Spine
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Cadaver dissection and case reports were used to describe a novel technique of lumbar interbody arthrodesis that accesses the intervertebral disc through a posterolateral intertransverse process approach. ⋯ This preliminary report suggests that lumbar interbody arthrodesis can be accomplished with a posterolateral intertransverse process approach. To the authors' knowledge, this is the first published report describing this approach for performing an interbody arthrodesis. The intertransverse lumbar interbody fusion (ILIF) approach avoids the need for either intraabdominal dissection or violation of the spinal canal-neural foramen in accessing the disc. This technique may therefore present an opportunity to accomplish a minimally invasive approach to lumbar fusion.
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A cross-sectional study design was used. ⋯ The Spurling test is not very sensitive, but it is specific for cervical radiculopathy diagnosed by electromyography. Therefore, it is not useful as a screening test, but it is clinically useful in helping to confirm a cervical radiculopathy.
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Comparative Study
Validity of the active straight leg raise test for measuring disease severity in patients with posterior pelvic pain after pregnancy.
A cross-sectional analysis was performed with a group of women meeting strict criteria for posterior pelvic pain after pregnancy. The active straight leg raise test and common severity measurement scales of lumbopelvic pain were scored. ⋯ The active straight leg raise test can be recommended as a disease severity scale for patients with posterior pelvic pain after pregnancy.
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Comparative Study
Comparison of outcomes for unstable lower cervical flexion teardrop fractures managed with halo thoracic vest versus anterior corpectomy and plating.
A retrospective cohort study with cross-sectional outcome analysis was conducted. ⋯ The results of this study indicate that anterior cervical plating is a safe and effective treatment for cervical teardrop fractures, and that it is superior to the halo thoracic vest for restoring and maintaining sagittal alignment and for minimizing treatment failures. There does not appear to be a relation between residual kyphosis and health-related quality-of-life outcomes. Although this raises questions about the relevance of restoring sagittal alignment in the treatment and outcome of cervical flexion teardrop fractures, the study was underpowered for secondary outcomes. Therefore, the secondary outcome results must be interpreted with caution.
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A retrospective follow-up study of adolescent idiopathic scoliosis after Harrington instrumentation and spondylodesis was conducted. ⋯ In patients with adolescent idiopathic scoliosis who undergo surgery with Harrington instrumentation, the overall long-term clinical outcome does not correlate with the radiologic outcome. However, a significant inverse correlation was found between the magnitude of the primary thoracic curve at follow-up assessment and the scores for questions on cosmetic matters in the Scoliosis Research Society questionnaire. Spine mobility is diminished as a result of spondylodesis, but the patients perform, on the average, as well as the normal population in nondynamometric trunk strength measurements.