Spine
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Improved information on the natural history of back pain is needed to enable doctors and their patients to understand the likely course of back pain and to evaluate whether alternative interventions are preferred over self care or watchful waiting. The course of back pain is highly variable, occurring in transient, recurrent, and chronic phases. Recent longitudinal studies suggest that back pain is typically a recurrent condition and that chronic phases of back pain occur more often than previously believed. New methods of studying the course of back pain, standardized definitions of phases in the natural history of back pain, and improved outcomes data are needed to better understand the short-term and long-term course of back pain.
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A retrospective case study was performed on the single-stage posterior transvertebral closing-wedge osteotomy for treatment of adult thoracolumbar kyphosis. ⋯ This technically demanding high-risk procedure provides an effective and mechanically superior correction for acute angle thoracolumbar kyphosis in selected adult patients, with high subjective satisfaction.
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Comparative Study
Outcome of lumbar fusion in Washington State workers' compensation.
This study covered a large, population-based cohort of workers in the Washington State workers' compensation system who received lumbar fusion between August 1, 1986 and July 31, 1987 to determine work disability status, reoperation rate, and patient satisfaction. ⋯ Outcome of lumbar fusion performed on injured workers was worse than reported in published case series. Prospective studies should be conducted to determine the biologic indications that might lead to improved outcomes in this disabled population.
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The purpose of this study was to evaluate the relationship between postoperative computed tomography findings and patients' pain patterns, walking capacity, and subjective disability after laminectomy for lumbar spinal stenosis. ⋯ Postoperative computed tomography has only limited value because asymptomatic and symptomatic patients yield similar findings after surgery for lumbar spinal stenosis.