Spine
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Review Meta Analysis
Radiofrequency denervation for neck and back pain: a systematic review within the framework of the cochrane collaboration back review group.
Systematic review. ⋯ There is limited evidence that radiofrequency denervation offers short-term relief for chronic neck pain of zygapophysial joint origin and for chronic cervicobrachial pain, and conflicting evidence for its effectiveness for lumbar zygapophysial joint pain. There is limited evidence suggesting that intradiscal radiofrequency may not be effective in relieving discogenic low back pain. Further high-quality randomized controlled trials are needed, with larger patient samples and data on long-term effects, for which current evidence is inconclusive.
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Randomized Controlled Trial Comparative Study Clinical Trial
Behavioral graded activity following first-time lumbar disc surgery: 1-year results of a randomized clinical trial.
In a randomized clinical trial, the effectiveness of behavioral graded activity was assessed as compared to usual care provided by physiotherapists for patients after first-time lumbar disc surgery (n = 105). ⋯ Both fear of movement and pain catastrophizing seem to be unaffected by either treatment in these patients. It is concluded that treatment principles derived from theories within the field of chronic low back pain might not apply to these patients. After 1 year of follow-up, there were no statistically significant or clinically relevant differences between the behavioral graded activity program and usual care as provided by physiotherapists for patients following first-time lumbar disc surgery.
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Analysis of health-related quality of life data obtained from a prospective cohort study of patients with sciatica due to an intervertebral disc herniation or lumbar spinal stenosis. ⋯ This short, simple, self-administered 12-item back-specific functional status questionnaire performed extremely well in comparison with the original 23-item scale. If validated in additional study populations, this new questionnaire may be useful in the clinical setting as a way for providers to prospectively compare their outcomes of care to other patient populations, and to study treatment effectiveness.
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This prospective, descriptive study determined the reliability of transcranial electric motor and posterior tibial nerve somatosensory-evoked potentials in children with neuromuscular scoliosis. ⋯ Both transcranial electric motor and posterior tibial nerve somatosensory-evoked potentials can be monitored reliably in most patients with neuromuscular scoliosis. Those with severe cerebral palsy present the greatest challenge to successful neurophysiologic monitoring.
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Our study was designed as a retrospective review of spinal cord patients with complex back wounds in whom the reverse latissimus muscle flap was used for closure. ⋯ Use of the reverse latissimus muscle flap is a reliable method of closing complex back wounds in patients with spinal cord syndrome. Should there be complications in the area of the flap, secondary wound healing can be achieved by wound debridement and closure of the wound by means of split-thickness skin grafting. There is no loss of function in the upper extremities. The complications typically seen in spinal cord patients can be avoided when the treatment is carried out in the conditions that obtain in a specialized spinal cord injury center.