Spine
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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.
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Biography Historical Article
Harvey Cushing, the spine surgeon: the surgical treatment of Pott disease.
Review of historical archival records. ⋯ These cases provide a view of Cushing early in his career, pointing to the extraordinary degree of independence that he had during his residency under William Steward Halsted; these cases may have been important in the surgical upbringing both of Cushing and his coresident, William Stevenson Baer, who became the first professor of Orthopedics at Johns Hopkins Hospital. At the turn of the last century, Pott disease was primarily treated by immobilization with bed rest, braces, and plaster-of-paris jackets; some surgeons also employed gradual correction of the deformity by hyperextension. Patients who failed a trial of conservative therapy (of months to years) were treated with a laminectomy. However, the limitations of these strategies led to the development of techniques that form the basis of contemporary spine surgery-instrumentation and fusion.
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A case report. ⋯ Diabetic myonecrosis is a reminder that aggressive diabetic control is essential in all patients to avoid end-organ damage. Diabetic myonecrosis may occur in paralumbar spinal muscle as well as thigh. When diabetic have severe back pain and tenderness with high signal intensity on T2 weighted MRI image, myonecrosis should be included in the differential diagnosis although one consider abscess or cellulitis primarily. The episode of myonecrosis in diabetic is marker of poor control and poor prognosis. Main strategy of treatment is pain control and immobilization, supportive care and diabetes control.