Spine
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In a prospective, single-blinded study, the incidence of false-positive screening tests for sacroiliac joint dysfunction was investigated using the standing flexion, seated flexion, and Gillet tests in 101 asymptomatic subjects. ⋯ This study suggests that asymmetry in sacroiliac motion due to relative hypomobility as determined by these tests can occur in asymptomatic joints. Obviously, one should not rely solely on these tests to diagnose symptomatic sacroiliac dysfunction.
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Five asymptomatic subjects underwent provocative injections of the lateral atlanto-axial and atlanto-occipital joints. ⋯ This study confirms the nociceptive ability of these cervical synovial joints. This study may assist the clinician in the differential diagnosis of head and neck pain.
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Comparative Study
Successful treatment of low back pain and neck pain after a motor vehicle accident despite litigation.
This prospective study evaluated 39 consecutive patients with low back pain (LBP) or neck pain that resulted from a motor vehicle accident who had litigation pending. ⋯ Patients with low back pain or neck pain resulting from a motor vehicle accident showed a statistically significant improvement with treatment despite ongoing litigation.
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The first clinical implementation of a microsurgical endoscopic technique for removal of thoracic disc herniation is described. ⋯ The microsurgical endoscopic technique allows spinal cord decompression with a substantial reduction in surgical trauma. It may shorten bed confinement and allow early return to active life. Application of this technique in other areas is being studied.
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The applicability of using video assisted thoracoscopic surgery (VATS) to resect thoracic discs was investigated. A laboratory study was conducted using two human cadavers and three live pigs as surgical specimens. A total of nine thoracic levels were decompressed. ⋯ VATS provides a useful means of performing thoracic discectomies using a small thoracotomy incision. The decrease in invasiveness provided by this new technology may reduce operative morbidity, hospitalization time, and costs. More work is needed, especially in the design of instrumentation, before this becomes a viable alternative to current surgical procedures.