Spine
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Randomized Controlled Trial Comparative Study
Magnetic resonance imaging interpretation in patients with symptomatic lumbar spine disc herniations: comparison of clinician and radiologist readings.
Retrospective review of imaging data from a clinical trial. ⋯ Radiology reports frequently fail to provide sufficient detail to describe disc herniation morphology. Agreement between MRI readings by clinical spine specialists and radiologists was excellent when comparing herniation vertebral level and location within level, but only fair comparing herniation morphology.
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Review Case Reports
Delayed hyper-reactivity to metal ions after cervical disc arthroplasty: a case report and literature review.
Anecdotal case report. ⋯ Although there is increased enthusiasm about motion preservation technology and disc replacement surgery for intervertebral disc herniation, unexpected complications like the present case need to be shared within the scientific community to better understand the risks associated with these new and promising devices.
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A comprehensive literature review. ⋯ The literature reveals a number of rare, potentially catastrophic neurologic sequelae including brain and spinal cord infarction. Most of these are thought to be due to intravascular uptake of particulate steroids. The true overall incidence remains obscure due to the lack of blinded controlled studies. Injectionists, referring physicians, and patients should be aware of the nature and potential consequences of these complications. Additionally, it is imperative for injectionists to standardize techniques to minimize complications, especially by using a test dose of local anesthetic before injection of preferably nonparticulate corticosteroid.
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Prospective longitudinal study, mean follow-up period; 11.7 +/- 0.8 years was conducted from 1995 to 2007. ⋯ Progression of degeneration of cervical spine on MRI was frequently observed during 10-year period, with development of symptoms in 34% of subjects. No factor related to progression of degeneration of cervical spine was identified except for age.
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Retrospective population-based cohort study. ⋯ Analgesic-related deaths are responsible for more deaths and more potential life lost among workers who underwent lumbar fusion than any other cause. Risk of analgesic-related death was especially high among young and middle-aged workers with degenerative disc disease.