Spine
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Randomized Controlled Trial Multicenter Study
Implementation of the Dutch low back pain guideline for general practitioners: a cluster randomized controlled trial.
Cluster randomized controlled trial for a multifaceted implementation strategy. ⋯ The multifaceted intervention strategy modestly improved implementation (for parts of the recommendations in) the Dutch low back pain guideline by general practitioners and produced small concomitant changes in patient management. The implementation strategy produced fewer referrals to therapists during follow-up consultations.
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A review article. ⋯ Spino-pelvic balance in the sagittal plane can be considered as an open linear chain linking the head to the pelvis where the shape and orientation of each successive anatomic segment are closely related and influence the adjacent segment. Pelvic morphology and spino-pelvic balance are abnormal in developmental spondylolisthesis. These abnormalities should be quantified on lateral standing radiographs of the spine and pelvis and have important implications for the evaluation and treatment of this pathologic condition.
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Systematic review. ⋯ NRT appears to be a safe and effective intervention for nonspecific LBP. This conclusion is limited to three trials conducted by a small number of experienced clinicians. Further trials in other settings are needed to determine whether these favorable results can be generalized.
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Comparative Study
Quantitative anatomic evaluation of cervical lateral mass fixation with a comparison of the Roy-Camille and the Magerl screw techniques.
An anatomic and computed tomography (CT) study of the Roy-Camille and the Magerl techniques with quantitative comparison of the safety zones of the two surgical techniques. ⋯ The Roy-Camille technique demonstrated a progressive decrease of its safety zone from C3-C6. At C5 and C6 there is a great probability to have a transarticular screw with a Roy-Camille screw. A similar variation was not observed for the Magerl technique. These anatomic results seem to be in relation with the morphologic variability of lateral masses from C3-C6 as demonstrated by an increase of the height/thickness ratio at the lower part of the cervical spine. According to these anatomic considerations and previously published biomechanical data, Roy-Camille technique appears to be the best option at C3 and C4. On the opposite at C5 and C6, the choice is more difficult considering that there is no biomechanical difference between the two techniques and that the Magerl technique is safer but a more demanding procedure.
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This study retrospectively examines outcomes of unilateral transforaminal lumbar interbody fusion (TLIF) with posterior fixation using anterior carbon fiber cages and 360 degrees fusion in spondylolisthesis. ⋯ Interbody cages in spondylolisthesis are useful to increase neuroforaminal height, to facilitate reduction, and to improve the chances of achieving a successful 360 degrees fusion.