Spine
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Trunk muscle strength and the effect of trunk muscle exercises on chronic low back pain were investigated in patients with chronic low back pain. ⋯ This difference in flexor/extensor ratio may have been due to reduced extensor strength resulting from neurogenic muscle weakness induced by the organic lumbar lesions in group 1. The exercise-associated increase in trunk muscle strength did not completely eliminate the low back pain induced by the organic lumbar lesions in group 1. However, increasing trunk muscle strength was extremely effective in patients of Group 2, in which decreased trunk muscle strength was a major factor in chronic low back pain.
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Babinski's sign probably is the best known neurologic eponym, referring to dorsiflexion of the great toe with or without fanning of the other toes and withdrawal of the leg. This follows plantar stimulation in patients with pyramidal tract dysfunction. Although the plantar reflex already had been described, Babinski--a French neurologist of Polish descent and a pupil of Charcot--was the first to differentiate between a normal and pathologic response of the toes and recognize its clinical implication. Despite the continuing controversy over its pathophysiologic interpretation, the clinical utility of Babinski's sign remains unchanged almost 100 years after its description.
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The authors encountered a unique case of nerve root herniation 9 days after multiple lumbar partial hemilaminectomies with discectomy were performed for lumbar canal stenosis combined with lumbar disc hernia. ⋯ This herniation resulted from an unrepaired minor dural laceration. The arachnoid membrane was intact during the first operation. Even a small tear in the spinal dura requires surgical closure to prevent herniation and entrapment of a nerve root. It is necessary to repair even small dural lacerations with no spinal fluid leakage during spinal surgery.