Spine
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This prospective study evaluated the diagnostic utility of historically accepted sacroiliac joint tests. A multidisciplinary expert panel recommended 12 of the "best" sacroiliac joint tests to be evaluated against a criterion standard of unequivocal gain relief after an intra-articular injection of local anesthetic into the sacroiliac joint. ⋯ Sacroiliac joint pain is resistant to identification by the historical and physical examination data from tests evaluated in this study.
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The effect on spine height changes from different combinations of time and angle of static prone hyperextension, and one intervention of dynamic hyperextension was explored. ⋯ The results indicate that hyperextension can be a beneficial maneuver to unload temporarily the spine after loading and to rehydrate the discs, providing enough time is given for the procedure. The optimal time and angle combination was 20 degrees for 20 minutes because this intervention resulted in the largest recovery that lasted for a relatively long period of time.
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A prospective study of psychological risk factors for first-time low back pain with repeated use of psychological questionnaires. ⋯ The scores from the Modified Somatic Perception Questionnaire and Zung questionnaire were reproducible over 18 months and were affected little by first episodes of back pain; yet these scores were significant predictors of it. "Abnormal" scores from these questionnaires precede back pain in a small number of people.
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The contribution of transversus abdominis to spinal stabilization was evaluated indirectly in people with and without low back pain using an experimental model identifying the coordination of trunk muscles in response to a disturbances to the spine produced by arm movement. ⋯ The delayed onset of contraction of transversus abdominis indicates a deficit of motor control and is hypothesized to result in inefficient muscular stabilization of the spine.
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The authors undertook a three-part study to better understand the impact of perioperative nutritional status on postoperative complications in patients undergoing spinal surgery. In preliminary Parts I and II, the authors targeted two groups of patients who are particularly nutritionally challenged. In Part III, they studied a large group of consecutive patients undergoing routine lumbar spinal fusion. ⋯ The prevalence data in our study population suggest that a large number (25%) of patients undergoing elective lumbar spine surgery are nourished inadequately at surgery. This number is higher (42%) in older patients. The authors recommend that close attention be paid to the perioperative nutritional status of patients undergoing lumbar spinal surgery. Patients with suboptimal nutritional parameters should be supplemented and replenished before elective surgery.