Spine
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A prospective clinical trial was conducted. ⋯ Lifting of postoperative restrictions after limited discectomy allowed shortened sick leave without increased complications. Postoperative precautions in these patients may not be necessary.
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Review Case Reports
Traumatic spondylopelvic dissociation. A case report and literature review.
A case of traumatic spondylopelvic dissociation and a method of fixation are described. ⋯ The unique fracture pattern described in this patient is presented to offer better insight into management of this complex injury and to delineate it from simpler patterns of injury to the lumbosacral junction.
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Comparative Study
Comparison of lumbar sagittal alignment produced by different operative positions.
This study is a prospective evaluation of the effects of commonly used spinal tables on lumbar sagittal alignment. ⋯ When instrumentation is used to augment lumbar fusions, positions incorporating hip flexion should be avoided to ensure maintenance of sagittal plane balance.
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Comparative Study
The Maine Lumbar Spine Study, Part III. 1-year outcomes of surgical and nonsurgical management of lumbar spinal stenosis.
A prospective cohort study of patients with lumbar spinal stenosis recruited from the practices of orthopedic surgeons and neurosurgeons throughout Maine. ⋯ At a 1-year evaluation of patient-reported outcomes, patients with severe lumbar spinal stenosis who were treated surgically had greater improvement than patients treated nonsurgically. Comparisons of outcomes by treatment received must be made cautiously because of differences in baseline characteristics. A determination of whether the outcomes observed persist requires long-term follow-up.
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Cervical spine manipulation and mobilization were reviewed in an analysis of the literature from 1966 to the present. ⋯ Cervical spine manipulation and mobilization probably provide at least short-term benefits for some patients with neck pain and headaches. Although the complication rate of manipulation is small, the potential for adverse outcomes must be considered because of the possibility of permanent impairment or death.