Spine
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Systematic review. ⋯ (1) Incisional biopsy or intralesional resection significantly increases the risk of local recurrence, therefore, transcutaneous computed tomography-guided trocar biopsy is recommended. When there is a suspicion of primary spine tumor, the surgeon who performs the definitive surgery should ideally perform or direct the biopsy procedure. (2) En bloc resection is achievable if staging determines that it is feasible. The adverse event profile of these surgeries is high even at experienced centers. Therefore, experienced, multidisciplinary teams should perform these surgeries. (3) Grade of Recommendation can be "strong recommendation, low-quality evidence."
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Systematic review of the literature. ⋯ There is strong recommendation and moderate evidence for vertebral augmentation as safe and effective in providing pain relief and improving functional outcome in patients with vertebral body fractures and axial pain due to metastatic disease. There is a strong recommendation and very low evidence for embolization techniques as safe and effective in decreasing intraoperative blood loss in hypervascular tumors.
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Prospective fluoroscopic and electromyographic study of coronal plane lumbar spine motion in healthy male volunteers. ⋯ These results suggest that reference limits from asymptomatic data for coronal plane passive recumbent intervertebral motion may be a useful resource for investigating the relationship between symptoms of chronic (nonspecific) low back pain and biomechanics and in the clinical assessment of patients and interventions that target the passive holding elements of the spine. Data pooling from multiple studies would be necessary to establish a complete database.
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Prospective cross-sectional measurement study. ⋯ Pain, self-image, and satisfaction scores could discriminate among management subgroups, but function, mental health and total scores could not. The total score and all domain scores except satisfaction discriminated among curve-severity subgroups. Using discriminant analysis, self-image was the only domain retained in a model predicting curve-severity categories.
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Prospective cohort study. ⋯ MDR-TB of the spine is a different disease and is here to stay. There is an urgent need to include culture and drug susceptibility testing in the protocol for the treatment of tuberculosis of the spine.