Spine
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Meta Analysis Comparative Study
Do manual therapies help low back pain? A comparative effectiveness meta-analysis.
Meta-analysis methodology was extended to derive comparative effectiveness information on spinal manipulation for low back pain. ⋯ Meta-analyses can extract comparative effectiveness information from existing literature. The relatively small portion of outcomes attributable to treatment explains why past research results fail to converge on stable estimates. The probability of treatment superiority matched a binomial random process. Treatments serve to motivate, reassure, and calibrate patient expectations--features that might reduce medicalization and augment self-care. Exercise with authoritative support is an effective strategy for acute and chronic low back pain.
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Retrospective study. ⋯ Pedicle screws can be used for infantile or juvenile patients, although complication rates associated with pedicle screws tended to be slightly higher in the younger groups.
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Cross-sectional study. ⋯ A single-item screening question was sensitive for depression but less sensitive for anxiety. The screening questions further performed equal to 2 widely used questionnaires. Validation of these results in other populations and compared with other short-item screeners is needed.
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Retrospective. ⋯ Routine full-length spine radiographs used with high frequency in the first 6 months after posterior spinal fusion rarely detected a radiographical abnormality that resulted in a meaningful change to a patient's clinical management. Blanket postoperative screening algorithms should be reconsidered to minimize patient radiation exposure.
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Retrospective review of prospectively accrued cohorts. ⋯ In pediatric patients, PVCR resulted in small but significant improvements in postoperative FVC and FEV1. In adult patients, no significant increases in PFTs were found. Patients who have the greatest potential for lung and thoracic cage growth after spinal correction are most likely to have improved pulmonary function after PVCR.