Spine
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A retrospective study was conducted, with clinical evaluation of hemivertebra resection using transpedicular instrumentation by a posterior approach in young children. ⋯ Posterior resection of hemivertebrae with transpedicular instrumentation is a safe and promising procedure that offers significant advantages for controlling congenital deformity: excellent correction in both the frontal and sagittal planes, short segment of fusion, high stability, no need for an anterior approach, and low neurologic risk. Surgery should be performed as early as possible to avert severe local deformities, to prevent secondary structural changes, and to avert extensive fusions.
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Surface electromyography measurements of the upper trapezius muscles were performed in patients with a chronic whiplash-associated disorder Grade 2 and those with nonspecific neck pain. ⋯ It appears that the cervical muscle dysfunction in patients with chronic whiplash-associated disorder Grade 2 is not related to the specific trauma mechanism. Rather, cervical muscle dysfunction appears to be a general sign in diverse chronic neck pain syndromes.
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Case Reports
Intramedullary injection of contrast into the cervical spinal cord during cervical myelography: a case report.
A case of iatrogenic intramedullary contrast injection during a C1-C2 cervical myelography is reported. ⋯ Intramedullary cord injection is a rare complication of cervical myelography. The mechanism of spinal cord injury appears to involve a combination of physical compression from the injected liquid and neurotoxicity of the contrast material. Iohexol rather than metrizamide should be used when C1-C2 myelography is indicated in patients who are unable to undergo magnetic resonance imaging, or those whose pathology is inadequately demonstrated magnetic resonance imaging alone. In the event of contrast injection into the spinal cord, administration of high-dose methylprednisolone is recommended.
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A retrospective review of a prospectively maintained spine database was conducted. ⋯ External beam radiation therapy was used successfully to treat patients with normal alignment or minimal subluxation. Selected patients warrant immediate stabilization. Patients with persistent pain and inability to wean from a hard collar after nonoperative therapy also should be considered for surgery. Posterior stabilization provides pain relief and neurologic preservation or recovery without the need for anterior decompression.
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Randomized Controlled Trial Comparative Study Clinical Trial
Continuous low-level heat wrap therapy provides more efficacy than Ibuprofen and acetaminophen for acute low back pain.
A prospective, randomized, single (investigator) blind, comparative efficacy trial was conducted. ⋯ Continuous low-level heat wrap therapy was superior to both acetaminophen and ibuprofen for treating low back pain.