Spine
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Study Design. Case report and literature review. Objective. ⋯ Conclusion. To our knowledge, the seven published reports of bilateral BHS or RVAO involve double etiologies both the atlanto-axial and subaxial levels, but one unspecified cases. Because of the difficulty to identify the proper affected side in the case of bilateral atlanto-axial BHS with certainty, fusion surgery may be suitable for the reliable treatment.
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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 cohort analysis. ⋯ As surgical intervention is associated with a higher rate of neurological complications and lacks a clear benefit, the resection of spinal cord astrocytomas should be reserved for select cases and should be used sparingly.