Spine
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A prospective observational study of a case series of patients with low back pain referred for epidural injection of corticosteroid. ⋯ Caudal epidural injection is performed ideally with fluoroscopic guidance as the gold standard for accurate drug placement. If fluoroscopic guidance is unavailable, impractical, or contraindicated, the presence of readily palpable anatomic landmarks at the sacral hiatus and the absence of palpable subcutaneous airflow over the sacrum significantly increase the operator's confidence in the likelihood of an accurate injection even before any products are administered into the epidural space.
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Comparative Study
Development of the Neck Pain and Disability Scale. Item analysis, face, and criterion-related validity.
The development and testing of a new comprehensive measure of neck pain and disability, the Neck Pain and Disability Scale. ⋯ The results suggest a highly reliable instrument for evaluating neck pain with at least four underlying dimensions. Further work to address the predictive validity of this new tool are under way.
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Comparative Study Clinical Trial Controlled Clinical Trial
The effect of lumbar fatigue on the ability to sense a change in lumbar position. A controlled study.
A cross-sectional study in patients with recurrent/chronic low back trouble and healthy control subjects. ⋯ Lumbar fatigue impairs the ability to sense a change in lumbar position. This feature was found in patients and control subjects, but patients with low back trouble had poorer ability to sense a change in lumbar position than control subjects even when they were not fatigued. There seems to be a period after a fatiguing task during which the available information on lumbar position and its changes is inaccurate.
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Case Reports Comparative Study
Recapping T-saw laminoplasty for spinal cord tumors.
A prospective study of patients whose spinal cord tumors were managed surgically with a unique posterior method of removing and replacing the posterior spinal elements using T-saw ("recapping T-saw laminoplasty"). ⋯ Recapping laminoplasty afforded anatomic reconstruction of the vertebral arch after excision of spinal cord tumors. This procedure appears to warrant further evaluation as an alternative to wide laminectomies for exposure of intraspinal tumors.
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Randomized Controlled Trial Comparative Study Clinical Trial
Recurrent low back pain and early disc degeneration in the young.
A prospective 9-year follow-up study involving randomized matched subgroups of 15-year-old schoolchildren with or without low back pain at baseline. ⋯ The authors' earlier findings already favored the hypothesis of a causal relation between the early evolution of a degenerative process of lower lumbar discs and recurrent low back pain in the near future. The current results further strengthen this hypothesis, indicating that individuals with disc degeneration soon after the phase of rapid physical growth not only have an increased risk of recurrent low back pain at this age, but also a long-term risk of recurrent pain up to early adulthood.