Spine
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A cross-sectional postal survey of 29,424 people aged 12-41 years obtained from a population-generated panel of twin individuals. ⋯ There is a definite link between smoking and low back pain that increases with the duration and frequency of the low back pain problem, but this link is unlikely to be causal.
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This prospective study consisted of mechanical stimulation of cervical nerve roots C4 to C8 in patients with cervical radicular symptoms undergoing diagnostic selective nerve root block. ⋯ The current study demonstrates a distinct difference between dynatomal and dermatomal maps.
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This study assessed the value of using lateral radiographs in evaluating the optimal screw length in transarticular C1-C2 screw fixation. ⋯ This results in this study indicate that a lateral radiograph may not be reliable in determining the optimal screw length, although it is valuable in directing accurate screw angle in the sagittal plane. Preoperative computed tomographic evaluation of the C1-C2 region may be helpful in estimating the location of the screw tip on the lateral radiograph during surgery.
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An increasing number of therapeutic spinal injections are performed each year despite little validation in randomized controlled trials. Additional injections are performed for diagnostic purposes of localizing symptomatic nerve roots, again without detailed evaluation of accuracy, specificity, or sensitivity. Drs. Slosar and White argue that selective nerve root blocks are extremely useful; Dr Wetzel believes that selective nerve root blocks have no role in selecting patients for surgery.
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In this anatomic study, the safety and accuracy of C1-C2 transarticular screw placement was tested in a normal anatomic situation in cadaver specimens using a specially designed aiming device. ⋯ This anatomic study demonstrates that C1-C2 transarticular screw fixation can be performed safely in a normal anatomic situation by surgeons who are familiar with the pertinent anatomy. The aiming device allowed safe instrumentation in all patients. In case of an irregular anatomic situation (e.g., congenital abnormalities or trauma), computed tomographic scan with sagittal reconstruction is recommended-in particular, to obtain information about the course of the vertebral artery.