Spine
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This investigation had two components: one was an item analysis that examined data obtained at the initial patient assessment, and the second was a validation study that used a pretest-posttest design. ⋯ The RM-18 can be used as an outcome measure in clinical trials or as a tool to aid in decision making concerning individual patients. In either case, its measurement properties are equal to those of the 24-item Roland-Morris Questionnaire.
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The authors investigated the innervation of discographically confirmed degenerated and "painful" human intervertebral discs. ⋯ Findings indicate a more extensive disc innervation in the severely degenerated human lumbar disc compared with normal discs. The nociceptive properties of at least some of these nerves are highly suggested by their substance P immunoreactivity, which provides further evidence for the existence of a morphologic substrate of discogenic pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
The use of intrathecal morphine for analgesia after posterolateral lumbar fusion: a prospective, double-blind, randomized study.
A prospective, randomized, double-blind, placebo-controlled study was undertaken to evaluate the efficacy and safety of intrathecal morphine for postoperative analgesia after posterolateral lumbar fusion. ⋯ Intrathecal morphine can be safe and efficacious as an early postoperative analgesic after lumbar fusion when respiratory monitoring is used.
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The use of epidural steroid injections to relieve sciatic pain from spinal stenosis is extremely variable and controversial. Drs. ⋯ Dr. Rydevik believes that epidural steroids might be considered as a nonsurgical alternative, especially in elderly patients where surgery carries greater risk.
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A prospective study of the accuracy of thoracic pedicle screw placement in patients with idiopathic scoliosis. ⋯ Pedicle or vertebral body cortical penetration occurred with 25% of the screws but with no neurologic compromise. Curve correction was slightly greater than with hooks, but not to a statistically significant extent.