Spine
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Review Case Reports
Nail gun injury to the sacrum: case report and review of the literature.
Case report. ⋯ On the basis of our experience and a review of the literature, in terms of treating a nail gun injury to the sacrum we recommend the following: exploration in the operating room to investigate the possibility of a dural tear, thorough irrigation, and debridement, especially in the case of barbed nails, and consultation with general surgery to determine if there is any injury to intrapelvic contents before surgery. An infectious disease consultation postoperatively may also assist in proper selection and duration of antibiotic therapy.
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Narrative review. ⋯ The fact that multiple lines of evidence, using independent techniques, consistently implicate the cervical zygapophysial joints as a site of injury and source of pain, strongly implicates injury to these joints as a common basis for chronic neck pain after whiplash.
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Systematic Review. ⋯ ACDA is a surgical procedure that may replace cervical fusion in selected patients suffering from cervical degenerative disc disease. Within 2 years of follow-up, the effectiveness of ACDA appears similar to that of cervical fusion. Weak evidence exists that ACDA may be superior to fusion for treating neck and arm pain. Future studies should report change scores and change score variance in accordance with RCT guidelines, in order to strengthen credibility of conclusions and to facilitate meta-analyses of studies.
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Nonsystematic review and discussion of prognosis after whiplash injury. ⋯ The current evidence is not sufficiently robust to be able to confidently predict outcome after whiplash injury. A preliminary set of consistent factors has been proposed to assist clinicians in identifying individuals at risk of poor recovery. Directions for the development of improved prognostic models are discussed.
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Literature review. ⋯ Current evidence from structural MRI based studies demonstrates the widespread presence of fatty infiltrates in neck muscles of patients with chronic whiplash. Such findings have not shown to feature in patients with chronic insidious onset neck pain, suggesting traumatic factors play a role in their development. Recent studies have revealed that muscle fatty infiltrates manifest soon after whiplash but only in those with higher pain and disability and symptoms of post-traumatic stress disorder. The possibility that such muscle changes are associated with a more severe injury including poor functional recovery remains the focus of current research efforts.