Spine
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Comparative Study
The pain disability questionnaire: a new psychometrically sound measure for chronic musculoskeletal disorders.
The Pain Disability Questionnaire (PDQ) is a psychometric evaluation study of a new measure of functional status. ⋯ The present study represents a comprehensive psychometric evaluation of a new functional status measure for musculoskeletal conditions in general, and a CDMD population in particular. The psychometric properties of the PDQ are excellent, demonstrating strong reliability, responsiveness, and validity, relative to many other existing measures of functional status. The many weaknesses cited for some of the existing measures were taken into account in designing this instrument. Consequently, the characteristics commonly noted as weaknesses for these other measures (such as a restriction to only the low back pain population, and inconsistent responsiveness) can be cited as strengths of the PDQ. Its generalizability and utility for assessing orthopedic treatment progress and functional outcomes must now be evaluated in broader settings.
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A retrospective review of charts and radiographs of all consecutive patients who underwent kyphoplasty at the authors' center from the initial procedure in September 2000 to the end of the collection period in July 2002. ⋯ This study demonstrated a higher rate of subsequent fracture after kyphoplasty compared with natural history data for untreated fractures. Most of these occurred at an adjacent level within 2 months of the index procedure. After this 2-month period, there were only occasional subsequent fractures, which occurred at remote levels. This confirms biomechanical studies showing that cement augmentation places additional stress on adjacent levels. Patients with an increase in back pain after kyphoplasty should be evaluated carefully for subsequent adjacent fractures, especially during the first 2 months after the index procedure.
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An animal model of postlaminectomy lumbar column sagittal plane deformity was designed in rats. ⋯ Kyphosis and consequent traction of the lumbar spine is one of the causes for increased epidural fibrosis formation after laminectomy. On the contrary, establishment of lordosis and relaxation of the lumbar spine decreased the scar tissue formation in rats.
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Distribution and appearance of tumor necrosis factor-alpha (TNF-alpha) in the dorsal root ganglion (DRG) exposed to experimental disc herniation were investigated using an immunohistochemical method in rats. ⋯ The immunoreactivity of TNF-alpha in the DRG directly exposed to nucleus pulposus increases during 2 weeks. A collapse of the positive cells was seen in the DRG directly exposed to the nucleus pulposus.