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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Randomized Controlled Trial Clinical Trial
The association between cigarette smoking and back pain in adults.
A retrospective cohort study of adolescent idiopathic scoliosis. A comparison group of persons without scoliosis was also selected randomly from the general population. ⋯ The finding that smokers have more frequent episodes of back pain may imply that smoking exacerbates back pain, and the observation that stronger associations between back pain and smoking were found in the scoliosis cohort suggests that smoking may have a greater impact on persons with damaged spines.
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A case report of metastatic cardiac angiosarcoma of the cervical spine. ⋯ Spinal involvement by primary cardiac angiosarcoma is very rare, and this is only the second operative case ever reported. The vascular nature of this tumor makes it behave in a manner similar to that of a high-flow arteriovenous malformation. Surgery should not be undertaken before preoperative angiography and embolization. The dismal prognosis for this rare malignancy is discussed.