The spine journal : official journal of the North American Spine Society
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There are no published studies on the relationship between total disc replacement (TDR) motion and the development of adjacent level degeneration (ALD). Because prevention of ALD is the underlying justification for TDR, studies investigating the validity of this concept are essential. ⋯ At 8.7-year follow-up, the prevalence of ALD after TDR is higher in patients with motion less than 5 degrees. The presence of ALD had no significant effect on clinical outcome, but the sample size was small. These data suggest that patients with significant ROM after lumbar TDR may have reduced risk for radiographic ALD.
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Brucellosis can affect the musculoskeletal system, and bony involvement ranges from 2% to 70% in the literature. Spinal brucellosis is generally localized to the sacroiliac region; thoracic brucellosis is rarely seen. ⋯ Early aggressive debridement and stabilization together with medical treatment, especially in the elderly and immunocompromised patients, would be the most beneficial treatment for eradication of pathology.
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The Short Form 36 (SF-36) health survey has been shown to be a valid instrument when used to measure the self-reported physical and mental health of patients. The impact of lumbar spinal disorders can be assessed as the difference between the SF-36 scale scores and age- and gender-specific population norms. ⋯ All four lumbar spine disorders have a significant negative impact on all eight of the SF-36 scales. The greatest negative impact was seen in those scales that measure physical health (role limitations due to physical symptoms [RP], physical functioning [PF], and bodily pain [BP]). The HNP diagnostic group experienced a significantly greater impact upon these three scales. This diagnostic group had the youngest patients, whose baseline physical functional status would be expected to be the most optimal. When we stratified by age in all the diagnostic groups, the greatest negative impact scores for physical health were seen in the <40 years and 40-60 years age groups. These patients were also more likely to perceive their health as poor, experience decreased energy, and have more social impairment when compared with their age/gender norms.
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Randomized Controlled Trial
Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations.
Acute back pain and sciatica are major sources of disability. Many medical interventions are available, including manipulations, with conflicting results. ⋯ Active manipulations have more effect than simulated manipulations on pain relief for acute back pain and sciatica with disc protrusion.
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Randomized Controlled Trial Comparative Study
Learning spinal manipulation: the importance of augmented feedback relating to various kinetic parameters.
Spinal manipulation is a widely accepted therapeutic approach in the treatment of back pain. In standard training programs, feedback on student performances is provided by an instructor based on teaching and clinical experience. Systematic study of the type of augmented feedback provided and skill learning is lacking in the literature. ⋯ The results of this study highlight the merits of practicing with an instrumented manikin or other instrumented training aids. Such a device can provide specific feedback on specific parameters of the task during learning; it can also serve as a tool to assess the progress of students and eliminate the risks relating to repetitive spinal manipulative therapy practice on student colleagues.