Spine
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Randomized Controlled Trial Clinical Trial
Intrathecal morphine. Double-blind evaluation of optimal dosage for analgesia after major lumbar spinal surgery.
A prospective, randomized, double-blind study. ⋯ For adult patients undergoing posterolateral lumbar fusion, 0.3 mg (0.004 mg/kg) is probably the optimal dose of intrathecal morphine to manage pain.
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Comparative Study
Cross-cultural adaptation of the Roland-Morris questionnaire for German-speaking patients with low back pain.
Cross-cultural adaptation and cross-sectional psychometric testing. ⋯ Because the German version of the Roland-Morris Questionnaire seems to be reliable and valid for the assessment of the functional status in German-speaking patients with low back pain, the use of this translated instrument can be recommended in future clinical trials.
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Clinical Trial
Hardware failure in an unconstrained lumbar pedicle screw system. A 2-year follow-up study.
A consecutive study of patients who underwent lumbar spinal arthrodesis with an unconstrained pedicle screw system. ⋯ The results of this study demonstrate an extremely high rate of hardware failure and pseudarthrosis using an unconstrained pedicle screw system. Interestingly, the initial rate of pain relief was higher and declined over time and was quite possibly associated with loosening of the hardware. Based on these data, it is difficult to recommend the use of an unconstrained fixation system in the lumbar spine.
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Meta Analysis Comparative Study
The effectiveness of acupuncture in the management of acute and chronic low back pain. A systematic review within the framework of the Cochrane Collaboration Back Review Group.
A systematic review of randomized controlled trials. ⋯ Because this systematic review did not clearly indicate that acupuncture is effective in the management of back pain, the authors would not recommend acupuncture as a regular treatment for patients with low back pain. There clearly is a need for more high-quality randomized controlled trials.