Spine
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Comparative Study
The association between clinical findings on physical examination and self-reported severity in back pain. Results of a population-based study.
A cross-sectional population-based study of back pain. ⋯ Assessment of severity in back pain can only partly be based on the clinical findings of a physical examination. There is a relatively weak agreement between the results of physical examination and the subjective reporting of pain and disability.
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Case Reports
Total en bloc spondylectomy. A new surgical technique for primary malignant vertebral tumors.
The study of seven patients with primary malignant or benign aggressive tumors who underwent a new aggressive surgical technique termed "total en bloc spondylectomy" is reported. ⋯ The advantages of total en bloc spondylectomy include resection of the involved vertebra(e) in two major blocs, rather than in a piecemeal pattern, and completion of the procedure during one surgical session posteriorly. The "total en bloc spondylectomy" offers one of the most aggressive modes of therapy for primary spinal malignancy.
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Eighty-one patients who were receiving workers' compensation and who met structured inclusion criteria for low back pain and disability underwent 360 degrees lumbar fusion with decompression and were compared to 16 similar patients who did not receive the surgery because of administrative reasons outside the authors' control. Patients completed standardized questionnaires to assess their level of functioning before surgery and every 6 months after surgery for 24 months or more. ⋯ Circumferential (360 degrees) lumbar fusion can be a highly effective method of reducing pain and disability in patients receiving workers' compensation.