Spine
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Comparative Study
Preventive effect of artificial ligamentous stabilization on the upper adjacent segment impairment following posterior lumbar interbody fusion.
A retrospective, comparative study. ⋯ These results demonstrated an effect of soft stabilization for the prevention of transition syndrome in lumbar spine fusion. Although the postoperative follow-up periods in this study were not sufficiently long to reach a definitive conclusion, intervertebral breakdown adjacent to the rigid spine fusion could be diminished by the application of soft stabilization.
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Questionnaire survey. ⋯ North American orthopedic surgeons' attitudes toward chiropractic range from very positive to extremely negative. Improved interprofessional relations may be important to ensure optimal care of shared patients.
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Comparative Study
Traumatic cervical discoligamentous injuries: correlation of magnetic resonance imaging and operative findings.
Retrospective review using prospectively collected data. ⋯ The ability of cervical MRI to detect surgically verified disruptions of the ALL, intervertebral disc, and PLL varied depending on the structure examined. MRI was sensitive but not specific for disc injury, and specific but not sensitive to ALL and PLL disruption. In this series, the comparison of cervical MRI and operative findings indicated that MRI was reliable only when positive for ALL and disc injury, and a reasonably reliable indicator of PLL status only when negative for PLL injury. Additionally, the high false-negative rates for ALL and PLL injury are concerning.
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Comparative Study
Degenerative spondylolisthesis in patients with neurogenic claudication effects functional performance and self-reported quality of life.
The effect of degenerative spondylolisthesis on functional performance and self reported quality of life in patients with lumbar spinal stenosis was compared to patients with lumbar spinal stenosis and no degenerative spondylolisthesis. ⋯ The presence and magnitude of degenerative spondylolisthesis does not correlate with decreased functional capacity. The Swiss Spinal Stenosis Questionnaire and Short Form 36 are accurate in defining the functional status of a patient. Comprehensive evaluation of patients with symptomatic lumbar spinal stenosis using functional assessment and self-assessment questionnaires are helpful in determining the severity of a patient's disability. Plain radiographs may be valuable adjuncts for surgical decision-making, but are not useful in quantifying the degree to which a patient is impaired.
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Prospective, longitudinal cohort study ⋯ A threshold of 50% improvement on the ODI may be a valid measure for defining a successful outcome for patients with LBP.