Spine
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An anatomic study was performed to investigate the ligamentum flavum of the human lumbar spine. ⋯ There is an inferoventral slip of the ligamentum flavum that attaches to the anterosuperior surface of the caudal lamina. This slip is the inferior portion of the deep ligamentum flavum. When the ligamentum flavum's superficial layer is selectively released, the inferoventral slip of the ligamentum flavum's deep layer remains attached to the anterosuperior surface of the caudal lamina and remains between the surgeon and the dura.
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A 5-year longitudinal interview and questionnaire-based survey of back pain in adolescents. ⋯ Back pain in adolescents is common; it increases with age and is recurrent, but in general does not deteriorate with time. Much of the symptomatology may be considered a normal life experience, probably unrelated to adult disabling trouble.
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Using magnetic resonance imaging, this study analyzed the anatomic characteristics of the iliolumbar ligament insertion on humans. ⋯ The minor width of the area of insertion on the iliac crest of the posterior band (and therefore its lower resistance with the mechanical overloads) could explain the frequency of the painful syndromes related, by some authors, to an enthesopathy of this ligament.
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Case Reports
Cyclic sciatica. A manifestation of compression of the sciatic nerve by endometriosis. A case report.
A case of cyclic sciatica secondary to ovarian cyst endometriosis is presented. ⋯ Magnetic resonance imaging may permit a specific diagnosis of this unusual cause of sciatica by showing a hemorrhagic mass in the region of the sciatic nerve. Early recognition is necessary to prevent permanent damage to the sciatic nerve.
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The Americans with Disabilities Act provides protection for equal access to services and employment opportunities for qualified persons with disabilities. Because hospital privileges are essential to physician practice, this article investigates the role of the Americans With Disabilities Act in acquiring and maintaining these privileges. Recent findings from the Act's case law support the concept that: 1) an employer employee relationship exists between the hospital and the non-staff physician for purposes of the Act's analysis, and thus, 2) the Act is applicable to questions of hospital privileges for non-staff physicians. Suggestions for ensuring patient welfare while maintaining compliance with the Act are discussed.