Spine
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Clinical Trial
Activation of back muscles during voluntary abduction of the contralateral arm in humans.
Motor-evoked responses to transcranial magnetic stimulation of the motor cortex were recorded from erector spinae and deltoid muscles while the arm was abducted voluntarily in 10 normal subjects. ⋯ Facilitation of erector spinae with arm abduction remains evident in the lying posture when spinal postural stabilization mechanisms are presumably reduced. Similar facilitation profiles have been seen previously with changing voluntary activation of erector spinae in a trunk extension task, supporting the notion that during arm abduction the drive to the contralateral erector spinae has a corticospinal origin.
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This report describes a case of successful surgical excision of an intrathoracic paraspinal desmoid tumor with an intraspinous extension causing scoliosis and paralysis in a 12-year-old girl. ⋯ This case report should help expand the understanding of the spectrum of this uncommon tumor.
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Randomized Controlled Trial Clinical Trial
Long-term functional outcome of pedicle screw instrumentation as a support for posterolateral spinal fusion: randomized clinical study with a 5-year follow-up.
A prospective randomized clinical study with a 5-year follow-up. ⋯ The long-term functional outcome of posterolateral spinal fusion improved significantly for boththose with and without pedicle screw instrumentation, with a global 70% satisfaction reported by the patients. Patients with isthmic spondylolisthesis Grades 1 and 2 with noninstrumented fusion had superior long-term outcomes after posterolateral spinal fusion in comparison with an instrumented fusion. In contrast, patients diagnosed as having primary degenerative instability improved significantly when the posterolateral fusion was supported by instrumentation. In actuality, pedicle screw instrumentation increased reoperation rate compared with noninstrumented posterolateral fusion.
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A prospective clinical trial to study the radiographic parameters and functional outcome in patients undergoing spinal osteotomy. ⋯ Correction of sagittal and coronal deformity is important in the treatment of spinal deformity. A significant association was found between outcomes and radiographic correction of coronal and/or sagittal deformity if postoperative sagittal lordosis was >25 degrees and if postoperative plumb coronal alignment was <2.5 cm. Therefore, these radiographic parameters should be the goal of a spinal osteotomy. The surgery has a relatively high complication rate.
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The Spine Patient Outcomes Research Trial (SPORT) was designed to assess the relative efficacy and cost-effectiveness of surgical and nonsurgical approaches to the treatment of common conditions associated with low back and leg pain. ⋯ The results of this study will provide high-quality scientific evidence to aid clinical decision-making and improve treatment outcomes for these common, costly, and, in some instances, debilitating conditions.