Spine
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Clinical Trial Controlled Clinical Trial
Lumbar paraspinal muscle function, perception of lumbar position, and postural control in disc herniation-related back pain.
A follow-up study evaluating postural control, lumbar movement perception, and paraspinal muscle reflexes in disc herniation-related chronic low back pain (LBP) before and after discectomy. ⋯ The results demonstrate impaired lumbar proprioception and postural control in sciatica patients. During short-term follow-up after operative treatment, postural control does not seem to change, but impaired lumbar proprioception and feed-forward control of paraspinal muscles seem to recover.
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A reliability study was performed. ⋯ The ODI was highly reliable. The questions about work, back satisfaction, and pain medication showed good agreement. The GFS, pain intensity, fear-avoidance beliefs, and life satisfaction appeared to lack sufficient reliability to be recommended in postal questionnaires.
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Comparative Study
Pedicle morphology of the lower thoracic, lumbar, and S1 vertebrae: an Indian perspective.
Analysis of morphometric data obtained from computed tomography scans in relation to the lower thoracic, lumbar, and S1 pedicle in patients from the Indian subcontinent. ⋯ Significant differences exist between the pedicles of Indian and white populations. It is suggested that preoperative computed tomography scans of the patients must be evaluated to choose the appropriately sized implant and avoid inadvertent complications. Preparation of the pedicle intraoperatively should take into account the orientation of the transverse pedicle angle.
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Lateral radiographs of the lumbar spine were taken of 40 patients with lumbar spondylolisthesis. These radiographs were taken in the neutral, flexion, and extension positions for both erect and recumbent postures, and also in the prone and supine positions with traction applied via a traction table. ⋯ Erect flexion and prone traction radiographs represent the extremes of subluxation and reduction of the olisthesis, respectively, and the change in olisthesis seen between these extremes is correlated with the change in disc area and the intervertebral slip angle. Vertical laxity of the affected functional spinal unit resulting from disc degeneration produces laxity in the ligaments and disc anulus, allowing olisthetic motion. Restoration of disc height in turn restores tension to the soft tissues around the disc and results in a spontaneous reduction of the subluxation. Restoration and maintenance of disc height with a spacer or interbody fusion therefore is recommended as a goal in the treatment of spondylolisthesis. When spondylolytic spondylolisthesis involves a posterior column deficiency, additional reconstruction of this column with posterior instrumentation is recommended. Application of the traction radiographic technique in planning for spondylolisthesis reduction is discussed along with the technique of stabilization.
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Case Reports
Concomitant spine infection with mycobacterium tuberculosis and pyogenic bacteria: case report.
A case report of an extremely rare condition describing lumbar spine tuberculosis associated with concurrent pyogenic infection is presented. ⋯ It is concluded from this case that recovery of pyogenic bacteria from an infected spine does not exclude spine tuberculosis. It is recommended, therefore, that mycobacterial investigations be performed for cases that have evidence of tuberculosis, even when pyogenic microorganisms already have been isolated. The clues that raise suspicion of tuberculosis in patients with pyogenic spine infection include chronic infection that does not respond to ordinary antibiotics, isolated pyogenic bacteria of low virulence, psoas muscle calcification, and immunosuppression.