Spine
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Comparative 3-dimensional biomechanical testing. ⋯ The iliosacral fixation with 2 6.5 mm AO-cancellous screws for complete sacroiliac dislocation demonstrated the highest stiffness and the short spinal instrumentation the poorest stiffness. All other fixation techniques could be generally considered of equivalent stability value.
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Comparative Study
MMPI disability profile: the least known, most useful screen for psychopathology in chronic occupational spinal disorders.
Prospective study on predicting psychopathology in chronic occupational spinal disorders (COSDs). ⋯ The prevalence of commonly cited MMPI profiles, often used for presurgical or chronic pain screening in this population, is relatively small. The prevalence of four or more elevations (DP), however, is large, representing two thirds of patients demonstrating any classifiable MMPI pattern. The DP group showed extremely high levels of associated psychopathology, which raises "red flags" to the surgeon likely to operate on such patients, or the interdisciplinary pain team. Screening COSD patients with the MMPI-2 may be effective in identifying psychopathology, but only if the physician is aware that the DP is commonplace and significant.
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Prospective, 5-year, cohort study of working subjects. ⋯ In this study cohort, minor trauma does not appear to increase the risk of serious LBP episodes or disability. The vast majority of incident-adverse LBP events may be predicted not by structural findings or minor trauma but by a small set of demographic and behavioral variables.
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Comparative Study
Is obesity overrated as a "risk factor" for poor outcomes in chronic occupational spinal disorders?
Prospective cohort study. ⋯ Obesity is more prevalent and severe in chronic occupational spinal disorders when entering a functional restoration program as the final step in a prolonged treatment regimen. We conclude that obesity, even gross obesity, has no significant impact on outcomes of an interdisciplinary functional restoration program for patients disabled an average of 16 months.
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Comparative Study
Mathematical calculation of pedicle subtraction osteotomy size to allow precision correction of fixed sagittal deformity.
This is a retrospective review of 15 consecutive fixed sagittal plane deformity patients who have undergone pedicle subtraction osteotomies. The focus of this article is the application of a trigonometric equation that calculates the degree of correction needed to achieve sagittal balance. The intraoperative predictive accuracy and clinical radiographic results of using this mathematical equation are discussed. ⋯ By using a simple mathematical equation, one can reliably determine the degree of pedicle subtraction osteotomy needed for correction of sagittal deformity. This technique is reproducible and has led to successful clinical outcomes.