Spine
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A rare case of Baastrup's disease as a cause of spinal canal stenosis in a patient with double-level spondylolisthesis is reported. ⋯ Baastrup's disease leading to neoarthrosis formation with synovial cavity and causing low back pain has been reported previously. The cyst can enter into the epidural space through the midline cleft of the ligamentum flavum to result in extradural compression.
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Randomized Controlled Trial Comparative Study Clinical Trial
Chronic spinal pain: a randomized clinical trial comparing medication, acupuncture, and spinal manipulation.
A randomized controlled clinical trial was conducted. ⋯ The consistency of the results provides, despite some discussed shortcomings of this study, evidence that in patients with chronic spinal pain, manipulation, if not contraindicated, results in greater short-term improvement than acupuncture or medication. However, the data do not strongly support the use of only manipulation, only acupuncture, or only nonsteroidal antiinflammatory drugs for the treatment of chronic spinal pain. The results from this exploratory study need confirmation from future larger studies.
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Comparative Study
Association of the Japanese Orthopaedic Association score with the Oswestry Disability Index, Roland-Morris Disability Questionnaire, and short-form 36.
Cross-cultural translation and cross-sectional psychometric testing were performed. ⋯ The Japanese versions of the ODI and the RMDQ were reliable and valid. The use of these translated instruments can be recommended for future clinical trials in Japan. The results also showed the JOA score had acceptable psychometric properties of reliability and construct validity, suggesting that this score is reliable and valid. Further studies are needed to verify the validity and responsiveness of the JOA score.
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To assess the biomechanical effects of unipedicular vertebroplasty on nonfractured vertebrae. ⋯ The introduction of 20% bone cement by volume results in a significant increase in the compressive strength of intact lumbar vertebrae, however upper thoracic vertebrae do not demonstrate a similar strength improvement. There was no difference in the stiffness of the vertebrae injected with cement regardless of location. Bone mineral density (BMD) may play a role in the magnitude of the strength increase, with lower BMD specimens realizing a relatively greater strength improvement. Cement leakage was frequently noted with 20% cement injection, especially in the specimens with higher BMD. The location of the cement did not appear to have an effect on the loading behavior of the bone but should be controlled to minimize the chance of cement escaping into the spinal canal.
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This is a case report of a young patient who experienced an acute epidural compression of cauda equina revealing Stage IV Hodgkin's disease. ⋯ Although a rare situation, Hodgkin's disease may involve the spinal epidural space at presentation. The management is complex, but surgery provides the most rapid means of diagnosis and neurologic tissue decompression in severely affected patients.