The spine journal : official journal of the North American Spine Society
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Epidural corticosteroid injections are commonly used to treat back and leg pain associated with lumbar spinal stenosis. However, little is known about which patient characteristics may predict favorable responses. ⋯ Among 21 baseline patient characteristics examined, none, including clinician-rated spinal stenosis severity, were consistent predictors of benefit from epidural injections of lidocaine+corticosteroid versus lidocaine only.
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Few instruments are available to measure disability associated with whiplash-associated disorders (WAD). The Whiplash Disability Questionnaire (WDQ) was developed to measure disability resulting from WAD, but its validity is unknown for acute WAD. ⋯ The WDQ includes two factors and has strong construct validity in individuals with acute WAD. Our results demonstrate that the WDQ is valid for use as an overall summative scale or as the daily activities and emotional subscales in clinical and research settings to determine disability status.
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Over the past two decades, soft-tissue structures communicating with the dura mater within the epidural space have become the focus of many anatomical and histopathologic studies. The relationship between these bridging structures has yet to be evaluated in situ. ⋯ E12 sheet plastination has provided in situ visualization of bridging structures within the cervical epidural space and offers new insight into these structures, as well as the composition and arrangement of the posterior atlantooccipital membrane and cerebrospinal dura at the craniocervical junction. This study aims to expand on the anatomical understanding of the upper cervical region while defining structures that may reduce neurosurgical complications, and aid in the understanding of the pathophysiology of certain neurogenic disorders.
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In adolescent idiopathic scoliosis (AIS), identification of curve patterns and determination of fusion levels are most important for correcting deformity, improving trunk balance, and saving motion segments. Lenke 1A scoliosis is the most common type of AIS, accounting for around 16% of all AIS; however, how to determine the lower instrumented vertebrae in this common curve type is unclear. ⋯ Our analysis suggested that not all Lenke 1A curves yield satisfactory outcome with the same fusion extend although a high percentage of the patients with Lenke 1A curves have shown satisfactory outcome with NV fusion. Thus, it seems that some Lenke 1A curves may require fusion to SV.
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Case Reports
Multifocal hemangioendothelioma of the lumbar spine and response to surgical resection and radiation.
Epithelioid hemangioendothelioma rarely occurs in the lumbosacral spine, with very few case reports of spinal hemangioendothelioma in the literature. There is variability in aggressiveness of these lesions without established treatment guidelines. ⋯ Spinal hemangioendothelioma is a rare disease and can present in variable forms, including as a multifocal regional process--which may be mistaken for infection. Additionally, there are no standard treatment protocols for this entity. We present the extensive imaging and treatment of a single case of rapidly progressive lumbar epithelioid hemangioendothelioma, which to our knowledge has not been described with this multifocal appearance in the lumbar spine.