The spine journal : official journal of the North American Spine Society
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Previous studies on the risk and prevalence of diabetes among spinal cord injury (SCI) patients are limited and controversial. ⋯ Our findings may facilitate the prioritizing of preventive health strategies and planning of long-term care for SCI patients.
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The diagnosis of sciatica is primarily based on history and physical examination. Most physical tests used in isolation show poor diagnostic accuracy. Little is known about the diagnostic accuracy of history items. ⋯ A few history items used in isolation had significant diagnostic value and the diagnostic accuracy of a model with six pre-selected items was poor.
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Although multiple mechanisms of device attachment to the spinous processes exist, there is a paucity of data regarding lumbar spinous process morphology and peak failure loads. ⋯ The present study demonstrated that variation in spinous process hole placement did not significantly influence failure load. However, there was a strong linear correlation between peak failure load and the anteroposterior and cephalocaudal anatomical dimensions. From a clinical standpoint, the findings of the present study indicate that attachment through the spinous process provides a viable alternative to attachment around the spinous processes. In addition, the anatomical dimensions of the lumbar spinous processes have a greater influence on biomechanical fixation than either hole location or BMD.
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Comparative Study Clinical Trial
Oswestry Disability Index is a better indicator of lumbar motion than the Visual Analogue Scale.
Lumbar pathology is often associated with axial pain or neurologic complaints. It is often presumed that such pain is associated with decreased lumbar motion; however, this correlation is not well established. The utility of various outcome measures that are used in both research and clinical practice have been studied, but the connection with range of motion (ROM) has not been well documented. ⋯ Extremes of lumbar motion and motions associated with ADLs are of increasing clinical interest. Although the ODI and VAS are associated with each other, the ODI appears to be a better predictor of these motion parameters than the VAS (axial extremity, lower extremity, or combined) and may be more useful in the clinical setting when considering functional movement parameters.
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Achieving a posterolateral fusion in conjunction with performing decompressive laminectomies can prevent recurrence of stenosis or worsening of spondylolisthesis. Facet bone dowels have been introduced and marketed as a less invasive alternative to pedicle screws. Surgeons have been placing them during lumbar laminectomy surgery and coding for intervertebral biomechanical device and posterolateral fusion. These bone dowels have also been placed percutaneously in outpatient surgery centers and pain clinics for facet-mediated back pain. ⋯ This article is mainly intended to question whether the implantation of facet bone dowels can produce a solid fusion radiographically. In our experience, the placement of facet bone dowels does not equal the time, skill, or attention to detail that is necessary for a posterolateral lumbar arthrodesis, and our follow-up radiographic studies clearly demonstrate an inadequate fusion rate.