Spine
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Comparative Study
The efficacy of using an image-guided Kerrison punch in performing an anterior cervical foraminotomy. An anatomic analysis.
This study comprised two parts: first, a feasibility study to determine the efficacy of using an image-guided Kerrison punch while performing a foraminotomy during an anterior cervical decompression and, second, an anatomic analysis using vector measurement to determine the distance from the entrance of the neuroforamen to the medial margin of the vertebral artery in the subaxial cervical spine. ⋯ An image-guided Kerrison punch may be used successfully when performing cervical foraminotomies during an anterior cervical discectomy, thus eliminating the risk of potential vertebral artery injury. These data confirm previous findings by other authors. Knowledge of these data may aid the spine surgeon in performing a foraminotomy during anterior cervical decompression.
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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.
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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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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.