The spine journal : official journal of the North American Spine Society
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There is conflicting evidence regarding erector spinae muscle fatigability because previous studies have not considered the thoracic and lumbar components separately. These muscles have very different mechanical responses and, therefore, would be recruited differentially for the chosen task. ⋯ The results of this study suggested that subjects with LBP demonstrated higher fatigability of the erector spinae muscles at the thoracic part than at the lumbar part. The increased fatigability of the thoracic part needs to be emphasized in rehabilitation strategies for subjects with LBP. In addition, as age increased, the median frequency of the lumbar part of the erector spinae muscles significantly decreased. Understanding the anatomical and biomechanical characteristics of the erector spinae muscle may enhance clinical outcomes and rehabilitation strategies for subjects with LBP.
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Pneumorrhachis (intraspinal air) is usually asymptomatic. Therefore, most patients with pneumorrhachis usually are managed conservatively. Rarely, pneumorrhachis is symptomatic and associated with discomfort, pain, and neurological deficits. ⋯ The possibility that neurological symptoms could be caused by non-traumatic intraspinal air should be considered.
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Back problems (BPs), with their cost and disability, are a substantial burden for individuals, employers, and society. ⋯ Systematic review Level I evidence.
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Randomized Controlled Trial
Choice of plate may affect outcomes for single versus multilevel ACDF: results of a prospective randomized single-blind trial.
Conflicting views exist according to the individual philosophy about various plate designs that can be used in anterior cervical discectomy and fusion (ACDF) to achieve clinical and radiological improvement within shortest time period. No prospective randomized study has ever been conducted to clarify the relationship between clinical outcomes, fusion rates, and the choice of plate (static vs. dynamic design). ⋯ Although clinical improvement is a good predictor of successful ACDF, radiological evidence of fusion alone is not reliable as a parameter of success. The design of plate does not affect the outcomes in single-level fusions but statistics indicate that multiple-level fusions may have better clinical outcome when a dynamic plate design is used.
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Cervical arthroplasty is designed to maintain cervical motion of the functional spinal unit after cervical discectomy. The impact of the ProDisc-C (Synthes Spine, Paoli, PA) on in vivo kinematics and sagittal alignment requires further assessment. ⋯ The ProDisc-C increased overall segmental ROM. A lordotic SA may be associated with restricted segmental ROM and translation in extension. This study did not detect any change in overall cervical spinal alignment after insertion of the device.