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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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.
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Clinical Trial
Changes in scoliotic curvature and lordotic angle during the early phase of degenerative lumbar scoliosis.
Longitudinal radiographic measurements of the lumbar alignment in clinical cases were performed. ⋯ Degenerative lumbar scoliosis was triggered by any disc degeneration at the lumbar level. Loss of segmental lordosis usually occurs at the same disc level as segmental wedging. In the early phase of degenerative lumbar scoliosis, the scoliotic curvature not only progresses, but also may retrogress.
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Case Reports Clinical Trial
Spinal wedge osteotomy by a single posterior approach for correction of severe and rigid kyphosis or kyphoscoliosis.
Seven patients with severe angular kyphotic deformity of the spine were treated by circumferential spinal wedge osteotomy using a single posterior approach. ⋯ Spinal wedge osteotomy by the single posterior approach is a reliable and safe surgical technique for correcting severe rigid angular kyphosis or kyphoscoliosis.
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A retrospective study evaluating early halo immobilization of Types II and IIA hangman's fractures. ⋯ Early halo immobilization after traction reduction of Type II and IIA hangman's fractures is an effective method of management. Type II fractures with an angulation of greater than or equal to 12 degrees may require an extended period of traction to ensure adequate long-term fracture alignment.