Spine
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Randomized Controlled Trial Comparative Study Clinical Trial
Cost-effectiveness of lumbar spine radiography in primary care patients with low back pain.
Fifty-two practices in the East Midlands, United Kingdom, were included. ⋯ Radiography is likely to be cost-effective only when satisfaction is valued relatively highly. Strategies to enhance satisfaction for patients with low back pain without using lumbar radiography should be pursued.
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized trial of medical care with and without physical therapy and chiropractic care with and without physical modalities for patients with low back pain: 6-month follow-up outcomes from the UCLA low back pain study.
A randomized clinical trial. ⋯ After 6 months of follow-up, chiropractic care and medical care for low back pain were comparable in their effectiveness. Physical therapy may be marginally more effective than medical care alone for reducing disability in some patients, but the possible benefit is small.
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Randomized Controlled Trial Comparative Study Clinical Trial
Approaches to spondylotic cervical myelopathy: conservative versus surgical results in a 3-year follow-up study.
A 3-year prospective randomized study was conducted. ⋯ The 3-year follow-up study did not show, on the average, that the surgery is superior to conservative treatment for mild and moderate forms of spondylotic cervical myelopathy.
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Review Case Reports
Hysterical paralysis: a report of three cases and a review of the literature.
Three cases of hysterical paralysis are reported and the literature is reviewed. ⋯ Hysterical paraplegia is a type of conversion disorder. It is a diagnosis of exclusion that typically presents as mono-, hemi-, para-, or quadriplegia. The pursuit of a diagnosis for the hysterical paraplegic patient necessarily consumes valuable resources and time. The typical patient is a female from a low socioeconomic background with limited education. The DSM-IV-TR criteria must be met to fulfill the diagnosis of conversion disorder. Electrodiagnostic and imaging studies can aid in the diagnosis. Treatment revolves around explaining the normal diagnostic results to the patients and guiding them to appropriate psychiatric and physiotherapy. Rapid recovery should be expected, but can take up to 6 months.