[Mortality in spinal cord injuries].
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Biomedical subjects
Publications and source records attributed to A Magora.
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Spondylolisthesis occurs mainly at the L5-S1 interval, thus involving the dynamic segment. The general incidence is between 2 and 5 per cent, but about half of these patients are asymptomatic. The conservative therapy for the asymptomatic patients includes preventive measures such as correction of poor posture, elimination of stressful occupational requirements, avoidance of certain spine movements, and special sport activities. The mild to moderate low back pain syndrome requires alleviation of anxiety, analgesics and muscle relaxants, deep heat and relaxation and range of movement exercises. The severe low back pain which may prevent neurological deficit as well, should include a brief period of bed rest with strong analgesics and then gradual mobilization. In most instances, corsets are not required. Paravertebral blocks may be administered in special recalcitrant cases.
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Neuro-orthopedic examination was carried out on 429 patients suffering from LBP, and on 271 controls. Neurological deficit was found in 49 LBP but in none of the controls. Of the orthopedic signs, the most significant indicators of LBP were hypolordosis, scoliosis, limitation of movement and contracted paraspinal muscles. Various degrees of affection of the hip joints were found in 49 LBP as against 4 controls; the majority of these patients complained of LBP and not of hip disorders. It is stressed that an early and thorough neuro-orthopedic examination is essential for diagnosis and therapy and has important legal implications, mainly with regard to the time factor.
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