Spine
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A systematic review of prospective cohort studies in low back pain. ⋯ Psychological factors (notably distress, depressive mood, and somatization) are implicated in the transition to chronic low back pain. The development and testing of clinical interventions specifically targeting these factors is indicated. In view of the importance attributed to other psychological factors (particularly coping strategies and fear avoidance) there is a need to clarify their role in back-related disability through rigorous prospective studies.
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Multicenter Study
The role of fluoroscopy in cervical epidural steroid injections: an analysis of contrast dispersal patterns.
A multicenter, retrospective analysis of cervical epidurograms. ⋯ The loss of resistance technique may not be an adequate method for ensuring accurate needle placement in blindly performed cervical epidural injections. The use of epidurography can improve the accuracy of needle placement and medication delivery to targeted areas of pathology.
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Retrospective review of cases in which a single solid rod was used for the anterior correction of thoracolumbar and lumbar idiopathic scoliosis in adults. ⋯ The results of anterior spinal fusion using a single solid rod in adults with idiopathic scoliosis in this series are excellent, with 100% fusion rate, no development of kyphosis, and no incidence of hardware failure.
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Randomized Controlled Trial Clinical Trial
Reduction in postoperative pain after spinal fusion with instrumentation using intrathecal morphine.
The efficacy of intrathecal (spinal) morphine in the treatment of pain after posterior spinal fusions was assessed. ⋯ Relatively high-dose spinal morphine administration provides simple, reliable postoperative pain control after posterior spinal fusions. This may contribute to reduced postoperative respiratory morbidity and an improved outcome.
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Review Comparative Study
Standard scales for measurement of functional outcome for cervical pain or dysfunction: a systematic review.
A systematic review was conducted. ⋯ The five scales identified in this study have similar characteristics. The Neck Disability Index, however, has been revalidated more times for evaluation of patient groups. For individual patient follow-up evaluation, the Patient-Specific Functional Scale has high sensitivity to change, and thus represents a good choice for clinical use. The final choice should be tailored according to the target population and the purpose of the evaluation.