Spine
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A retrospective population study. ⋯ The Swedish society has provided ample social benefits to allow the pregnant woman to take leave from work, without having to be labeled as "ill," because of normal conditions such as back pain during pregnancy. Instead of an expected decrease in sick leave because of back pain during pregnancy, an increase was observed.
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An international group of back pain researchers considered recommendations for standardized measures in clinical outcomes research in patients with back pain. ⋯ Standardized measurement of outcomes would facilitate scientific advances in clinical care. A short, 6-item questionnaire and a somewhat expanded, more precise battery of questionnaires can be recommended. Although many considerations support such recommendations, more data on responsiveness and the minimally important change in scores are needed for most of the instruments.
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A retrospective review of a clinical series. ⋯ Isolated stable burst fracture of the atlas can be treated effectively with a rigid cervical collar alone for 10 to 12 weeks with good neurologic recovery and segmental stability. Unstable Jefferson fractures with concurrent unstable fracture of other cervical vertebrae, especially C2, requires surgical stabilization.
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Randomized Controlled Trial Clinical Trial
Capacity of the clinical picture to characterize low back pain relieved by facet joint anesthesia. Proposed criteria to identify patients with painful facet joints.
Prospective randomized study to compare the efficacy of facet joint injection with lidocaine and facet joint injection with saline in two groups of patients with low back pain, with and without clinical criteria that were determined in a previous study to implicate the facet joint as the primary source of the pain. ⋯ A set of five clinical characteristics can be used in randomized studies to select lower back pain that will be well relieved by facet joint anesthesia. These characteristics should not, however, be considered as definite diagnostic criteria of lower back pain originating from facet joints.
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This is a retrospective revue of the long-term outcome of posterior Louis plate fixation for the treatment of irreducible or ligamentously unstable fractures of the thoracolumbar and lumbar spine with or without neurologic deficit. ⋯ Fractures of the thoracolumbar spine can be treated effectively with the semirigid Louis plating system. Because of its low cost and ease of insertion, the Louis system is an excellent choice for short arthrodesis and instrumentation of these fractures. Although there is some loss of reduction when compared with more rigid systems, there is no functional compromise in these patients.