Spine
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Postal survey. OBJECTIVES.: To determine whether Australian primary-care clinicians think that nonspecific low back pain (NSLBP) is one condition or a number of conditions (subgroups), and whether this belief influences their management of NSLBP. ⋯ Although assigning NSLBP patients to subgroups has not been validated, it is common in primary-care settings and influences case management. If subgroups exist within the NSLBP population, there are implications for research into the effects of treatment. Further research into the validity of subgroups is warranted.
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This report aims, in the light of the recent literature, to describe the clinical features of bilateral thoracic outlet syndrome in a case of Klippel-Feil syndrome, the results of electrophysiologic evaluation, and the outcome after surgical intervention. ⋯ It is often difficult to diagnose thoracic outlet syndrome by conventional neurophysiology. Dynamic changes in F waves appear to be a useful finding. In the absence of symptoms of myeloradiculopathy, thoracic outlet syndrome could be the sole manifestation of Klippel-Feil syndrome.
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Complete cervical disc complex extrusion, defined as the extrusion of both cartilaginous end-plates, the entire nucleus pulposus, and portions of the anulus fibrosus, is rare. A case of complete cervical disc complex extrusion with spinal cord injury in the absence of facet dislocation or subluxation in an obtunded patient is reported. ⋯ The case report highlights the occurrence of complete traumatic cervical disc extrusion in the absence of facet dislocation with normal plain radiographic findings and consequent spinal cord injury, which can accompany such an injury.
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Surgeon- and patient-based (SF-36) outcome measures were used to assess the results of decompressive laminectomies for the excision of synovial cysts with coexistent lumbar spinal stenosis (45 patients) or for synovial cysts with coexistent lumbar stenosis and degenerative spondylolisthesis (35 patients). ⋯ Using both surgeon and SF-36 outcome measures, 2 years following laminectomy for synovial cysts/lumbar stenosis with or without olisthy, patients exhibited a moderate degree of improvement. As synovial cysts reflect disruption of the facet joint and some degree of instability, primary fusion should be considered to improve operative results for patients in both categories.