Spine
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Retrospective multi-institutional study. ⋯ Although most neurological deterioration can be expected to recover to some extent, the frequency of short-term neurological complications was higher than the authors expected.
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A measurement reliability study. ⋯ Three quantitative measures are suggested to assess the severity of MCs, which provide reliable, precise measurements for research on the etiology, pathogenesis, and clinical relevance of MCs.
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STUDY DESIGN.: Longitudinal qualitative interview study, nested within a back pain cohort study. OBJECTIVE.: Enhance the understanding of patients' own perspectives on living with sciatica to inform improvements in care and treatment outcomes. SUMMARY OF BACKGROUND DATA.: Reports of patients' own accounts of sciatica and its impact on daily life are still scarce. ⋯ Our findings emphasize the importance of leg pain in identifying a subgroup of back-pain patients more likely to have severe symptoms, be at risk of poor outcome, and who should be considered a priority for early diagnosis and management. Future management of sciatica needs to include listening to patients' stories, offering a credible physical assessment, explanation, and diagnosis of the condition. Explaining the limits to treatment is seen as positively contributing to the partnership between patients and clinicians.
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Retrospective case series study of surgical outcome for 21 atlantoaxial subluxation patients treated with a new technique, called cable-dragged reduction/cantilever beam internal fixation. Surgery was performed by a single surgeon. ⋯ Cable-dragged reduction/cantilever beam internal fixation is almost as effective for reduction as anterior release but is less invasive and risky. It has similar operative time and blood loss to occipitocervical fusion but avoids arthrodesis of occipitoatlantal joint. It is also suitable for patients with severe myelopathy before surgery. Its major disadvantage is that C3, which is left free in the traditional atlantoaxial fusion surgery, has to be involved in fusion. And it is suitable only for patients with intact posterior arches in C1.
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Retrospective Case Series. ⋯ Intramedullary, intradural and extradural spinal neoplasms can be resected through a minimally invasive approach without increased risk for adverse neurologic outcome. This technique may be an appropriate alternative to the open approach for well-circumscribed extramedullary lesions spanning one or two spinal levels. With increasing experience, reduced operative time, blood loss, complications, length of hospital stay, postoperative pain, and spinal instability may be seen.