Spine
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A surgical simulation study in human cadaver spine specimens was conducted to evaluate the accuracy of thoracic vertebral body screw placement using four different intraoperative imaging techniques. ⋯ Fluoroscopy-based image guidance that uses only a single reference marker for the entire thoracic spine is highly inaccurate and unsafe. Systems with registration based on the instrumented vertebrae provide more accurate placement of thoracic vertebral body screws than standard fluoroscopy, but expose the patient to more radiation and require more time for screw insertion.
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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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A descriptive study was conducted to investigate the paraspinal muscle function in patients with lumbar spinal stenosis. ⋯ Abnormal findings in needle electromyography of the paraspinal muscles were observed in 18 of the 22 (81.8%) examined patients. Abnormal flexion-extension activation of the paraspinal muscles was observed in all the examined patients. The change in mean power frequency was significantly smaller than in previously evaluated healthy subjects and patients with nonspecific chronic low back pain (P < 0.001) who were not experiencing symptoms of lumbar spinal stenosis. Paraspinal muscle fatigability was not associated with the denervation of the muscles. CONCLUSIONS Denervation and abnormal activation of lumbar paraspinal muscles are frequent findings in patients with lumbar spinal stenosis who have not undergone surgery. The paraspinal muscle endurance of the patients was unexpectedly good.
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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.