Spine
-
Randomized Controlled Trial Multicenter Study Clinical Trial
The Sygen multicenter acute spinal cord injury study.
Randomized, double-blind, sequential, multicenter clinical trial of two doses of Sygen versus placebo. ⋯ Although not proven in the primary efficacy analysis of this trial, Sygen appears to be beneficial in patients with severe spinal cord injury.
-
A questionnaire survey. ⋯ The use of methylprednisolone in the treatment of acute traumatic spinal cord injury is still controversial. It would appear from a recent prospective audit at the authors' spinal injuries unit that a large percentage of patients in the United Kingdom are not receiving methylprednisolone. Because so much doubt exists, the NASCIS studies should be repeated.
-
The management of acute spinal cord injury has traditionally concentrated on preventative measures as well as, for the better part of the previous century, conservative care. Pharmacologic interventions, in particular intravenous methylprednisolone therapy, have shown modest improvements in clinical trials and are still undergoing evaluation. More recent interest has focused on the role of surgical reduction and decompression, particularly "early" surgery. ⋯ Whereas there is biologic evidence from experimental studies in animals that early decompression may improve neurologic recovery after SCI, the relevant time frame in humans remains unclear. To date, the role of decompression in patients with SCI is only supported by Class III and limited Class II evidence and accordingly can be considered only a practice option. Accordingly, there is a strong rationale to undertake prospective, controlled trials to evaluate the role and timing of decompression in acute SCI.
-
A reliability and validity study of a previously translated version of the Roland-Morris Disability Questionnaire (RMDQ). ⋯ The RMDQ is a robust unidimensional ordinal measure, largely free of differential item functioning, which works well in the Turkish population. Nonparametric effect sizes of ordinal scales are found to overestimate or underestimate the true effect size depending on the nature of the scale and the distribution of patients at baseline.
-
Case Reports
Bone graft incorporation in radiographically successful human intervertebral body fusion cages.
Biopsies were obtained from within radiographically successful human intervertebral body fusion cages to document the histology of remodeling bone graft. ⋯ Autogenous bone graft was incorporated in these radiographically successful human intervertebral body fusion cages. A few debris particles were observed, but there was no histologic evidence of particle-induced bone resorption or inflammation.