Spine
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A retrospective review was performed of a single surgeon's experience with partial corpectomy over a 9-year period. The measures evaluated included fusion rate, complications, and neurologic symptoms. ⋯ Partial corpectomy is an effective strategy for treating multilevel cervical disc disease. It is associated with a high fusion rate. In addition, partial corpectomy facilitates a complete decompression by providing excellent visualization of the dural interface.
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Outcome study to determine response distribution, internal consistency, reproducibility, and concurrent validity of the Scoliosis Research Society-22 (SRS-22) health-related quality-of-life (HRQL) questionnaire. ⋯ The SRS-22 HRQL questionnaire is reliable with internal consistency and reproducibility comparable to SF-36. In addition, it demonstrated concurrent validity when compared to SF-36. It is shorter and more focused on the health issues related to idiopathic scoliosis than SF-36.
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STUDY DESIGN A prospective, observational, human, study was conducted. OBJECTIVES To evaluate the incidence of vascular penetration during fluoroscopically guided, contrast-enhanced transforaminal cervical epidural steroid injections, and to determine whether the observation of blood in the needle hub can be used to predict a vascular injection. SUMMARY OF BACKGROUND DATA Incorrectly placed intravascular cervical spinal injections result in medication flow systemically and not to the desired target. ⋯ The reported sensitivity and specificity rates are similar to lumbar data. Fluoroscopically guided procedures without contrast confirmation instill medications intravascularly, and therefore not in the desired epidural location. This study confirms that there is a need not only for fluoroscopic guidance, but also for contrast instillation in cervical transforaminal epidural steroid injections.
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Clinical Trial
Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy.
A blinded, prospective diagnostic test study was conducted. ⋯ Many items of the clinical examination were found to be reliable and to have acceptable diagnostic properties, but the test item cluster identified was more useful for indicating cervical radiculopathy than any single test item. Upper limb tension Test A was the most useful test for ruling out cervical radiculopathy. Further investigation is required both to validate the test item cluster and to improve point estimate precision.
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A cross-sectional survey using patient questionnaires was conducted. OBJECTIVE To assess whether the Roland Disability Questionnaire satisfies the Rasch model including unidimensionality and item separation. ⋯ The Roland Disability Questionnaire largely satisfies the Rasch model for unidimensionality. However, the instrument could be improved through the removal of poorly fitting items and the addition of items at the upper and lower points of the scale hierarchy. The distribution of Roland Disability Questionnaire scores should be carefully considered before statistical testing is undertaken. Rasch transformed scores can be used to deal with deficiencies in the scale hierarchy.