Spine
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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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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.
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In this prospective study, a cohort of 2077 workers free of sciatic pain and another cohort of 327 workers with severe sciatic pain were followed up for 1 year. ⋯ The findings from this study suggest that mental stress and smoking are independent risk factors for incidental sciatic pain. Overall physical exercise and most of the sports activities, except jogging and walking, had no effect on sciatic pain. Physical workload factors seemed to be more involved in the onset of sciatic pain, whereas psychosocial factors were related to the persistence of symptoms.
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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.