Spine
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The outcome of a herniated disc in patients with cervical myelopathy treated by laminoplasty without discectomy and in those treated conservatively was studied by magnetic resonance imaging. ⋯ The size of the herniated disc in cervical lesions regressed as it does in the lumbar lesions. Laminoplasty for patients with narrowed spinal canals showed favorable surgical results. Therefore, the therapeutic method for cervical disc herniation should be chosen after taking the natural history of the disc herniation into consideration.
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A prospective study was conducted in 37 patients with cervical spondylosis with incomplete cord injury to assess the role of decompression in these patients. ⋯ Although neurologic improvement after an incomplete spinal cord injury when no bony lesion was present was slow during the first few months after trauma, more than 60% of the patients showed neurologic recovery with a muscle grade higher than 3 at 2-year follow-up. Surgical decompression, however, was associated with immediate neurologic improvement, faster recovery of neurologic function, early mobilization, better long-term neurologic outcome, briefer hospital stays, and fewer complications related to long confinements in bed than was nonoperative treatment.
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The psychometric properties and clinical use of a battery of physical performance measures were tested on 44 patients with low back pain and 48 healthy, pain-free control subjects. ⋯ The results provide support for the use of these physical performance measures as a complement to patient self-report.
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Twenty-five patients with a pseudarthrosis after previous spinal fusion surgery were reviewed after a circumferential fusion was performed. ⋯ A fusion rate of 100% was noted in the face of factors often placing patients at high risk for developing a pseudarthrosis, namely multiple levels of previous spinal surgery, including previous pseudarthrosis, and a habit of heavy smoking. Complications were few. However, the satisfactory outcome rate was only somewhat better than 50%, based on a lack of substantial pain improvement and return to work.
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Randomized Controlled Trial Clinical Trial
Early active training after lumbar discectomy. A prospective, randomized, and controlled study.
A prospective, randomized, and controlled study was conducted. ⋯ Patients rehabilitated according to the early active training program had a better short-term outcome of objective values. At 2 years' follow-up, more patients were satisfied with the result of the operation. The early active treatment program is recommended.