Spine
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Comparative Study
Nonsurgical treatment of three-column thoracolumbar junction burst fractures without neurologic deficit.
Retrospective review of the outcome of neurologically intact patients with three column thoracolumbar junction burst fractures that were treated nonsurgically. ⋯ Despite the use of less restrictive criteria, no brace, and early activity as tolerated, the results are similar to those obtained with more restrictive protocols. The presence of vertical lamina fracture, spinous process fracture, and transverse process fracture are not contra--indications. Activity restriction and bracing may be important for pain control but probably does not change the long-term result.
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Comparative Study
The use of coralline hydroxyapatite with bone marrow, autogenous bone graft, or osteoinductive bone protein extract for posterolateral lumbar spine fusion.
A posterolateral lumbar arthrodesis animal model using coralline hydroxyapatite as a bone graft substitute. ⋯ These data indicate that coralline hydroxyapatite with bone marrow was not an acceptable bone graft substitute for posterolateral spine fusion. When combined with autogenous iliac crest bone graft-coralline hydroxyapatite served as a graft extender yielding results comparable to those obtained with autograft alone. Coralline hydroxyapatite served as an excellent carrier for the bovine osteoinductive bone protein extract yielding superior results to those obtained with autograft or bone marrow.
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Multicenter Study Comparative Study Clinical Trial
Laparoscopic fusion of the lumbar spine: minimally invasive spine surgery. A prospective multicenter study evaluating open and laparoscopic lumbar fusion.
Two hundred-forty consecutive patients underwent laparoscopic instrumented interbody fusion using custom-designed instrumentation and BAK (Sulzer Spine Tech, Minneapolis, MN) fusion cages. The surgeries were performed at eight spine centers during U.S. Food and Drug Administration investigational device evaluation clinical trials. This cohort was compared with 591 consecutive patients undergoing open anterior fusion with the same device. ⋯ The laparoscopic procedure is associated with a learning curve, but once mastered, it is effective and safe when compared with open techniques of fusion.
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Comparative Study
Effectiveness of Waddell's nonorganic signs in predicting a delayed return to regular work in patients experiencing acute occupational low back pain.
Consecutive case series. ⋯ Patients with acute, occupational low back pain exhibiting Waddell's nonorganic signs had a four times lengthier time for return to unrestricted, regular work and a greater use of physical therapy and lumbar computed tomographic scans.
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Case report of a 49-year-old woman with a lower thoracic disc herniation mimicking acute lumbosacral radiculopathy. ⋯ A case of thoracic disc herniation mimicking an acute lumbosacral radiculopathy is presented. Compression of the lumbosacral spinal nerve roots at the lower thoracic level after exit from the lumbar enlargement may be the mechanism for this unusual presentation.