Objective Prospectively evaluate the clinical outcomes of acute cervical radiculopathy with respect to soft disc herniations vs osteophytes. Methods Sixty consecutive patients who had had cervical radiculopathy for ≤1 month were enrolled in the study. Inclusion criteria were radicular pain greater than axial pain and a pain score ≥4 out of 10 on a numerical rating scale. Patients had at least one positive clinical finding: motor, sensory, or reflex changes. Plain films and magnetic resonance imaging were ordered. Follow-up was at 6 weeks and 3, 6, and 12 months. Outcomes included pain scores (neck and upper limb), neck disability index, medication use, opioid use, and need for surgery. Two attending musculoskeletal radiologists reviewed imaging findings for osteophytes vs soft disc herniations at the symptomatic level. Results More than 75% reduction in pain was seen in 77% of patients with soft disc herniations and 66% of patients with osteophytes (P > 0.05) at 12 months. A pain score ≤2 out of 10 within 6 to 12 months was seen in 86% of patients with soft disc herniations and 81% of patients with osteophytes (P > 0.05). Moderate or marked improvement at 12 months was seen in 85% of patients with soft discs and 77% of patients with osteophytes (P > 0.05). Baseline–to–12-month numerical rating scale pain scores of patients with soft discs vs osteophytes had overlapping confidence intervals at each follow-up. At 12 months, very few had undergone surgery (7% of patients with soft discs, 11% of patients with osteophytes; P > 0.05) or were on opioids (7% of patients with soft discs, 9% of patients with osteophytes; P > 0.05). Conclusions The majority of patients, but not all patients, with acute radiculopathies improved with time. This was seen with both soft disc herniations and osteophytes.
Laura (Riding) Jackson's early collaborations with Robert Graves are well known, as is her renunciation of poetry to embark on a lifelong linguistic project with her second husband, Schuyler B. Jackson. The centrality of collaboration to her theory of language has not, however, been properly expounded. In the later work, especially, she puts forward a notion of intense collective effort in which personalities are to be changed through labour on words and meaning. Collaboration is both the means and the ends of an improved understanding of language and its potential. Critics and biographers have pointed to the ways in which her collaborations tended to involve conflicts of authority, and she is often charged with a desire to dominate. Focusing too much on personality, however, misses the more fundamental contradictions of her work. This paper argues that (Riding) Jackson's gendered notion of ‘co-operative hostility’ offers a sharp critique of masculine domination, cultural capital, and appropriation, as well as a speculative notion of social transformation based on mutual exploration and use. These elements of her work run into conflict, however, with her explicit and absolute commitment to private property.
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