Spine
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Comparative Study
Minimal clinically important change of the Neck Disability Index and the Numerical Rating Scale for patients with neck pain.
Prospective, single-cohort study. ⋯ The estimated MCIC should be used as an indication for relevant changes in clinical practice. Using the optimal cutoff point of the ROC curve, false positives and false negatives are equally weighted; and if there are no objections doing so, the optimal cutoff point of the ROC curve may be a good choice.
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Case Reports Comparative Study
Spinal cord injury in patients with ankylosing spondylitis: a 10-year review.
Retrospective study. ⋯ Neurologic deficits were often subtle on initial presentation, resulting in many injuries being missed because of a low index of suspicion and poor visualization of lower cervical fractures on conventional radiographs. Extension of the ankylosed kyphotic cervical spine during conventional immobilization or for radiologic procedures resulted in neurologic deficits. Patients with an ankylosed cervical spine are normally unable to see the ceiling lying supine because of cervicothoracic kyphosis and use pillows to support their head. Cervical spine alignment in a similar flexed position is essential during immobilization or imaging. Medical alert cards as for patients with diabetes would be a way forward in correctly identifying patients with AS so that appropriate precautions can be instituted by emergency services.
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Comparative Study
From chronic low back pain to disability, a multifactorial mediated pathway: the InCHIANTI study.
Clinicoepidemiologic study in the Chianti area (Tuscany, Italy). ⋯ The cross-sectional association between LBP and self-reported disability, in specific tasks is modulated by performance measures. Specific performance-based tests that explore the functional consequences of LBP may help design specific interventions of disability prevention and treatment in patients with LBP.
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Comparative Study
An outcome measure for Japanese people with chronic low back pain: an introduction and validation study of Japan Low Back Pain Evaluation Questionnaire.
Development of a nationwide patient-based outcome measure for patients with chronic low back pain (CLBP). ⋯ The JLEQ was shown to be a valid and reliable questionnaire scale for measurement of patient-based outcomes in CLBP patients.
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Comparative Study
Risk factors for false positive transcranial motor evoked potential monitoring alerts during surgical treatment of cervical myelopathy.
Retrospective consecutive series review. ⋯ In this series of cervical myelopathy patients, sensitivity and specificity of TcMEP for detection of clinically significant intraoperative cord injury were 100% and 90%, respectively. Sensitivity and specificity of SSEP were 0% and 100%, respectively. The positive predictive value of a TcMEP alert was 17%. Possible risk factors for false positive TcMEP alerts include obesity and increased length of surgery. This study supports superior sensitivity of TcMEP compared with SSEP monitoring but identifies a relatively high false positive rate even in a selected high-risk cervical myelopathy population when this modality is applied in practice.