Spine
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Clinical Trial
Clinical outcome of symptomatic unilateral stress injuries of the lumbar pars interarticularis.
A prospective case-series study. ⋯ The increased incidence of the unilateral lumbar pars stress injuries or frank defect on the contralateral side in a throwing sports, e.g., cricket (fast bowling), may be related to the hand dominance of the individual. Nonoperative treatment for patients with a unilateral lumbar pars stress injuries or spondylolysis resulted in a high rate of success, with 81% (34/42) of patients avoiding surgery. If symptoms persist beyond a reasonable period, i.e., 6 months, and reverse gantry CT scan confirms a nonhealing defect of the pars interarticularis, one may consider a unilateral direct repair of the defect with good functional outcome. Direct repair in patients with spina bifida at the same lumbar level as the unilateral defect may be complicated by nonunion.
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Case report. ⋯ This is the first report of a synovial cyst hematoma due to anticoagulation therapy. Its magnetic resonance imaging features can be similar to synovial cyst, especially when it is hemorrhagic. Spinal decompression was the definitive treatment.
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Comparative Study
Neck and shoulder pains in relation to physical activity and sedentary activities in adolescence.
A cross-sectional survey among adolescents aged 15-16 years. ⋯ Neck or occipital pain and shoulder pain are very common symptoms among adolescents, and both prolonged sitting and a high level of physical activity seem to be related to them.
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Retrospective cohort of 258 consecutive patients. ⋯ Cervical flexion-extension radiographs are a method of assessing potential instability. In the degenerative population studied here, 1% had spondylolisthesis noted only on the flexion-extension images, and 3% had a change in spondylolisthesis. None of these, however, led to a changes in clinical management. These data, in conjunction with the extra cost and radiation exposure associated with additional views, led us to no longer regard dynamic radiographs as a useful part of the initial imaging for the patient with degenerative cervical conditions.