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[PMID]:29297667
[Au] Autor:Byvaltsev VA; Kalinin AA; Okoneshnikova AK; Kerimbaev TT; Belykh EG
[Ti] Título:Facet Fixation Combined with Lumbar Interbody Fusion: Comparative Analysis of Clinical Experience and A New Method of Surgical Treatment of Patients with Lumbar Degenerative Diseases.
[So] Source:Vestn Ross Akad Med Nauk;71(5):375-84, 2016.
[Is] ISSN:0869-6047
[Cp] País de publicação:Russia (Federation)
[La] Idioma:eng
[Ab] Resumo:Background: For the treatment of patients with degenerative diseases of the lumbar spine the technique of pedicle fixation is widespread, when after open decompression channel structure locking screws are introduced into the vertebral body through the back vertebra legs. We first used a fundamentally new way of fixing the rear using the facet-boards Cage «Facet Wedge¼, when posterior fixation is done by closing the facet joints with minimally invasive, percutaneous method. We have not found data on the clinical efficacy of facet fixation in scientific literature. Aims: To compare the clinical efficacy of facet fixation combined with interbody fusion in the treatment of patients with degenerative lumbar spine disease. Materials and Methods: The study included 145 patients who were divided into 2 groups. The study group with long-term observation included patients (n=100) who underwent a new method for lumbar fixation; the method comprises unilateral or bilateral implantation of titanium Cage «facet Wedge¼ in the joint space facet joint in combination with the anterior, lateral, and transforaminal interbody fusion. Clinical comparison group (n=45) included retrospectively recruited patients who were performed titanium pedicle screw installation after open decompression and interbody fusion posterior lumbar fixation. Dynamic observation and comprehensive evaluation of the treatment clinical results was carried out for 18 months after surgery. Results: Cage facet installation technology is quite simple, universal for the stabilization of the rear of the complex after interbody fusion from the front, side, and rear access; and does not require the intraoperative application of expensive high-tech equipment. Comparative analysis of the main group showed significantly better results in terms of the duration of the operation [CG 125 (90; 140) min, the CCG 205 (160; 220) min; p=0.01], the volume of blood loss [CG 80 (70; 120) ml, CCG 350 (300; 550) ml; p=0.008], activation time [CG 2 (1; 2) days, 4 CCG (3; 5) days; p=0.02], length of hospitalization [CG 9 (10; 11) days, the CCG 13 (12; 15) days; p=0.03], the level of pain on a visual analog scale [CG 3 (2; 4) mm, CCG 15 (12; 18) mm; p=0.001], quality of life (by index Oswestry) [CG 8 (6; 8) points, the CCG 23 (20; 28) points, p=0.003], and labor rehabilitation [CG 3 (2; 6) months, CCG 9 (6; 12) months; p=0.0001]. The number of postoperative complications in group 1 was 13%, in the 2nd ­ 31,1% (p=0,0012). The new method involves fixing the back with considerably less surgical trauma of paravertebral soft tissue that results in early activation of patients, reduction of stay in hospital period, and better functional recovery of patients. Conclusions: The application of facet fixation combined with interbody fusion in the treatment of patients with degenerative diseases of the lumbar spine allows achieving the best clinical outcomes and fewer postoperative complications during the short and long-term follow-up if compared with the traditional method of transpedicular stabilization. The combination of low-impact and reliability facet fixation techniques for posterior stabilization of the operated segment creates favorable conditions for the restoration of a functional condition of patients, full social and physical rehabilitation.
[Mh] Termos MeSH primário: Fixação de Fratura
Degeneração do Disco Intervertebral
Deslocamento do Disco Intervertebral
Vértebras Lombares
Complicações Pós-Operatórias
Fusão Vertebral
Articulação Zigapofisária/cirurgia
[Mh] Termos MeSH secundário: Adulto
Feminino
Fixação de Fratura/efeitos adversos
Fixação de Fratura/instrumentação
Fixação de Fratura/métodos
Seres Humanos
Degeneração do Disco Intervertebral/diagnóstico
Degeneração do Disco Intervertebral/psicologia
Degeneração do Disco Intervertebral/cirurgia
Deslocamento do Disco Intervertebral/diagnóstico
Deslocamento do Disco Intervertebral/psicologia
Deslocamento do Disco Intervertebral/cirurgia
Vértebras Lombares/diagnóstico por imagem
Vértebras Lombares/patologia
Vértebras Lombares/cirurgia
Masculino
Meia-Idade
Parafusos Pediculares
Complicações Pós-Operatórias/diagnóstico
Complicações Pós-Operatórias/etiologia
Qualidade de Vida
Recuperação de Função Fisiológica
Estudos Retrospectivos
Federação Russa
Fusão Vertebral/efeitos adversos
Fusão Vertebral/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.15690/vramn738


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[PMID]:29234803
[Au] Autor:Maas E; Juch J; Huygen F
[Ad] Endereço:Department of Health Sciences, VU University Amsterdam, Amsterdam, the Netherlands.
[Ti] Título:Radiofrequency Denervation for Chronic Low Back Pain-Reply.
[So] Source:JAMA;318(22):2256-2257, 2017 12 12.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Denervação
Dor Lombar/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Vértebras Lombares
Ondas de Rádio
Resultado do Tratamento
Articulação Zigapofisária
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171215
[Lr] Data última revisão:
171215
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.16390


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[PMID]:29234800
[Au] Autor:Vorobeychik Y; Stojanovic MP; McCormick ZL
[Ad] Endereço:Department of Anesthesiology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
[Ti] Título:Radiofrequency Denervation for Chronic Low Back Pain.
[So] Source:JAMA;318(22):2254-2255, 2017 12 12.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Denervação
Dor Lombar/cirurgia
[Mh] Termos MeSH secundário: Dor nas Costas/cirurgia
Seres Humanos
Vértebras Lombares
Ondas de Rádio
Resultado do Tratamento
Articulação Zigapofisária
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171215
[Lr] Data última revisão:
171215
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.16386


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[PMID]:29234799
[Au] Autor:Kao MC; Leong MS; Mackey S
[Ad] Endereço:Department of Anesthesiology, Stanford University, Stanford, California.
[Ti] Título:Radiofrequency Denervation for Chronic Low Back Pain.
[So] Source:JAMA;318(22):2256, 2017 12 12.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Denervação
Dor Lombar/cirurgia
[Mh] Termos MeSH secundário: Dor nas Costas/cirurgia
Seres Humanos
Vértebras Lombares
Ondas de Rádio
Resultado do Tratamento
Articulação Zigapofisária
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171215
[Lr] Data última revisão:
171215
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.16382


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[PMID]:29234798
[Au] Autor:Rimmalapudi V; Buchalter J; Calodney A
[Ad] Endereço:Gulf Coast Pain Institute, Pensacola, Florida.
[Ti] Título:Radiofrequency Denervation for Chronic Low Back Pain.
[So] Source:JAMA;318(22):2255-2256, 2017 12 12.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Denervação
Dor Lombar/cirurgia
[Mh] Termos MeSH secundário: Dor nas Costas/cirurgia
Seres Humanos
Vértebras Lombares
Ondas de Rádio
Resultado do Tratamento
Articulação Zigapofisária
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171215
[Lr] Data última revisão:
171215
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.16378


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[PMID]:28869622
[Au] Autor:Hawrylak A; Chromik K; Ratajczak B; Barczyk-Pawelec K; Demczuk-Wlodarczyk E
[Ad] Endereço:Faculty of Physiotherapy, The University School of Physical Education in Wroclaw, Wroclaw, Poland.
[Ti] Título:Spinal range of motion and plantar pressure in sport climbers.
[So] Source:Acta Bioeng Biomech;19(2):169-173, 2017.
[Is] ISSN:1509-409X
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The aim of the study was to investigate the range of motion (ROM) of lumbar and thoracic articulations and static and dynamic plantar pressure in sport climbing athletes. METHODS: The sample included 30 sport climbers with a minimum of 2 years training experience and 30 physical education students who served as an active untrained control. ROM was assessed by a Saunders digital inclinometer and plantar pressure by a baropodometric platform. RESULTS: Mean spinal ROMs were greater in the sport climbers with an exception of extension, rotation, and lateral thoracic flexion, with a high degree of statistical significance obtained in the majority of the analyzed ROMs. The climbers exhibited increased mean forefoot pressure (smaller rearfoot pressure) in both the dominant and nondominant extremities, with significant intergroup differences found in dominant forefoot/rearfoot pressure distribution. CONCLUSIONS: Sport climbers present increased lumbar and thoracic ROM. The characteristics of climbing may also affect transverse arch structure and plantar pressure distribution.
[Mh] Termos MeSH primário: /fisiologia
Vértebras Lombares/fisiologia
Amplitude de Movimento Articular/fisiologia
Esportes/fisiologia
Vértebras Torácicas/fisiologia
Articulação Zigapofisária/fisiologia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Pressão
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170905
[St] Status:MEDLINE


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[PMID]:28767595
[Au] Autor:Shi W; Tian D; Liu D; Yin J; Huang Y
[Ad] Endereço:aDepartment of Ultrasound bDepartment of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China.
[Ti] Título:The comparison of measurement between ultrasound and computed tomography for abnormal degenerative facet joints: A STROBE-compliant article.
[So] Source:Medicine (Baltimore);96(31):e7680, 2017 Aug.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Besides the study on examining facet joints of lumbar spine by ultrasound in normal population, there has not been any related report about examining normal facet joints of lumbar spine by ultrasound so far. This study was aimed to explore the feasibility of ultrasound assessment of lumber spine facet joints by comparing ultrasound measure values of normal and degenerative lumber spine facet joints, and by comparing measure values of ultrasound and computed tomography (CT) of degenerative lumber spine facet joints.This study included 15 patients who had chronic low back pain because of degenerative change in lumbar vertebrae, and 19 volunteers who did not have low back pain or pain in the lower limb. The ultrasound measure values (height [H] and width [W]) of normal and degenerative lumber spine facet joints were compared. And the differentiation between measure values (H and W) of ultrasound and CT of degenerative lumber spine facet joints was also analyzed.The ultrasound clearly showed abnormal facet joints lesion, which was characterized by hyperostosis on the edge of joints, bone destruction under joints, and thinner or thicker articular cartilage. There were significant differences between the ultrasound measure values of the normal (H: 1.26 ±â€Š0.03 cm, W: 0.18 ±â€Š0.01 cm) and abnormal facet joints (H: 1.43 ±â€Š0.05 cm, W: 0.15 ±â€Š0.02 cm) (all P < .05). However, there were no significant differences between the measure values of the ultrasound (H: 1.43 ±â€Š0.17 cm, W: 0.15 ±â€Š0.03 cm) and CT (H: 1.42 ±â€Š0.16, W: 0.14 ±â€Š0.03) of the degenerative lumber spine facet joints (all P > .05).Ultrasound can clearly show the structure of facet joints of lumbar spine. It is precise and feasible to assess facet joints of lumbar spine by ultrasound. This study has important significance for the diagnosis of lumbar facet joint degeneration.
[Mh] Termos MeSH primário: Degeneração do Disco Intervertebral/diagnóstico por imagem
Vértebras Lombares/diagnóstico por imagem
Tomografia Computadorizada por Raios X
Ultrassonografia
Articulação Zigapofisária/diagnóstico por imagem
[Mh] Termos MeSH secundário: Cartilagem Articular/diagnóstico por imagem
Dor Crônica/diagnóstico por imagem
Dor Crônica/etiologia
Estudos de Viabilidade
Seres Humanos
Degeneração do Disco Intervertebral/complicações
Dor Lombar/diagnóstico por imagem
Dor Lombar/etiologia
Variações Dependentes do Observador
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170803
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007680


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[PMID]:28723774
[Au] Autor:Cha YD; Choi JK; Yang CW; Lim HK; Heo GA; Kim BG
[Ad] Endereço:aDepartment of Anesthesiology and Pain Medicine, Inha University School of Medicine, Inha University Hospital, Incheon bDepartment of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
[Ti] Título:Relationship between first dorsal sacral foramen and lumbar facet joint connecting line in South Korea populations: Retrospective study.
[So] Source:Medicine (Baltimore);96(29):e7544, 2017 Jul.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The first sacral nerve root block (S1 nerve root block) is a practical procedure for patients with radiating lower back pain. In general, S1 nerve root block is performed under x-ray fluoroscopy. It is necessary to adjust the position of the patient and angle of fluoroscopy to properly visualize the first dorsal sacral foramen (dorsal S1 foramen). The purpose of this study was to analyze the location of dorsal S1 foramen and lumbar facet joint in S1 nerve root block.A total of 388 patients undergoing x-ray fluoroscopy-guided S1 nerve root block in the prone position were examined. X-ray fluoroscopy was fixed at the corresponding location of facet joint of L4-5 and L5-S1. The relationship of the connecting line vertical to L5-S1 facet joint and upper margin sacrum was evaluated. The surface anatomical relationships between dorsal S1 foramen and lumbar facet joint were assessed.Based on the localization of dorsal S1 foramen, the line drawn from point to upper margin sacrum passed through the dorsal S1 foramen in all cases. The horizontal distance from the spinous process to the dorsal S1 foramen was 25.9 ±â€Š3.0 mm for men and 26.2 ±â€Š1.4 mm for women. The horizontal distance from the between posterior superioriliac spine to the dorsal S1 foramen was 26.2 ±â€Š2.7 mm for men and 26.8 ±â€Š1.7 mm for women. The vertical distance from the upper margin of sacrum to dorsal S1 foramen to the dorsal S1 foramen was 45.6 ±â€Š6.5 mm for men and 43.8 ±â€Š6.0 mm for women.The connecting line vertical to L5-S1 facet joint and upper margin sacrum is located on the same line from the dorsal S1 foramen. For difficult cases of locating dorsal S1 foramen, the lumbar facet joint can assist in predicting the vertical location of the dorsal S1 foramen.
[Mh] Termos MeSH primário: Vértebras Lombares/diagnóstico por imagem
Sacro/diagnóstico por imagem
Articulação Zigapofisária/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Feminino
Fluoroscopia
Seres Humanos
Masculino
Meia-Idade
Bloqueio Nervoso
Decúbito Ventral
República da Coreia
Estudos Retrospectivos
Caracteres Sexuais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170801
[Lr] Data última revisão:
170801
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007544


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[PMID]:28672319
[Au] Autor:Juch JNS; Maas ET; Ostelo RWJG; Groeneweg JG; Kallewaard JW; Koes BW; Verhagen AP; van Dongen JM; Huygen FJPM; van Tulder MW
[Ad] Endereço:Department of Anesthesiology, Erasmus University Medical Centre, Rotterdam, the Netherlands.
[Ti] Título:Effect of Radiofrequency Denervation on Pain Intensity Among Patients With Chronic Low Back Pain: The Mint Randomized Clinical Trials.
[So] Source:JAMA;318(1):68-81, 2017 Jul 04.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Radiofrequency denervation is a commonly used treatment for chronic low back pain, but high-quality evidence for its effectiveness is lacking. Objective: To evaluate the effectiveness of radiofrequency denervation added to a standardized exercise program for patients with chronic low back pain. Design, Setting, and Participants: Three pragmatic multicenter, nonblinded randomized clinical trials on the effectiveness of minimal interventional treatments for participants with chronic low back pain (Mint study) were conducted in 16 multidisciplinary pain clinics in the Netherlands. Eligible participants were included between January 1, 2013, and October 24, 2014, and had chronic low back pain, a positive diagnostic block at the facet joints (facet joint trial, 251 participants), sacroiliac joints (sacroiliac joint trial, 228 participants), or a combination of facet joints, sacroiliac joints, or intervertebral disks (combination trial, 202 participants) and were unresponsive to conservative care. Interventions: All participants received a 3-month standardized exercise program and psychological support if needed. Participants in the intervention group received radiofrequency denervation as well. This is usually a 1-time procedure, but the maximum number of treatments in the trial was 3. Main Outcomes and Measures: The primary outcome was pain intensity (numeric rating scale, 0-10; whereby 0 indicated no pain and 10 indicated worst pain imaginable) measured 3 months after the intervention. The prespecified minimal clinically important difference was defined as 2 points or more. Final follow-up was at 12 months, ending October 2015. Results: Among 681 participants who were randomized (mean age, 52.2 years; 421 women [61.8%], mean baseline pain intensity, 7.1), 599 (88%) completed the 3-month follow-up, and 521 (77%) completed the 12-month follow-up. The mean difference in pain intensity between the radiofrequency denervation and control groups at 3 months was -0.18 (95% CI, -0.76 to 0.40) in the facet joint trial; -0.71 (95% CI, -1.35 to -0.06) in the sacroiliac joint trial; and -0.99 (95% CI, -1.73 to -0.25) in the combination trial. Conclusions and Relevance: In 3 randomized clinical trials of participants with chronic low back pain originating in the facet joints, sacroiliac joints, or a combination of facet joints, sacroiliac joints, or intervertebral disks, radiofrequency denervation combined with a standardized exercise program resulted in either no improvement or no clinically important improvement in chronic low back pain compared with a standardized exercise program alone. The findings do not support the use of radiofrequency denervation to treat chronic low back pain from these sources. Trial Registration: trialregister.nl Identifier: NTR3531.
[Mh] Termos MeSH primário: Denervação/métodos
Terapia por Exercício
Dor Lombar/terapia
Ondas de Rádio/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Idoso
Dor Crônica/terapia
Terapia Combinada
Feminino
Seres Humanos
Dor Lombar/diagnóstico
Vértebras Lombares
Meia-Idade
Diferença Mínima Clinicamente Importante
Bloqueio Nervoso
Articulação Sacroilíaca
Falha de Tratamento
Articulação Zigapofisária
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; PRAGMATIC CLINICAL TRIAL; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1707
[Cu] Atualização por classe:171011
[Lr] Data última revisão:
171011
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170704
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.7918


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[PMID]:28622486
[Au] Autor:Ita ME; Zhang S; Holsgrove TP; Kartha S; Winkelstein BA
[Ti] Título:The Physiological Basis of Cervical Facet-Mediated Persistent Pain: Basic Science and Clinical Challenges.
[So] Source:J Orthop Sports Phys Ther;47(7):450-461, 2017 Jul.
[Is] ISSN:1938-1344
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Synopsis Chronic neck pain is a common condition and a primary clinical symptom of whiplash and other spinal injuries. Loading-induced neck injuries produce abnormal kinematics between the vertebrae, with the potential to injure facet joints and the afferent fibers that innervate the specific joint tissues, including the capsular ligament. Mechanoreceptive and nociceptive afferents that innervate the facet have their peripheral terminals in the capsule, cell bodies in the dorsal root ganglia, and terminal processes in the spinal cord. As such, biomechanical loading of these afferents can initiate nociceptive signaling in the peripheral and central nervous systems. Their activation depends on the local mechanical environment of the joint and encodes the neural processes that initiate pain and lead to its persistence. This commentary reviews the complex anatomical, biomechanical, and physiological consequences of facet-mediated whiplash injury and pain. The clinical presentation of facet-mediated pain is complex in its sensory and emotional components. Yet, human studies are limited in their ability to elucidate the physiological mechanisms by which abnormal facet loading leads to pain. Over the past decade, however, in vivo models of cervical facet injury that reproduce clinical pain symptoms have been developed and used to define the complicated and multifaceted electrophysiological, inflammatory, and nociceptive signaling cascades that are involved in the pathophysiology of whiplash facet pain. Integrating the whiplash-like mechanics in vivo and in vitro allows transmission of pathophysiological mechanisms across scales, with the hope of informing clinical management. Yet, despite these advances, many challenges remain. This commentary further describes and highlights such challenges. J Orthop Sports Phys Ther 2017;47(7):450-461. Epub 16 Jun 2017. doi:10.2519/jospt.2017.7255.
[Mh] Termos MeSH primário: Vértebras Cervicais/fisiopatologia
Lesões do Pescoço/fisiopatologia
Cervicalgia/fisiopatologia
Articulação Zigapofisária/lesões
[Mh] Termos MeSH secundário: Fenômenos Biomecânicos
Dor Crônica
Seres Humanos
Ligamentos Articulares/lesões
Ligamentos Articulares/inervação
Ligamentos Articulares/fisiopatologia
Nociceptores/fisiologia
Entorses e Distensões/fisiopatologia
Pesquisa Médica Translacional
Traumatismos em Chicotada/fisiopatologia
Articulação Zigapofisária/inervação
Articulação Zigapofisária/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170801
[Lr] Data última revisão:
170801
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170617
[St] Status:MEDLINE
[do] DOI:10.2519/jospt.2017.7255



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