Spine
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Comparative Study
Reverse causality in the association between whiplash and symptoms of anxiety and depression: the HUNT study.
Longitudinal population-based cohort study. ⋯ This is the first published study with a prewhiplash prospective evaluation of psychological status. Our findings are in conflict with previous research suggesting whiplash to be the cause of associated psychological symptoms rather than their consequence. Self-reported whiplash injury was clinically relevant as it independently increased subsequent disability pension award. The strength of this effect, even in the absence of neck pain, suggests the ascertainment of this diagnostic label, or factors associated with this, are important predictors of disability.
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Comparative Study
Preoperative evaluation of the cervical spondylotic myelopathy with flexion-extension magnetic resonance imaging: about a prospective study of fifty patients.
The authors evaluated preoperative modifications of the cervical spinal canal in flexion and extension in 50 patients with cervical spondylotic myelopathy (CSM) and looked for impingement of the spinal cord not diagnosed in the neutral position. ⋯ Cervical spondylotic myelopathy results from the synergistic action of static and dynamic factors, the latter of which play an important role. In some patients, IHIS on T2 images is only visible with the neck in flexion. That might explain why IHIS is first detected after surgery in some patients in whom MRI was obtained before surgery only in the neutral position. Dynamic MRI is useful to determine more accurately the number of levels where the spinal cord is compromised, and to better evaluate narrowing of the canal and IHIS. New information provided by flexion-extension MRI might change our strategy for CSM management.
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Case Reports
Percutaneous endoscopic lumbar discectomy via contralateral approach: a technical case report.
Technical case report. ⋯ When a conventional transforaminal PELD is difficult because of some anatomical reasons, PELD via a contralateral route could be a good alternative option in selected cases.
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Comparative Study
Legal sequelae of occupational back injuries: a longitudinal analysis of Missouri judicial records.
Telephone survey and longitudinal analysis of judicial database for cohort of worker's compensation (WC) claimants in Missouri. ⋯ The results confirm that workers with occupational back injuries, especially African American and younger adults, encounter long-term financial and domestic duress that appears to escalate with each passing year after claim settlement. This pattern suggests that short-term studies underestimate postsettlement difficulties, particularly among selected demographic cohorts.