Spine
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A retrospective chart review. ⋯ The results of this study raise several questions regarding the embryologic development of the intervertebral disc and its somite, neurologic transmission of discogenic pain, distribution of chemical inflammagens, validity of discography, technique of ESI, and technique and validity of IDET.
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This study was designed to investigate, using neurophysiologic techniques in an in vivo rat model, the effect of application of nucleus pulposus to the nerve root on the neural activity of the dorsal root ganglion and the corresponding receptive fields. ⋯ After application of nucleus pulposus to the nerve root, the dorsal root ganglion demonstrated increased excitability and mechanical hypersensitivity. These results suggest that nucleus pulposus causes excitatory changes in the dorsal root ganglion.
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Clinical Trial
Active therapy for chronic low back pain: part 3. Factors influencing self-rated disability and its change following therapy.
Cross-sectional analysis of the factors influencing self-rated disability associated with chronic low back pain and prospective study of the relationship between changes in each of these factors and in disability following active therapy. ⋯ A combination of pain, psychological and physiological factors was best able to predict baseline disability, although its decrease following therapy was determined only by reductions in pain and psychological variables. The active therapy program-in addition to improving physical function-appeared capable of modifying important psychological factors, possibly as a result of the positive experience of completing the prescribed exercises without undue harm.
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This is a comparison of primary (N = 18) to revision (N = 26) combined (anterior and posterior surgery) adult spinal deformity patients with regard to late (>6 months) complications and radiographic/functional outcomes at a minimum 2-year follow-up. ⋯ At a minimum 2-year follow-up the late complications were not higher in the revision patients than in the primary group. The rate of major long-term complications, specifically pseudarthroses, was higher in the primary group. Patient satisfaction was higher in the revision patients, probably because they were experiencing a greater level of perceived pain and dysfunction at the time of their reconstruction.