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Brucellosis can affect the musculoskeletal system, and bony involvement ranges from 2% to 70% in the literature. Spinal brucellosis is generally localized to the sacroiliac region; thoracic brucellosis is rarely seen. ⋯ Early aggressive debridement and stabilization together with medical treatment, especially in the elderly and immunocompromised patients, would be the most beneficial treatment for eradication of pathology.
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Randomized Controlled Trial
Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations.
Acute back pain and sciatica are major sources of disability. Many medical interventions are available, including manipulations, with conflicting results. ⋯ Active manipulations have more effect than simulated manipulations on pain relief for acute back pain and sciatica with disc protrusion.
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Randomized Controlled Trial Comparative Study
Learning spinal manipulation: the importance of augmented feedback relating to various kinetic parameters.
Spinal manipulation is a widely accepted therapeutic approach in the treatment of back pain. In standard training programs, feedback on student performances is provided by an instructor based on teaching and clinical experience. Systematic study of the type of augmented feedback provided and skill learning is lacking in the literature. ⋯ The results of this study highlight the merits of practicing with an instrumented manikin or other instrumented training aids. Such a device can provide specific feedback on specific parameters of the task during learning; it can also serve as a tool to assess the progress of students and eliminate the risks relating to repetitive spinal manipulative therapy practice on student colleagues.
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Assessment of patients with complaints of low back or leg pain varies with the subspecialty of the treating physician. The evaluation of the spine patient may include magnetic resonance imaging (MRI), bone scan, or single-photon emission computed tomography (SPECT) imaging. The interpretation of these tests and the examiner's biases will impact the outcome of patient treatment and the cost to the health-care system. ⋯ MRI interpretation of the lumbar spine is comparable between specialties. Nuclear imaging studies (bone scan/SPECT) demonstrated a poorer correlation between examiners. The presence of MRI changes enables an accurate prediction of bone scan or SPECT scan findings. SPECT scan demonstrates an increased sensitivity in the detection of spinal abnormalities and the ability to localize a lesion when compared with planar bone scan.