The spine journal : official journal of the North American Spine Society
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Outcomes of spinal treatments are evaluated by clinical relevance: the proportion of patients who reach a minimum clinically important outcome change. Outcomes are evaluated through multiple measurements, and the inconsistency of outcome change across measurements is not known. ⋯ Efforts should be made to take into account the inconsistency of outcomes and to make clinical relevance more readily understandable by patients and clinicians.
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Image-guided cervical nerve injections are being performed with increasing frequency. Severe complications are being reported. ⋯ A technique for cervical nerve injection is described with the results of the injection. This technique may allow some standardization in the procedure, decrease the learning curve for training physicians, and minimize the potential complications.
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Low back pain (LBP) is a widespread musculoskeletal condition that frequently occurs in the working-age population. Numerous occupational physical activities have been implicated in its etiology. ⋯ A summary of existing studies was not able to find any high-quality studies that satisfied more than two of the Bradford-Hill causation criteria for occupational standing or walking and LBP. Based on the evidence reviewed, it is unlikely that occupational standing or walking is independently causative of LBP in the populations of workers studied.
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Single-level corpectomy and two-level discectomy with anterior cervical plating have been reported to have comparable fusion and complication rates. However, there are few large series that have compared the two for sagittal alignment, cervical lordosis, graft subsidence, and adjacent-level ossification. ⋯ Our data suggest that the two procedures yield comparable results in terms of sagittal alignment, cervical lordosis, graft subsidence, and adjacent-level ossification. Graft subsidence and loss of cervical lordosis appeared to occur mainly during the first 6 weeks after surgery. Single-level corpectomy and fusion continued to subside at the posterior portion of caudal end plate even after 6 weeks. On the other hand, graft subsidence did not correlate with preoperative and final postoperative sagittal alignments.