Spine
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A retrospective study investigating the clinical outcome of the inside-outside cranial bolt technique for occipitocervical stabilization used to manage rheumatoid arthritis was conducted. ⋯ The "inside-outside" technique is safe and effective for stabilizing the occipitocervical junction in rheumatoid patients. It is associated with significant reduction of neck pain, improved neurologic status, and maintenance of alignment and stability.
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Back pain online: a cross-sectional survey of the quality of web-based information on low back pain.
A cross section of Web sites accessible to the general public was surveyed. ⋯ This study highlighted the poor quality of information, particularly information about low back pain, available to "typical" patient users on the Internet. Health care professionals must have a role in evaluating existing information and in developing good-quality evidence-based Web sites. Patients with back pain should be discouraged from using the Internet as a source of information unless the Web sites they access have been evaluated and found to provide evidence-based messages.
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Four strata of randomly selected health care providers in North Carolina (primary care MDs, Doctors of Chiropractic, orthopedic surgeons, and group model HMO primary care providers) enrolled 1633 consecutive patients with low back pain into a cohort study. ⋯ The relation of patient race to outcomes from and care for low back pain is complex. Blacks have slightly worse functional status than whites on presentation and at follow-up assessment. Blacks receive less intense diagnostic and treatment approaches from MDs, although the severity of their impairment is at least as great.
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Comparative Study Clinical Trial
Gabapentin effect on neuropathic pain compared among patients with spinal cord injury and different durations of symptoms.
This study evaluated the effect of gabapentin on neuropathic pain in patients with spinal cord injury. ⋯ Gabapentin may be effective in decreasing neuropathic pain refractory to conventional analgesics in some patients with spinal cord injury whose duration of symptoms is less than 6 months, although those with duration of symptoms longer than 6 months showed a significant decrease as well. The drug is unlikely to cause serious adverse effects that limit its use in patients with spinal cord injury.
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Serum concentrations of bone formation markers were correlated with the type, location, and progression of ossification of the posterior longitudinal ligament. ⋯ Serum concentrations of intact osteocalcin, osteocalcin, and carboxyterminal propeptide of human type 1 procollagen may reflect the activity of general ectopic bone formation in patients with ossification of the posterior longitudinal ligament.