Spine
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Comparative Study
Long-term outcome of laminoplasty for cervical myelopathy due to disc herniation: a comparative study of laminoplasty and anterior spinal fusion.
A retrospective study was conducted. ⋯ Because the 2 procedures provided the same neurologic improvement, the risks of bone graft complication with ASF must be weighed against the risks of chronic neck pain associated with laminoplasty for determining the best technique. Therefore, because our present surgical strategy for cervical myelopathy due to disc herniation, laminoplasty is the procedure of choice except for a patient with single level disc herniation without developmental canal stenosis, who is considered to be a good candidate for ASF.
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Comparative Study
Standardized provocation of lumbar spine mobility: three methods compared by radiostereometric analysis.
By radiostereometric analysis (RSA), the intervertebral mobility was measured for the 3 most distal lumbar disc levels in 12 patients at 3 types of standardized provocation: changing body position from supine to standing, supine to standing with load, and supine to sitting. ⋯ The intervertebral mobility response provided in the lumbar spine when changing position from supine to sitting is more pronounced than both to standing and to standing with a 20 kg load. By the supine to sitting provocation, mean lumbar mobility is increased, and mobility can be revealed in some cases being stable in the other 2 situations. Combined with RSA, the method brings a refined possibility for studying lumbar spine kinematics.
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Subchondral mineralization of adjacent and transfixed facet joints was analyzed in patients with thoracolumbar spinal injuries, both before posterior instrumentation and after removal of the spinal implant. ⋯ Decrease in subchondral mineralization indicates reduced load acting on the examined zygapophysial joints. This finding in patients with early follow-up CT seems to be caused by reduced activity in most of the patients until removal of the spinal implant. In patients with longer intervals between removal of the fixator and second CT, higher loads acting on the adjacent and bridged joints are shown morphologically. Whether or not these changes lead to spondylarthritis has to be studied in a long-term follow-up.
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A systematic review. ⋯ It is impossible to define a generic set of predictors of outcome of multidisciplinary rehabilitation and back schools for patients with chronic low back pain because the reviewed studies were descriptive or exploratory in nature, and most predictors were only studied once. Nevertheless, for several predictors, consistent evidence was found. Large confirmatory studies are needed to test the value of these predictors.
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Randomized Controlled Trial
A randomized clinical trial comparing two physiotherapy interventions for chronic low back pain.
A randomized clinical trial with blinded assessment. ⋯ Both forms of intervention were associated with significant improvement. On-going clinical research is necessary to provide guidance as to the clinical efficacy of various forms of intervention.