Spine
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Multicenter Study Clinical Trial
Predictors of a favorable outcome in patients treated by chiropractors for neck pain.
Prospective, multicenter, cohort study. ⋯ On the basis of the patient's history, the clinician can identify a number of determinants, which are predictive of a favorable outcome. Shorter duration of neck pain at the first visit was the only variable consistently found to be predictive of a favorable outcome for all 3 outcome measures examined.
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Evaluation of the psychometric properties of the Neck Pain and Disability Scale (NPDS). ⋯ The NPDS-I outcome questionnaire was successfully translated into Italian, showing good multidimensional and psychometric properties, supporting the results of the already existing versions of the scale. Its use is recommended in clinical and research practice.
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Retrospective analysis of transcranial motor evoked potential (TcMEP) responses and clinical outcome. ⋯ The use of TcMEPs is sensitive and specific to change in neural function. No patients had a false negative test. The rate of neural deficits is consistent with previous literature, suggesting that TcMEP monitoring may not prevent neural injury. However, there were several cases in which intraoperative intervention resulted in recovery of TcMEPs, and none of these patients sustained any postoperative neural deficit. The severity of neural deficits in this series was minor and the duration was limited. TcMEPs may contribute to calling attention to the need for intraoperative corrections including widening decompressions, improving perfusion, and limiting deformity correction so that more severe neural compromise may be prevented.
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Comparative Study
Biomechanical testing of a novel four-rod technique for lumbo-pelvic reconstruction.
A biomechanical testing protocol was used to study different lumbo-pelvic fixation techniques in a human cadaveric lumbar spine model. ⋯ The four-rod technique improved fixation stability over the conventional linked two-rod technique in flexion and extension, and when cross-linked, in left-right axial rotation. The four-rod technique also significantly reduced L5-Pelvic junction movement in flexionand extension, which may have implications for bony fusion. The use of cross-links is recommended.
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Clinical Trial
Midterm results of prostaglandin E1 treatment in patients with lumbar spinal canal stenosis accompanied by intermittent claudication.
The midterm results of prostaglandin E1 (PGE1) treatment in patients with lumbar spinal canal stenosis, and discuss the factors influencing the improvement rate by using multivariable analysis. ⋯ Our midterm results showed that PGE1 was useful for treating intermittent claudication in patients with lumbar spinal canal stenosis. The effect of PGE1 was not related to the degree of stenosis obtained with images, age, or claudication distance, but was correlated with baseline disease severity (JOA scores before administration).