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 of individual patient data. ⋯ The characteristic progressive sensory-motor CESE defects in lower extremities marked CES onset. Instead of waiting for the onset of sphincter function abnormalities, CES should be diagnosed when the CESE symptoms manifest.
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Systematic review. ⋯ Subgroup analyses performed in NSLBP trials have been severely underpowered, are only able to provide exploratory or insufficient findings, and have rather poor quality of reporting. Using current approaches, few definitive trials of subgrouping in back pain are very likely to be performed. There is a need to develop new approaches to subgroup identification in back pain research.
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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.