Spine
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A questionnaire survey. ⋯ The majority (90.5%) of responding surgeons used the steroid protocol; however, only 24.1% used the steroid protocol due to a belief in improved clinical outcomes.
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Biomechanical study, using human cadaveric spines, of two types of posterior fixation in the thoracolumbar spine. ⋯ This method offers a firm construct without sacrificing a normal motion segment.
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Review Meta Analysis
The McKenzie method for low back pain: a systematic review of the literature with a meta-analysis approach.
Meta-analysis of randomized controlled trials to evaluate the effectiveness of the McKenzie method for low back pain (LBP). ⋯ There is some evidence that the McKenzie method is more effective than passive therapy for acute LBP; however, the magnitude of the difference suggests the absence of clinically worthwhile effects. There is limited evidence for the use of McKenzie method in chronic LBP. The effectiveness of classification-based McKenzie is yet to be established.
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Immunohistochemistry for tumor necrosis factor (TNF) and protein gene product (PGP) 9.5 in vertebral endplates of patients with discogenic low back pain and Modic Type 1 or Type 2 endplate changes on MRI. ⋯ The results suggest that endplate abnormalities are related to inflammation and axon growth induced by TNF. TNF expression and PGP 9.5-positive nerve in-growth in abnormal endplates may be a cause of low back pain.
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Presented is a case series of 3 patients, all of whom developed neurologic deficits due to cord or cauda equina compression during elective extremity surgery. ⋯ Spontaneous neural injury is rare but can occur to the anesthetized patient. Neurologic examination should be routinely performed in the recovery room; and if significant neurologic deficits are seen, investigative workup should not be delayed. If an intraspinal lesion is identified, immediate decompression may offer favorable results. Neurologic deficits should not be dismissed as peripheral palsies without careful evaluation.