Clinical spine surgery
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Clinical spine surgery · Nov 2017
Comparative StudyExplanatory Versus Pragmatic Trials: An Essential Concept in Study Design and Interpretation.
Randomized clinical trials often represent the highest level of clinical evidence available to evaluate the efficacy of an intervention in clinical medicine. Although the process of randomization serves to maximize internal validity, the external validity, or generalizability, of such studies depends on several factors determined at the design phase of the trial including eligibility criteria, study setting, and outcomes of interest. ⋯ In this article we describe the explanatory-pragmatic continuum for clinical trials in greater detail. Further, a well-accepted tool for grading trials on this continuum is described, and applied, to 2 recently published trials pertaining to the surgical management of lumbar degenerative spondylolisthesis.
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Clinical spine surgery · Nov 2017
ReviewIntraoperative Neuromonitoring in Pediatric and Adult Spine Deformity Surgery.
Review of techniques and description of institutional clinical experience. ⋯ Familiarity with the history of neuromonitoring in spinal deformity surgery and an understanding of the physiological systems used for neuromonitoring provide a framework from which spine surgeons can select appropriate monitoring for their patients.
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Clinical spine surgery · Nov 2017
Incidence and Factors Predictive of Dysphagia and Dysphonia After Anterior Operation With Multilevel Cervical Spondylotic Myelopathy.
Retrospective database analysis. ⋯ The incidence of postoperative dysphagia and dysphonia is relative higher after multilevel anterior operation. Age and operation time carry a greater risk of postoperative dysphagia and dysphonia. Tracheal traction exercise might help patients reduce postoperative dysphagia. Sufficient preoperative preparation and evaluation combining with proficient and precise operation technique are suggested when multilevel anterior fusion is performed.
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Clinical spine surgery · Nov 2017
Randomized Controlled TrialCryopreserved Amniotic Membrane Improves Clinical Outcomes Following Microdiscectomy.
Prospective, randomized controlled trial. ⋯ The data demonstrate statistically superior clinical outcomes following lumbar microdiscectomy as measured by ODI and SF-12 (physical composite scale) and a lower rate of recurrent herniation with the use of a cAM tissue graft compared with traditional microdiscectomy.
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Clinical spine surgery · Nov 2017
Comparative StudyPropensity-matched Analysis of Outcomes and Hospital Charges for Anterior Versus Posterior Cervical Fusion for Cervical Spondylotic Myelopathy.
Retrospective analysis of data from the Nationwide Inpatient Sample, a nationally representative, all-payer database of inpatient diagnoses and procedures in the United States. ⋯ In treating CSM, ACF led to lower hospital charges, shorter hospital stays, and an increased likelihood of being discharged to home relative to PCF.