Spine
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A case report of low back pain associated with a diagnosis of melorheostosis of the lumbosacral spine. ⋯ Melorheostosis rarely causes severe low back pain that can respond favorably to fusion surgery.
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Pavlov's ratio from plain radiographs in patients with neck pain but no radicular symptoms was compared with the areas of the cervical spinal cord and cerebrospinal fluid column on magnetic resonance scans. ⋯ This study shows a poor correlation between Pavlov's ratio and the space available for the cord. Therefore, this ratio cannot be solely relied upon to predict the area changes in that plane of the cervical spinal canal.
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A retrospective clinical study was conducted. ⋯ Posterior decompression and partial reduction followed by circumferential stabilization performed in one stage combining pedicle fixation with trans-sacral titanium cage interbody fusion is an effective and safe technique for the management of severe spondylolisthesis.
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A case report of distant discitis and vertebral osteomyelitis involving skip levels after caudal epidural steroid injection. ⋯ Distant discitis and vertebral osteomyelitis involving skip levels and without the occurrence of epidural abscess formation is a serious but rare complication after epidural injection.
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Comparative Study Clinical Trial
Standing lateral radiographic positioning does not represent customary standing balance.
Normal cohort evaluation of the accuracy of existing methods for radiographic measurement of sagittal spinal balance. ⋯ Measurement of the sagittal vertical axis on radiographs from commonly utilized standing positions (shoulders flexed) results in an sagittal vertical axis that is at least 3 to 4 cm more posterior than a sagittal vertical axis observed during a functional position. Subject repositioning resulted in an intertrial variability of at least 0.8 cm in sagittal vertical axis, while variation as the subject held each standing posture had little contribution to overall error of measurement. Of the analyzed positions, shoulder flexion (45 degrees ) alone was the best position for a lateral radiograph due to minimal compromise to repeatability of sagittal vertical axis measurement. However, none of the radiographic positions reproduced the spinal balance of the subject's functional standing posture.