Spine
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A prospective clinical study using venography to evaluate deep venous thrombosis after posterior spinal surgery. ⋯ The prevalence of deep venous thrombosis after posterior spinal surgery is higher than generally recognized. Therefore, further study is necessary to clarify the appropriate method for screening and the effect of prophylaxis against thromboembolism after spinal surgery.
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Review Randomized Controlled Trial Comparative Study Clinical Trial
The Cochrane review of bed rest for acute low back pain and sciatica.
A systematic review within the Cochrane Collaboration Back Review Group. ⋯ Bed rest compared with advice to stay active at best has no effect, and at worst may have slightly harmful effects on LBP. There is not an important difference in the effects of bed rest compared with exercises in the treatment of acute low back pain, or 7 days compared with 2-3 days of bed rest in patients with low back pain of different durations with and without radiating pain.
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The Oswestry Disability Index (ODI) has become one of the principal condition-specific outcome measures used in the management of spinal disorders. This review is based on publications using the ODI identified from the authors' personal databases, the Science Citation Index, and hand searches of Spine and current textbooks of spinal disorders. ⋯ The ODI remains a valid and vigorous measure and has been a worthwhile outcome measure. The process of using the ODI is reviewed and should be the subject of further research. The receiver operating characteristics should be explored in a population with higher self-report disabilities. The behavior of the instrument is incompletely understood, particularly in sensitivity to real change.
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Clinical Trial Controlled Clinical Trial
Training primary care physicians to give limited manual therapy for low back pain: patient outcomes.
Randomized controlled study of standard manual therapy given by 31 generalist physicians to 295 patients, in primary care practice. ⋯ Limited training in manual therapy techniques offers very modest benefit compared with high-quality (enhanced) care for acute low back pain. Outcomes may have been modified by failure of some participant physicians to undertake the required sequence of maneuvers. Intensity of manual therapy may be a factor in improving patient outcomes and needs further study.