Spine
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The possibility to prevent nucleus pulposus-induced functional and structural nerve root injury by selective tumor necrosis factor-alpha inhibition was assessed in an experimental model in the pig spine. ⋯ The data clearly indicate that tumor necrosis factor-alpha is involved in the basic pathophysiologic events leading to nerve root structural and functional changes after local application of nucleus pulposus. The study therefore provides a basic scientific platform with potential clinical implications regarding the use of anti-tumor necrosis factor-alpha medication as treatment in patients with disc herniation and sciatica.
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An experimental study to clarify the effects of pentoxifylline, as an anti-tumor necrosis factor-alpha therapy on endoneurial fluid pressure in the dorsal root ganglion using an animal model of herniated nucleus pulposus. ⋯ Pentoxifylline, an anti-tumor necrosis factor-alpha drug, prevented the dorsal root ganglion compartment syndrome caused by topical application of nucleus pulposus. Anti-inflammatory cytokine therapy may become an effective treatment of sciatica due to disc herniation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Active therapy for chronic low back pain part 1. Effects on back muscle activation, fatigability, and strength.
Randomized prospective study of the effects of three types of active therapy on back muscle function in chronic low back pain patients. ⋯ Significant changes in muscle performance were observed in all three active therapy groups post-therapy, which appeared to be mainly due to changes in neural activation of the lumbar muscles and psychological changes concerning, for example, motivation or pain tolerance.
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Randomized Controlled Trial Clinical Trial
Active therapy for chronic low back pain: part 2. Effects on paraspinal muscle cross-sectional area, fiber type size, and distribution.
Randomized prospective study to compare the effects of three types of active therapy on the back muscle structure of chronic low back pain patients. ⋯ Three months active therapy is not sufficient to reverse the typical "glycolytic" profile of the muscles of cLBP patients or to effect major changes in backmuscle size. The alterations in muscle performance observed (increased strength and endurance; Part 1) werenot explainable on the basis of structural changes within the muscle.
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Retrospective review of patients who underwent lumbar juxtafacet cyst resection with questionnaire follow-up. ⋯ Juxtafacet cysts are an uncommon cause of radiculopathy. Surgical resection is the treatment of choice with low rates of complications, recurrences, and residual complaints.