Spine
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Intensity of pain and level of disability (Oswestry Disability Index [ODI]) were compared with the relative size of Modic type 1 (M1) and Modic type 2 (M2) lesions. Clinical symptoms of patients having mixed M1-M2 lesion (n = 49) were compared with patients having a "pure" M1 lesion (n = 13). ⋯ We conclude that the size of M1 lesion does not directly correlate with the clinical symptoms but that the type of Modic lesion is more important. This study supports the previous observations that when the inflammatory process turns to the mixed M1-M2 lesions, clinical symptoms decrease.
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Clinical Trial
Simple foot tapping test as a quantitative objective assessment of cervical myelopathy.
A clinical and cohort study. ⋯ The FTT results correlated with those of other tests for cervical myelopathy, and the FTT scores were improved by surgery. The FTT is an easy and useful quantitative assessment method for lower extremity motor function in patients with cervical myelopathy, especially those who cannot walk.
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Case report. ⋯ This report presents a very rare case of extradural nodular fasciitis arising in the lumbar spinal canal, which could have been misinterpreted as a malignant tumor such as extraskeletal Ewing sarcoma/primitive neuroectodermal tumor because of its rapid growth and absence of distinguishing radiologic features. A detailed histopathologic examination including immunohistochemistry is important for the correct diagnosis.
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Retrospective case series. ⋯ In this series, en bloc resection, the absence of metastasis, low-grade tumors, and negative margins were associated with improved overall survival. The aggressive use of sophisticated surgical and radiation techniques appears to confer an advantage to patients, decreasing local recurrence and increasing overall survival, even following incomplete surgical resection.
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Randomized Controlled Trial Multicenter Study Comparative Study
Who should have surgery for an intervertebral disc herniation? Comparative effectiveness evidence from the spine patient outcomes research trial.
Combined prospective randomized controlled trial and observational cohort study of intervertebral disc herniation (IDH), an as-treated analysis. ⋯ IDH patients who met strict inclusion criteria improved more with surgery than with nonoperative treatment, regardless of specific characteristics. However, being married, without joint problems, and worsening symptom trend at baseline were associated with a greater TE.