Spine
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Prospective diagnostic imaging study. ⋯ The sensitivity and specificity of MRI for diagnosing injury of the PLC are lower than previously reported in the literature. The integrity of the PLC as determined by MRI should not be used in isolation to determine treatment.
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Primary clinical trial of limited fixation for unstable Atlas fracture. ⋯ Osteosynthesis of the atlas by C1 lateral mass screws C2 pedicle screws and crosslink compression fixation is an ideal option for C1 burst fracture with or without rupture of the transverse ligament. The procedure allows for partially physiologic reconstruction of the C0-C1-C2 joint and shortens external fixation.
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Prospective clinical study of total lumbar disc replacement (TDR) with ProDisc II (Synthes, Paoli, PA). ⋯ Baseline ODI and early postoperative outcome parameters (< or =6 months) revealed significant and strong associations with the final results following TDR. While the vast majority of patients with an early highly satisfactory outcome maintained satisfactory results at later FU stages, any significant improvement considered as "highly satisfied" is unlikely in a group of patients which reported early unsatisfactory results. In summary, any clinically relevant changes are unlikely to occur after the early postoperative period.The current findings offer a foundation for weighing both the patients and the spine surgeons expectations against possible realistic achievements. Although the data show that the midterm outcome at a FU of 4 years (mean: 45.5 months, range: 24.1-94.4 months) is predictable following TDR, the long-term results of lumbar disc replacements still need to be established.
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Cross-cultural adaptation of an outcome questionnaire. ⋯ Overall, the rank correlation level in general was good, whereas the agreement between questionnaires outcome was variable, most of which seems to be attributable to absolute scale differences. The NBQ-NL is a useable patient-orientated tool for assessing disability in clinical studies and clinical diagnosis in Dutch speaking patients with WAD.
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Case Reports
A hard fall: an isolated fracture of lumbarized S1 spinous process: a case report and review of the literature.
A case of an isolated lumbarized S1 spinous process fracture due to direct trauma from a fall on the lower back is reported here. The patient was treated nonoperatively. Pain subsided and he returned to every day. ⋯ Few cases of isolated spinous process fractures have been described, and, to our knowledge, this is the first reported case of an isolated fracture of a lumbarized S1 spinous process to due to direct trauma. Radiograph imaging was adequate to determine the extent of the injury. Nonoperative treatment can allow the patient to return to every day life without the need of surgery.