Spine
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Comparative Study Clinical Trial Controlled Clinical Trial
Characterization of acute whiplash-associated disorders.
An experimental study of motor and sensory function and psychological distress in subjects with acute whiplash injury. ⋯ Acute whiplash subjects with higher levels of pain and disability were distinguished by sensory hypersensitivity to a variety of stimuli, suggestive of central nervous system sensitization occurring soon after injury. These responses occurred independently of psychological distress. These findings may be important for the differential diagnosis of acute whiplash injury and could be one reason why those with higher initial pain and disability demonstrate a poorer outcome.
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A retrospective outcomes study. ⋯ Two-level discectomy is an effective treatment with clinical outcome comparable with single-level discectomy. Patients with posterolateral disc herniations and definitive radiculopathy without osseous degenerative changes at the same levels have better clinical outcome and quality of life scores compared with those patients having concomitant degenerative arthritis at the same levels. Patients having two-level discectomy may be at increased risk of requiring subsequent lumbar fusion compared with those with single-level discectomy.
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Traction was applied to muscles attaching to the posterior and middle layers of lumbar fascia (PLF, MLF). Effects on fasciae were determined via tensile force measures and movement of markers. ⋯ Low levels of tension are effectively transmitted between TrA and the MLF or PLF. Via them, TrA may influence intersegmental movement.
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Cross-sectional magnetic-resonance imaging (MRI) study. OBJECTIVE To investigate the relation of the lumbosacral transitional vertebra to signs of disc degeneration in MRI and to low back pain (LBP). ⋯ Lumbosacral transitional vertebra increases the risk of early degeneration in the upper disc. This effect seems to be obscured by age-related changes in the middle age. The degenerative process is slowed down in the lower disc. For these effects, the presence of a transitional vertebra should be noticed when morphologic methods are used in research on lumbosacral spine. Transitional vertebra is not associated with any type of LBP.
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Brown-Sequard syndrome is an incomplete spinal cord lesion characterized by a clinical picture reflecting hemisection of the spinal cord in the cervical or thoracic region. Brown-Sequard syndrome may be the result of penetrating injury to the spine, but many other etiologies have been described. In particular, cervical disc herniation has been rarely reported as a cause of this syndrome, and including the first article of Stookey in 1928, 9 only 22 cases have been reported. ⋯ A critical review of the pertinent literature is proposed, and the neuroradiologic, therapeutic, and prognostic implications are discussed. Brown-Sequard syndrome produced by a cervical disc herniation is presumably often underdiagnosed, and early surgical intervention is always recommended.