Spine
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A case series of patients with cerebral palsy treated for spinal deformity using Luque-Galveston instrumentation was retrospectively analyzed. ⋯ Preoperative hyperkyphosis in the thoracic, thoracolumbar, or lumbar spine was associated with an increased incidence of proximal and distal loss of sagittal plane correction in patients with spastic quadriplegic cerebral palsy treated with Luque-Galveston instrumentation alone. An anterior lumbar release and fusion without instrumentation in a patient with thoracolumbar or lumbar kyphosis increased the risk for posterior pullout of the Galveston rods from the pelvis.
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Spinal injuries and diseases have been diagnosed and treated since antiquity. We attempt to record any available information in this area, starting from the prehistoric period and going up to Roman times. ⋯ The epitome of their wisdom is to be found in Galen's works made available via Khun's edition (Leipzig, 1829) written in both ancient Greek and Latin. Galen not only presents the Hippocratic knowledge and comments on it, but adds his own opinions and thoughts.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of classification-based physical therapy with therapy based on clinical practice guidelines for patients with acute low back pain: a randomized clinical trial.
A randomized clinical trial was conducted. ⋯ For patients with acute, work-related low back pain, the use of a classification-based approach resulted in improved disability and return to work status after 4 weeks, as compared with therapy based on clinical practice guidelines. Further research is needed on the optimal timing and methods of intervention for patients with acute low back pain.
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Clinical Trial Controlled Clinical Trial
Quantifying the lumbar flexion-relaxation phenomenon: theory, normative data, and clinical applications.
A two-part investigation was conducted: 1) a prospective study of asymptomatic subjects quantitatively comparing trunk mobility to surface electromyographic (sEMG) signals from the erector spinae during trunk flexion; and 2) a prospective repeated-measures cohort study of patients with chronic disabled work-related spinal disorder tested for the flexion-relaxation (FR) phenomenon while measured simultaneously for lumbar spine inclinometric range of motion (ROM). ⋯ Flexion-relaxation measures a point at which true lumbar flexion ROM approaches its maximum in asymptomatic subjects. This also is the point at which lumbar extensor muscle contraction relaxes, allowing the lumbar spine to hang on its posterior ligaments. The gluteal and hamstring muscles then lower the flexed trunk even further by allowing the pelvis to rotate around the hips. This phenomenon was subsequently found in Part 2 to offer a potentially promising method for individualizing rehabilitation treatment, decreasing unnecessary utilization, identifying potential postrehabilitation treatment failures, and assessing permanent impairment rating validity. Moreover, this is the first study to demonstrate systematically that an absence of FR in patients with chronic low back pain can be corrected with treatment.
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A 2-year follow-up study of patients with back disorders certified as sick. ⋯ Information about the age of the patients, diagnoses, pain intensity, self-assessed work ability, and self-predicted absence status may be used as predictors of time until return to work in patients with back disorders certified as sick who attend a back disorder outpatient clinic.