Spine
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Comparative Study
Straight-forward versus anatomic trajectory technique of thoracic pedicle screw fixation: a biomechanical analysis.
A biomechanical study on cadaveric thoracic vertebrae using pullout strength, insertional torque, and bone mineral density to determine the optimal sagittal trajectory of thoracic pedicle screws. ⋯ The straight-forward technique results in a 39% increase in maximum insertional torque and a 27% increase in pullout strength compared to the anatomic technique. The maximum insertional torque at the neurocentral junction resulted in a 36% increase using the straight-forward technique versus the anatomic trajectory. Bone mineral density directly correlates with pullout strength for both techniques.
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A retrospective radiographic review was performed on 41 patients with scoliosis associated with a Chiari I malformation and/or syringomyelia. ⋯ Although the decision to obtain magnetic resonance imaging in a patient with scoliosis should be based on both clinical and radiographic criteria, we suggest that a heightened index of suspicion is warranted with certain curve patterns (left thoracic, double thoracic, triple, and a long right thoracic curve with end vertebra caudal to T12), and with a high or low apex and/or end vertebra, especially in males and patients with a normal to hyperkyphotic thoracic spine.
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A cross-sectional survey of 481 children aged 8-10 years and 325 adolescents aged 14-16 years obtained through a proportional two-stage cluster sample of children living in Odense, Denmark. ⋯ There is no obvious association between the objectively measured level of physical activity and back pain in children and adolescents. Simple self-reported levels of physical activity and inactivity cannot be used meaningfully on young people in back pain research.
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Comparative Study
Electromagnetic field-based image-guided spine surgery part two: results of a cadaveric study evaluating thoracic pedicle screw placement.
Human cadaveric. ⋯ Our study has shown that EMF image-guided thoracic pedicle screw placement results in a similar incidence of safely placed screws as does conventional fluoroscopy. When set-up time and image-capture time were factored in for image guidance, the average time to insert a pedicle screw was equal for both techniques. The use of EMF image guidance significantly reduced fluoroscopic time and thus radiation exposure per screw compared with conventional fluoroscopic techniques.
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Review Meta Analysis Comparative Study
Muscle relaxants for nonspecific low back pain: a systematic review within the framework of the cochrane collaboration.
A systematic review of randomized and/or double-blinded controlled trials. ⋯ Muscle relaxants are effective in the management of nonspecific low back pain, but the adverse effects require that they be used with caution. Trials are needed that evaluate if muscle relaxants are more effective than analgesics or nonsteroidal anti-inflammatory drugs.